• Lim Joensen posted an update 2 months ago

    Pembrolizumab, a PD1 immune checkpoint inhibitor (ICI), was recently reported to be very effective in patients with microsatellite instable/deficient mismatch repair metastatic colorectal cancer (MSI/dMMR mCRC), unlike patients with microsatellite stable/proficient MMR (MSS/pMMR) mCRC, in whom ICIs are generally ineffective. However, about 15% of MSS/pMMR CRCs are highly infiltrated by tumour infiltrating lymphocytes. In addition, both oxaliplatin and bevacizumab have been shown to have immunomodulatory properties that may increase the efficacy of an ICI. We formulated the hypothesis that patients with MSS/pMMR mCRC with a high immune infiltrate can be sensitive to ICI plus oxalipatin and bevacizumab-based chemotherapy. POCHI is a multicenter, open-label, single-arm phase II trial to evaluate efficacy of Pembrolizumab with Capox Bevacizumab as first-line treatment of MSS/pMMR mCRC with a high immune infiltrate for which we plan to enrol 55 patients. Primary endpoint is progression-free survival (PFS) at 10 months, which is expected greater than 50%, but a 70% rate is hoped for. Main secondary objectives are overall survival, secondary resection rate and depth of response. GSK1265744 order Patients must have been resected of their primary tumour so as to evaluate two different immune scores (Immunoscore® and TuLIS) and are eligible if one score is “high”. The first patient was included on April 20, 2021.

    Today’s routine prenatal care in Germany includes regular in-person appointments of pregnant women with doctors or midwives. Considering an increasing digitalization of the healthcare sector and in view of the global COVID-19 pandemic, the frequency of in-person visits could be reduced by remote monitoring using smart sensor technology. We aim to give an overview of the current international research on the use of smart sensors in prenatal care and its benefits, costs and resource consumption.

    For this narrative review, PubMed and Science Direct were searched for clinical trials using smart sensors in prenatal care published in English or German language from 1/2016 to 12/2020. We included studies which addressed the benefits, costs and resource consumption of this innovative technology.

    We identified 13 projects using smart sensors in the fields of basic prenatal care, prenatal care for patients with hypertensive disease in pregnancy and prenatal care for women with gestational diabetes. The projects dincrease user acceptance, there should not be any additional costs for pregnant women and health care professionals using modern healthcare apps. However, health insurance providers need to invest in smart sensor technology in order to eventually benefit from it.The current staffing levels for nursing care in long-term care are too low. There are no empirically verified figures with regard to the exact quantitative and qualitative need for additional staff. In order to develop a scientifically based method that is able to determine the number and qualifications of the nursing staff required for nursing care based on a facility-specific resident structure, a qualification mix model (QMM) was needed that indicates the minimum level of qualification available for the professional provision of nursing interventions. Such a model has not yet existed. Due to a lack of normative or empirically based assignment of interventions and qualification levels, a theoretical approach was chosen for the conception of the QMM using existing qualification frameworks, competence models, legal stipulations, the new assessment tool and nursing studies. By differentiating the complexity of work requirements, a total of 10 intervention classes-some with sub-classes-were formed, each of which was linked to one of five qualification levels. The resulting QMM enables qualifications to be assigned to care-relevant interventions as a normative basis of measuring staffing requirements, and also provides orientation for a more competence-oriented distribution of work and responsibility in inpatient long-term care. Since the model is structurally conservative and based on current (i. ie at the time of development) legal stipulations, it is a minimum standard.

    So far there has been little evidence of the extent to which project steps can affect the timing and successful implementation of research projects in general practitioner (GP) practices. Using the example of an intervention study on palliative care, the aim of this article is to report a) how the overall course of the project turned out compared to the original planning, and b) what recommendations can be derived to promote efficient implementation of intervention studies in GP practices.

    In two workshops each, GP practice teams selected specific measures to improve their palliative care and tested them during a four-month implementation phase. In order to track the course of the project, the times at which the practice teams reported their participation in the study, the individual project steps and the contacts were documented and descriptively analysed using Microsoft Excel.

    Due to a high willingness of practice teams to participate in the intervention study, recruitment was completed on time. The overall duration of the project was extended due to an increased workload for the preparation of an unexpectedly high number of selected measures to improve palliative care.

    Conducting intervention studies in GP practices is promising if practice teams take an active and co-determining role during the entire research process. Research projects can best be implemented if they involve minimal time commitment for the practice teams, and if continuous personal support from the study team is ensured.

    When planning future intervention studies with a high participatory share of GP practice teams, it is advisable to take into account potential additional work for the preparation and further development of intervention measures.

    When planning future intervention studies with a high participatory share of GP practice teams, it is advisable to take into account potential additional work for the preparation and further development of intervention measures.

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