Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

The effects of work motivations of the academic staff at departments of physical education and sports on their performances

WOS: 000304504700048The objective of this study is to analyse the relation between the work motivations and performances of the academic staff at Physical Education and Sports departments of Universities in Turkey. While the population of the study is consisted of the Physical Education and Sports departments of Universities in Turkey, the sample is consisted of 497 academic staff working at these departments. Work Motivation Scale and Employee Performance Scale were used as the data collection tools in the study. The prediction of the Employee Performance by the Work Motivation was surveyed by the recreation analysis. While a negative and low-level significant relation was found between the lower dimension of the Internal and External Motivation of the work motivation and the performance, a positive and medium-level significant relation was found between the Stimulation-related Internal Motivation and the performance

MUHASEBE STANDARTLARININ OLUŞUMU VE UYGULANMA ALANI

Muhasebe standartları, muhasebe uygulamalarının yöntemini belirleyerek hem uygulayıcılar açısından, hem de finansal tablo kullanıcıları açısından finansal bilgilerin güvenilir, doğru, gerçeğe uygun ve karşılaştırılabilir olmasını sağlamaktadır. Bu çalışmada, Konya bölgesinde muhasebe mesleğini farklı düzeylerde icra eden muhasebe meslek elemanlarının, ulusal ve uluslararası meslek kuruluşlarınca belirlenen muhasebe standartlarının uygulanabilirliği konusundaki görüşlerine yer verilmiş ve alınan görüşler analiz edilip yorumlanmıştır

HASTANE İŞLETMELERİNDE REKABET ÜSTÜNLÜĞÜ SAĞLAMADA FAALİYET ESASINA DAYALI MALİYETLEME YÖNTEMİNİN ROLÜ

Günümüzde giderek gelişen bir hizmet üretim sektörü olan hastane işletmeleri, yoğun rekabet koşulları altında faaliyetlerini sürdürmektedirler. Rekabete karşı koyarak rekabetçi üstünlükler elde etmek isteyen hastane işletmeleri, maliyet yönetim stratejilerini belirlerken, değişen müşteri taleplerine anında cevap veren, yüksek kaliteli, doğru ve düşük maliyet bilgisi ve geniş hizmet yelpazesi sunma kabiliyetine sahip maliyetleme yöntemlerine ihtiyaç duyarlar. Bu ihtiyaç günümüzde doğru maliyet bilgisi sağlayacak yeni stratejik ve ileri maliyet hesaplama yöntemi gereksinimini ortaya çıkarmıştır. Kuramsal analiz ve saha araştırmasına dayalı bu çalışmanın amacı, stratejik ve ileri maliyet hesaplama yöntemlerden biri olan Faaliyet Esasına Dayalı Maliyetleme Yönteminin hastane işletmelerinde bir rekabet silahı olarak rolünü, işletme performansına etkisini ve bu yöntemin hastane yöneticilerine verecekleri kararlarda yol gösterici olmasını sağlamaktır

İŞLETMELERDE KURUMSAL KAYNAK PLANLAMASI UYGULAMALARINDA KRİTİK BAŞARI FAKTÖRLERİ

Bu makalede kurumsal kaynak planlamasının başarılı bir şekilde uygulanmasına etki eden kritik başarı faktörleri incelenmiştir. Çalışmada, ERP sisteminin özellikleri ve gelişimi ile sistem hakkında genel bilgilerin sunulmaktadır. Günümüz ortamında küresel elemanlar olan rekabet, hız, yüksek hacimli üretim, yüksek kalite, düşük maliyet ve düşük stok gibi kriterlerin yerine getirilmesi için yönetim sistemlerinin tam, etkin ve entegre çalışması zorunlu hale gelmiştir. Kurumsal Kaynak Planlamasının çok kapsamlı ve uzun zaman alan bir sistem olması ve uzman ve katılımcı bir yönetim gerektirmesi nedeniyle işletme faaliyetleri sürekli bir değişim ve gelişim içindedir