United Negro College Fund

As treatments for multiple myeloma (MM) evolve, there is a need for real-world insights into treatment patterns and outcomes. The treatment practices and clinical outcomes in patients with MM (TOTEMM) was a database study (2018-2024) of newly diagnosed transplant-ineligible patients with MM in Argentina (TOTEMM-A) and Brazil (TOTEMM-B) in a private healthcare setting. In TOTEMM-A (n = 72) and TOTEMM-B (n = 892), 37 and 92 different drug regimens were reported, respectively. In each country, treatment duration reduced across lines of therapy (LOT) (TOTEMM-A: range, 6.2-3.4 months; TOTEMM-B: range, 4.4-3.5 months); attrition rates increased across LOT (TOTEMM-A: range, 52.8-86.1%; TOTEMM-B: range, 41.9-88.0%); triplet regimens (mainly bortezomib based) were used most frequently in first-line (1L); >75% relapsed within 12 months, regardless of the drug prescribed; over 90% of relapses occurred between 1L and second-line, and up to half of patients were rechallenged with the same drug; >65% of patients experienced disease progression after 1L; and the 1- to 5-year adjusted cumulative risk of progression or death increased across LOT (TOTEMM-A: range, 47.1-88.5%; TOTEMM-B: range, 40.4-91.7%). The rapid and marked progression underscores the urgent need for novel treatments and regimens.

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The aim of this study was to understand the relationship between employees' perception of work load, group interactional quality, and their effects on employee's psychological strain (need for recovery after work and fatigue) and job accidents. Questionnaire was used to collect data form 401 employees in the transport service industry in Taiwan. (1) Workload was positively related with need for recovery after work; (2) group interaction quality was negatively related with need for recovery after work; (3) need for recovery after work was positively related with fatigue; (4) fatigue was positively related with job accidents. The findings highlight the importance for organizations to provide adequate work design and build a supportive working environment, which may ultimately contribute to decreased psychological strain and fewer job accidents.

O presente artigo apresenta uma pesquisa analítica sobre as tipografias impressas em algumas páginas das edições da Revista de Pernambuco de 1926. A pesquisa almejou identificar os tipos, relacionando-os com o contexto histórico e buscando a origem dos desenhos em catálogos de fundições nacionais e internacionais atuantes no início do século XX. Utilizando métodos de análise comparativos entre as tipografias da revista e catálogos dessas fundições foi possível identificar alguns desenhos da Funtimod, a maior fundição nacional do século XX, e apontar a necessidade de estudos sobre os tipos que circulavam no Brasil.

Intraoperative electrocardiographic monitoring is considered a standard of care. However, there are no evidence-based algorithms for using intraoperative ST segment data to identify patients at high risk for adverse perioperative cardiac events. Therefore, we performed an exploratory study of statistical measures summarizing intraoperative ST segment values determine whether the variability of these measurements was associated with adverse postoperative events. We hypothesized that elevation, depression, and variability of ST segments captured in an anesthesia information management system are associated with postoperative serum troponin elevation. We conducted a single-institution, retrospective study of intraoperative automated ST segment measurements from leads I, II, and III, which were recorded in the electronic anesthesia record of adult patients undergoing noncardiac surgery. The maximum, minimum, mean, and SD of ST segment values were entered into logistic regression models to find independent associations with myocardial injury, defined as an elevated serum troponin concentration during the 7 days after surgery. Performance of these models was assessed by measuring the area under the receiver operator characteristic curve. The net reclassification improvement was calculated to quantify the amount of information that the ST segment values analysis added regarding the ability to predict postoperative troponin elevation. Of 81,011 subjects, 4504 (5.6%) had postoperative myocardial injury. After adjusting for patient characteristics, the ST segment maximal depression (e.g., lead I: odds ratio [OR], 1.66; 95% confidence interval [CI], 1.26-2.19; P = 0.0004), maximal elevation (e.g., lead I: OR, 1.70; 95% CI, 1.34-2.17; P < 0.0001), and SD (e.g., lead I: OR, 0.16; 95% CI, 0.06-0.42; P = 0.0002) were found to have statistically significant associations with myocardial injury. Increased SD was associated with decreased risk when accounting for the maximal amount of ST segment depression and elevation and for patient characteristics. The ST segment summary statistics model had fair discrimination, with an area under the receiver operator characteristic curve of 0.71 (95% CI, 0.68-0.73). Addition of ST segment data produced a net reclassification improvement of 0.0345 (95% CI, 0.00016-0.0591; P = 0.0474). Analysis of automated ST segment values obtained during anesthesia may be useful for improving the prediction of postoperative troponin elevation.

Cardiac arrest occurs in approximately 1:12,000 parturients. Among nonpregnant patients who have in-hospital cardiac arrest, those whose spontaneous circulation does not return within 15 to 20 minutes have a high risk of death and disability, so life support efforts are generally stopped after this period. However, among parturients, witnessed in-hospital arrest is often reversible and has a better prognosis. We describe a successful clinical outcome after maternal cardiac arrest and 55 minutes of advanced cardiac life support. This case underscores the importance of high-quality cardiopulmonary resuscitation and raises questions about the appropriate duration of resuscitation efforts in otherwise healthy young mothers with a potentially reversible cause of arrest.

Acute disruption of venous return during cardiopulmonary bypass (CPB) may be due to malposition of the venous cannula, kinks or obstruction of the venous tubing by a smaller cannula, airlock, or mechanical disruption of blood flow. We describe an acute obstruction of the venous cannula by blood clots that were visualized on the transesophageal echocardiogram during CPB. Appropriate measures were taken by the surgeon to evacuate the clot and restore CPB. The clots were not seen on the transesophageal echocardiogram before CPB raising suspicion that they originated in a lower extremity and migrated to the right atrium resulting in venous cannula obstruction.

“By three methods we may learn wisdom: first, by reflection, which is noblest; second, by imitation, which is easiest; and third by experience, which is the bitterest.” —Confucius