Search

BACKGROUND: Studies concerning total ankle arthroplasty could be influenced by several forms of bias. Independent national arthroplasty registries represent objective data on survival and patient reported outcomes. The aim of this study was to determine survival and identify risk factors for early failure in a nationwide series of total ankle arthroplasties from the Dutch Arthroplasty Register (LROI).PATIENTS AND METHODS: Data of 810 patients, who received 836 total ankle arthroplasties between 2014 and 2020 were obtained from the Dutch Arthroplasty Register (LROI) with a median follow-up of 38 months (range 1-84 months). Survival was expressed in Kaplan-Meier analysis and associated hazard ratios for implant failure were determined. Implant failure was defined as the need for revision surgery for any reason or (pan)arthrodesis.RESULTS: During follow-up, we recorded 39 failures (4.7%) resulting in a implant survival of 95.3% with a median follow-up of 38 months (range 1-84 months). Medial malleolus osteotomy (HR = 2.27), previous surgery (HR = 1.83), previous osteotomy (HR = 2.82) and previous ligament reconstruction (HR = 2.83) all showed potentially clinically meaningful associations with a higher incidence of implant failure, yet only previous OCD treatment (HR = 6.21), BMI (HR = 1.09) and age (HR = 0.71) were statistically significant.INTERPRETATION: Excellent short-term survival (95.3%) with a median follow-up of 38 months was reported for TAA patients from the Dutch Arthroplasty Register. Patients with a lower age, a higher BMI or who had a prior surgical OCD treatment before TAA surgery appear to have a higher risk for revision after short-term clinical follow-up. Thorough patient selection with emphasis on risk factors associated with early implant failure might be essential to improve TAA survivorship.

This thesis examines questions related to the prevalence of anxiety symptomatology and disorders in older adults, and compares two brief low-threshold psychological interventions (blended Acceptance and Commitment Therapy versus face-to-face Cognitive Behavioral Therapy) for older adults with anxiety symptoms in primary care.

Additional file 1.

Additional file 2.

Background A previous randomized controlled trial in older adults with anxiety symptoms found no differences between a brief blended Acceptance and Commitment Therapy (ACT) intervention and brief face-to-face Cognitive Behavior Therapy (CBT) regarding anxiety symptom severity at posttreatment and 12-month follow-up. A health-economic evaluation comparing these interventions has not yet been conducted. Objective This study examined the one-year cost-effectiveness and cost-utility of blended ACT compared to face-to-face CBT for older adults with anxiety symptoms. Methods The economic evaluation was embedded in a randomized controlled trial comparing blended ACT to CBT in 314 older adults with mild to moderately severe anxiety symptoms. Data were collected at baseline and 3, 6 and 12 months post baseline. For the cost-effectiveness analysis, treatment response was defined as a reliable improvement in anxiety symptom severity (measured with the Generalized Anxiety Disorder-7) between baseline and 12-month follow-up. To assess cost-utility, quality-adjusted life years (QALYs) were computed using EuroQol-5 Dimensions-5 Levels-5 utility scores. Analyses took the societal perspective, including both healthcare costs and productivity costs. Incremental cost-effectiveness ratios were calculated using 2500 bootstraps of seemingly unrelated regression equations of costs and effects. Sensitivity analyses were performed to assess the robustness of the findings. Results Differences between the blended ACT group and CBT group in treatment response and QALYs were statistically insignificant and clinically irrelevant. The ACT intervention was associated with an average per-participant cost reduction of €466 ($593) compared to CBT, which resulted from lower productivity costs in the blended ACT group. From a healthcare perspective, the ACT intervention was associated with higher costs (by €71 ($90)) than CBT. Conclusions The results do not indicate that from a health-economic perspective blended ACT should be preferred over CBT in the treatment of older adults with anxiety symptoms. The findings support a model of shared decision making, where clinicians and patients collaboratively decide on the preferred intervention, based on ethical-medical, practical and personal considerations. Trial registration Netherlands Trial Register: TRIAL NL6131 (NTR6270); https://www.trialregister.nl/trial/6131.

