42 research outputs found

    An Evidence-Based Rationale for Dose De-escalation of Subcutaneous Atezolizumab

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    Background: Atezolizumab is a programmed death-ligand 1 (PD-L1) checkpoint inhibitor for the treatment of different forms of cancer. The subcutaneous formulation of atezolizumab has recently received approval. However, treatment with atezolizumab continues to be expensive, and the number of patients needing treatment with this drug continues to increase. Objective: We propose two alternative dosing regimens for subcutaneous atezolizumab to reduce drug expenses while ensuring effective exposure; one may be directly implemented in the clinic. Patients and Methods: We developed two alternative dose interval prolongation strategies based on pharmacokinetic modeling and simulation. The first dosing regimen was based on patients’ weight while maintaining equivalent systemic drug exposure by adhering to Food and Drug Administration (FDA) guidelines for in silico dose adjustments. The second dosing regimen aimed to have a minimum atezolizumab concentration above the 6 µg/mL threshold, associated with 95% intratumoral PD-L1 receptor saturation for at least 95% of all patients. Results: We found that, for the weight-based dosing regimen, the approved 3-week dosing interval could be extended to 5 weeks for patients &lt; 50 kg and 4 weeks for patients weighing 50–65 kg. Besides improving patient convenience, these alternative dosing intervals led to a predicted 7% and 12% cost reduction for either the USA or European population. For the second dosing regimen, we predicted that a 6-week dosing interval would result in 95% of the patients above the 6 µg/mL threshold while reducing costs by 50%. Conclusions: We have developed and evaluated two alternative dosing regimens that resulted in a cost reduction. Our weight-based dosing regimen can be directly implemented and complies with FDA guidelines for alternative dosing regimens of PD-L1 inhibitors. For the more progressive alternative dosing regimen aimed at the intratumoral PD-L1 receptor threshold, further evidence on efficacy and safety is needed before implementation.</p

    The effects of performance-based assessment criteria on student performance and self-assessment skills

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    This study investigated the effect of performance-based versus competence-based assessment criteria on task performance and self-assessment skills among 39 novice secondary vocational education students in the domain of nursing and care. In a performance-based assessment group students are provided with a preset list of performance-based assessment criteria, describing what students should do, for the task at hand. The performance-based group is compared to a competence-based assessment group in which students receive a preset list of competence-based assessment criteria, describing what students should be able to do. The test phase revealed that the performance-based group outperformed the competence-based group on test task performance. In addition, higher performance of the performance-based group was reached with lower reported mental effort during training, indicating a higher instructional efficiency for novice students

    Medical students and physical education students as CPR instructors: an appropriate solution to the CPR-instructor shortage in secondary schools?

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    BACKGROUND: Integrating cardiopulmonary resuscitation (CPR) training in secondary schools will increase the number of potential CPR providers. However, currently too few certified instructors are available for this purpose. Training medical students and physical education student teachers to become CPR instructors could decrease this shortage. AIM: Examine whether medical students and physical education student teachers can provide CPR training for secondary school pupils as well as (i. e., non-inferior to) registered nurses. METHODS: A total of 144 secondary school pupils were randomly assigned to CPR training by a registered nurse (n = 12), a  medical student (n = 17) or a physical education student teacher (n = 15). CPR performance was assessed after training and after eight weeks in a simulated cardiac arrest scenario on a resuscitation manikin, using manikin software and video recordings. RESULTS: No significant differences were found between the groups on the overall Cardiff Test scores and the correctness of the CPR techniques during the post-training and retention test. All pupils showed sufficient CPR competence, even after eight weeks. CONCLUSION: Training by medical students or physical education student teachers is non-inferior to training by a registered nurse, suggesting that school teachers, student teachers and medical students can be recruited for CPR training in secondary schools

    Heilig en Profaan 3. 1300 laatmiddeleeuwse insignes uit openbare en particuliere collecties

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    Local digital etching and infiltration for tuning of a H1- Cavity in deeply etched InP/InGaAsP/InP photonic crystals

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    Local post-production processing of single holes in a planar photonic crystal is demonstrated by selectively opening a masking layer by focused ion beam milling. Local tuning was optically demonstrated by both blueshifting and subsequent red-shifting th

    Controlling charge injection by self-assembled monolayers in bottom-gate and top-gate organic field-effect transistors

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    We investigate the modulation of the charge injection in organic field-effect transistors with self-assembled monolayers (SAMs) using both a bottom-gate and a top-gate geometry. The current modulation by using SAMs is more pronounced in the top-gate geometry due to the better defined upper surface of the bottom source and drain electrodes. By modifying Ag electrodes with a perfluoriflared monolayer an injection barrier as high as 1.6 eV into poly(9,9-dioctylfluorene) can be surmounted, enabling the measurement of the saturated field-effect mobility of 6 x 10(-5) cm(2) V(-1) s(-1). (C) 2011 Elsevier B.V. All rights reserved
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