Transportation Risk ANalysis tool for hazardous Substances (TRANS): a user-friendly, semi-quantitative multi-mode hazmat transport route safety risk estimation methodology for Flanders

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'Het beste uit studenten': onderzoek naar de werking van het Sirius Programma om excellentie in het hoger onderwijs te bevorderen

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Excellentieonderwijs: Selectie van studenten en individuele effecten

Item does not contain fulltextIn de periode van medio oktober 2015 tot december 2019 hebben wij onderzoek gedaan naar de effecten van excellentieonderwijs in het Nederlandse hoger onderwijs. Dit onderzoek was onderdeel van het onderzoeksprogramma Excellentie van het Nationaal Regieorgaan Onderwijsonderzoek. In dit rapport presenteren wij twee deelstudies van het bredere onderzoek naar excellentieonderwijs, namelijk op het gebied van (1) selectie van studenten voor excellentieonderwijs, en (2) individuele effecten van deelname aan excellentieonderwijs. De andere deelstudies binnen dit bredere onderzoek (namelijk over uitstralingseffecten van excellentieonderwijs op het reguliere onderwijs en op de reguliere organisatie, en over het werkgeversperspectief op excellentieonderwijs) worden besproken in separate rapporten. Een gezamenlijke korte samenvatting over alle deelstudies binnen dit bredere onderzoek naar excellentieonderwijs wordt even-eens gepresenteerd in een afzonderlijke bijdrage.126 p

Excellentie in het hoger onderwijs: Selectie, effectiviteit en uitstralingseffecten

Item does not contain fulltextIn het afgelopen decennium is binnen het hoger onderwijs in Nederland geleidelijk meer aandacht gekomen voor verschillen tussen studenten en de vraag hoe het onderwijs daarop goed kan inspelen. Door differentiatie - het bieden van variëteit in de inhoud, de vorm en het niveau - kan het onderwijs beter op studenten worden afgestemd. Excellentieonderwijs is onderwijs gericht op studenten die zich in het reguliere onderwijs te weinig uitgedaagd voelen. Hiermee wordt het vizier scherper dan voorheen gericht op studenten die meer dan gemiddeld gemotiveerd en getalenteerd zijn.13 p

Thioguanine is Effective as Maintenance Therapy for Inflammatory Bowel Disease:A Prospective Multicentre Registry Study

Background and Aims: Thioguanine is a well-tolerated and effective therapy for inflammatory bowel disease [IBD] patients. Prospective effectiveness data are needed to substantiate the role of thioguanine as a maintenance therapy for IBD.Methods: IBD patients who previously failed azathioprine or mercaptopurine and initiated thioguanine were prospectively followed for 12 months starting when corticosteroid-free clinical remission was achieved (Harvey-Bradshaw Index [HBI] ≤ 4 or Simple Clinical Colitis Activity Index [SCCAI] ≤ 2). The primary endpoint was corticosteroid-free clinical remission throughout 12 months. Loss of clinical remission was defined as SCCAI &gt; 2 or HBI &gt; 4, need of surgery, escalation of therapy, initiation of corticosteroids or study discontinuation. Additional endpoints were adverse events, drug survival, physician global assessment [PGA] and quality of life [QoL].Results: Sustained corticosteroid-free clinical remission at 3, 6 or 12 months was observed in 75 [69%], 66 [61%] and 49 [45%] of 108 patients, respectively. Thioguanine was continued in 86 patients [80%] for at least 12 months. Loss of response [55%] included escalation to biologicals in 15%, corticosteroids in 10% and surgery in 3%. According to PGA scores, 82% of patients were still in remission after 12 months and QoL scores remained stable. Adverse events leading to discontinuation were reported in 11%, infections in 10%, myelo- and hepatotoxicity each in 6%, and portal hypertension in 1% of patients.Conclusion: Sustained corticosteroid-free clinical remission over 12 months was achieved in 45% of IBD patients on monotherapy with thioguanine. A drug continuation rate of 80%, together with favourable PGA and QoL scores, underlines the tolerability and effectiveness of thioguanine for IBD.</p

A Systematic Evaluation of Cost-Saving Dosing Regimens for Therapeutic Antibodies and Antibody-Drug Conjugates for the Treatment of Lung Cancer

Background: Expensive novel anticancer drugs put a serious strain on healthcare budgets, and the associated drug expenses limit access to life-saving treatments worldwide. Objective: We aimed to develop alternative dosing regimens to reduce drug expenses. Methods: We developed alternative dosing regimens for the following monoclonal antibodies used for the treatment of lung cancer: amivantamab, atezolizumab, bevacizumab, durvalumab, ipilimumab, nivolumab, pembrolizumab, and ramucirumab; and for the antibody-drug conjugate trastuzumab deruxtecan. The alternative dosing regimens were developed by means of modeling and simulation based on the population pharmacokinetic models developed by the license holders. They were based on weight bands and the administration of complete vials to limit drug wastage. The resulting dosing regimens were developed to comply with criteria used by regulatory authorities for in silico dose development. Results: We found that alternative dosing regimens could result in cost savings that range from 11 to 28%, and lead to equivalent pharmacokinetic exposure with no relevant increases in variability in exposure. Conclusions: Dosing regimens based on weight bands and the use of complete vials to reduce drug wastage result in less expenses while maintaining equivalent exposure. The level of evidence of our proposal is the same as accepted by regulatory authorities for the approval of alternative dosing regimens of other monoclonal antibodies in oncology. The proposed alternative dosing regimens can, therefore, be directly implemented in clinical practice.</p