In conservation, mock-ups are routinely used as surrogate works of art that can be subjected to treatments proposed for use on the original objects. This paper investigates the role of mock-ups in conservation research, specifically, research into dirt removal from the monumental Aula paintings by Edvard Munch housed at the University of Oslo. The mock-ups, prepared to support an empirical evaluation of a selection of novel cleaning systems, inspired reflections on the broader socio-material role of mock-ups in research. This paper relates the philosophical basis for the use of mock-ups in conservation to aspects of perspectivism and applies categories and terminology borrowed from the medical sciences to paintings research. Through the case study, the research context, notion of material agency and the roles of mock-ups in conservation ethics, research and practice are explored.

Pipe organs have always reflected the artisanal knowledge and skills of their makers. Since the 1990s, replicating historical instruments has opened new ways of studying practices of knowledge and making that revolve around historical organs. In this chapter, we argue that the idea of how a pipe should sound always involves a certain degree of reenactment of the building process. We follow the history of explicating concepts of sound, from one of the most prominent sources for organ builders and reconstructors written by the 18th-century monk Bédos de Celles via an explication of why sound was not centrally discussed in sources before the mid-19th century up to the historically informed pipe making and voicing by Japanese organ builder Munetaka Yokota.

Performative methods in archaeology provide a valuable heuristic tool for investigating the many behaviours and interactions of both producers and consumers of material culture. Focusing on the potter’s wheel at Bronze Age Akrotiri as a socially embedded performance of technical know-how, this chapter outlines an integrated approach to material engagement across three arenas of archaeological action – experiment, analysis, and visualisation – connected by an explicit engagement with the chaîne opératoire approach. An innovative tool-kit is presented for the investigation of this technology by the wider archaeological community. Given the large-scale regional and diachronic questions that the adoption and adaptation of ancient technologies can raise, a collective approach is proposed for the interpretation of the potter’s wheel.

The application of 3D techniques and digital methodologies in visualization is by no means new for Archaeology, but relatively new to other disciplines, like heritage studies, museology, conservation and restoration, and (art)-history. This chapter focuses on the understanding of ancient built structures, taking the famous courtyard building (Zone F) from the 6th century BC in Aquarossa, Italy, as a starting point. When the path that leads to the final (3D) reconstruction of material objects, however small, monumental or intangible, is thoroughly documented, it generates a vast amount of new data otherwise never encountered. It is these data that we want to use to understand fully the concept of reconstructing ancient and historical communities.

In this study, we compare the hyperspectral imaging capabilities of a custom-built visible light OCT with those of a commercial grade hyperspectral camera. Using the Short-Time-Fourier-Transform algorithm on the OCT signal, we estimate the variation in the surface spectral response from two paint pigments. Our study aims at comparing the spectral measurements obtained from calibration samples and to estimate an optimal working point for OCT-based hyperspectral processing.

This paper discusses decision-making processes for the treatment of oil paintings (1950s–present) exhibiting oil exudates (This research was performed by Jazzy de Groot in 2016 as a part of the post-graduate paintings conservator training at the University of Amsterdam.). Oil exudates and ‘drips’ that exude from the paint, can have different appearances, liquid to solid and transparent to opaque. How practicing conservators treat paintings exhibiting such phenomena was established by interviews and questionnaires as well as a review of published treatments. Factors that influence decision-making processes turned out to be, among others, the possible cause, the artist intention, the extent to which exudates disturb the painting and priorities during treatment. Conservators are generally reluctant to remove exudates, especially when exudates are older. The main factors contributing to this reluctance are the uncertainty about their origin and the fact that exudates are not always considered disturbing for the image. Further research into how to detect, determine and evaluate the possible consequences of exudates will help conservators to make better-informed decisions for the treatment of paintings on which they occur.

This research investigates the effects of varnish removal from oil paintings using Evolon® CR microfibre cloth. Nine interviews were conducted with conservators, leading to an inventory of current Evolon® applications. Based on the interviews, experiments were devised to assess the properties of Evolon® and its effects during varnish removal from oil paintings in comparison to cotton swabs. Observations were made using the naked eye, microscopy (stereomicroscopy, Hirox®3D Digital Microscopy, Micro Reflectance Transformation Imaging (Micro-RTI)) and photography in both ultraviolet (UV) and daylight fluorescent lights. Furthermore, the solvent distribution behavior for the different application methods was visualized using a gelatin substrate and a fluorescein isothiocyanate (FITC) fluorescent stain in ethanol. Application methods influence the efficacy of varnish removal, the solvent effect on the (paint) surface, the amount of solvent used and the solvent distribution. In general, this research revealed that in comparison with the use of cotton swabs, Evolon® facilitates the use of lower amounts of solvent and a reduction in mechanical action at the paint surface. This is potentially advantageous for cleaning solvent-sensitive paint surfaces. This practical approach will serve to guide conservators considering using this material for the first time.

This study investigates the use of an ultrasonic mister and hydrophobization with a silicone solvent barrier for the surface cleaning of water sensitive oil paints. Details are presented regarding the reconstruction of water sensitive paints through the growth of epsomite crystals on contemporary Winsor and Newton (W&N) oil paints via exposure to sulphuric gases, using samples that had been previously artificially aged and soiled. These samples were subsequently used for surface cleaning evaluations, specifically tailored to water sensitive oil paints. A number of aqueous solutions were tested with different application methods, including swabs and application with an ultrasonic mister in combinations with a brush and Evolon® tissue. Additionally, gels prepared with aqueous based solutions were tested with and without prior hydrophobization of the surface with silicone solvent cyclomethicone D5. The application of aqueous solutions with the mister were found to decisively reduce pigment removal from the water sensitive paints when compared to swab application. It was also found that the use of a cyclomethicone D5 solvent barrier reduces pigment removal during spreadable gel cleaning.

We are at present closer to the ‘original state’ of any artwork than anyone in the future will be. This proximity creates a particular urgency to document artworks before significant changes occur through ageing, handling or treatment; and whilst the works can still be interpreted within their contemporary context. Recording the appearance, materials, meaning and artistic intent will enable others to make more informed decisions about the treatment and display of the artworks as they progress through time (and away from their original context and initial material state). This paper explores this concept through the results of case study research of a painting by the American artist Robert Ryman from the collection of the Stedelijk Museum Amsterdam. Because various other artists worked in a similar abstract style during the same period, Ryman’s works are prone to ill-matched comparison and confusion regarding his artistic intent. During this research interviews with the artist and prominent conservators and scholars of his oeuvre were scrutinized for statements about his artistic intent. This provided a greater understanding of Ryman’s body of work as the basis for formulating some guidelines for consideration when treating similar works by the artist.

The privately owned oil painting Composition with Color Planes 4 (1917) by Piet Mondrian (1872–1944) has been the subject of ongoing investigation since 2011. The painting consists of color planes in a field of differing whites. Some~of these white areas suffer from delamination issues, in combination with flaking. Previous research demonstrated a link between the presence of zinc oxide and the delamination phenomena. More recently, the formation of zinc soaps was found to play a role. In this study, cross sections from both delaminating and relatively intact white areas were investigated with light microscopy, SEM-EDX, and ATR-FTIR imaging to obtain more information about the stratigraphy and condition of the paint layers. Two stages in metal soap formation were identified in the delaminating areas. The first stage consists of noncrystalline zinc soaps or zinc ions bound to carboxylate functional groups in the polymerized oil network. Crystalline zinc soaps, which represent the second, final stage of metal soap formation, are generally linked to the development of zinc soap related deterioration phenomena. In this case, they were found at the interface between the delaminating paint layers. Possible implications for treatment and factors that might trigger further delamination will be discussed.

The early twentieth century oil painting Beach Scene had severe delamination problems. The painting consisted of an oak panel primed with three white, oil-based ground layers with several oil paint layers on top. The reverse of the panel was varnished. The delamination occurred at the interface between the first ground layer and the panel. A brownish, semi-translucent zone was visible at the bottom of the first preparation layer. Material analyses with SEM-EDX, FTIR-ATR and THM-Py-GC/MS offered insight into the materials present and their degree of deterioration. The brownish zone was explained as dissolution of the zinc white pigment by (fatty) acids from the panel and the oil binder. It was hypothesised that the glazed framing system of the painting restricted natural expansion and contraction of the tangentially cut panel in fluctuating climate. Compression shrinkage then caused tenting of the paint film. This study improved our understanding of Akkeringa’s painting technique and the current condition of the painting. The study also provided support for future decisions on treatment and preventive conservation measures not only for Beach Scene, but also for Akkeringa’s other works on panel.

Edvard Munch’s (1863–1944) unvarnished oil paintings (1909–16) in the Aula of the University of Oslo have a long conservation history, including issues associated with soiling and cleaning. Despite the high frequency of previous cleaning campaigns, the removal of dirt and soot from these surfaces continues to be a challenge. This paper relates to ongoing research into novel methods for surface dirt removal (soft-particle blasting CO2-snow, and Nanorestore Gel® Peggy and Dry series). The paper discusses the first steps of this research, focussing on the preparation of mock-up painting samples that will be used to evaluate the effects and to optimise these methods, hence the rationale and limitations of using simplified samples to represent real paintings are discussed. The aim of the wider study is to devise appropriate cleaning strategies for the Aula paintings.

This paper presents a survey of the issues conservators encounter when surface-cleaning paintings by Asger Jorn, with the aim of contributing to the formulation of best practices for cleaning Jorn’s and similar paintings.Nine interviews were conducted with experienced conservators working throughout Europe. In addition, the conservation reports of 95 of Jorn’s paintings were studied and 34 works were visually assessed.Conservators are conservative in their approach when surface-cleaning Jorn’s paintings, which are described as suffering from cracked, brittle and powdery paint, soft paint with imbibed dirt and water and solvent sensitivity/solubility. They feel that Jorn’s unstable materials and paint modifications strongly limit the range of safe cleaning treatments. Conservators fear removing original material and unwanted optical or chemical changes. Time-consuming preliminary examinations and extensive testing followed by careful treatments that utilise different cleaning methods per colour, appears to be the approach favoured most commonly by the conservators interviewed.

‘Goede coloristen, zoals Rubens, schilderen op een witte grondering’, schrijft de Fransman Roger de Piles in 1673. ‘Op een witte grondering blijven de kleuren fris, levendig en bloemig (fleurie) en transparante kleuren blijven helder’. Roger de Piles is niet de enige historische auteur die over de voordelen van witte gronderingen schreef, gronderingskleur is een terugkerend onderwerp in historische schildertractaten. Van Karel van Mander in 1604 tot aan het eind van de negentiende eeuw houden schrijvers over schilderkunst zich bezig met de kleur van de grondering, en de invloed van deze kleur op het schilderij.

Grounds, or preparatory layers, form the basis upon which all artistic paintings are executed and can have a great impact on the ‘success’ of a painting, influencing both its aesthetic qualities and its longevity. Artists in different locations and at different times selected various materials and techniques to prepare their supports for painting. The subject of grounds also occupied the minds of the authors of artists’ manuals, recipe books and related historical sources. They wrote about ground colour and the devastating effect a faulty ground could have on the long-term stability of a painting, discussing materials, application methods, ground texture and its effects on the visual qualities of paintings. A Perfect Ground is the first comprehensive study of the materials and techniques described in historical recipes for ground layers, focusing on North West Europe during the period 1550–1900. It evaluates these recipes, places them within a time frame and investigates geographical differences. The role of recipe books in the daily life of painters is examined as is the influence of commercial ground preparation on painting practice and the relationship between written recipes and actual life in the painter’s studio. A Perfect Ground will be of interest to researchers and students in the fields of art history and conservation. The case studies form a useful introduction to recipe-based research, particularly for those interested in the application of reconstructions in the field of cultural heritage.