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The effects of changing academic environments on faculty well-being have attracted considerable research attention. However, few studies have examined the multifaceted relationships between the academic work environment and the multiple dimensions of faculty well-being using a comprehensive theoretical framework. To address this gap, this study implemented the Job Demands-Resources (JDR) model to investigate how job demands/resources in the academic environment interact with multiple dimensions of faculty well-being. The study participants were 1389 full-time faculty members employed in public universities in the Czech Republic. The participants completed a questionnaire assessing perceived job resources (influence over work, support from supervisor and colleagues), job demands (quantitative demands, work-family conflicts and job insecurity) and three dimensions of faculty well-being (job satisfaction, stress and work engagement). A structural equation model was used to test the effects of "dual processes" hypothesized by the JDR theory, i.e., the existence of two relatively independent paths between job demands/resources and positive/negative aspects of faculty well-being. The model showed a very good fit to our data and explained 60% of the variance in faculty job satisfaction, 46%, in stress and 20% in work engagement. The results provide evidence for the dual processes, including the "motivational process" (i.e., job resources were related predominantly to work engagement and job satisfaction) and the "health impairment process" (i.e., job demands were predominantly associated with stress, mostly through work-family conflict). The study expands current research on faculty well-being by demonstrating the complex, non-linear relationships between academic work environments and different dimensions of faculty well-being.

Smoldering multiple myeloma (SMM) is an asymptomatic precursor to active multiple myeloma (MM). The aim of this study was to report clinical characteristics and outcomes of patients with SMM stratified based on their risk of progression to MM using the Mayo 20/2/20 criteria. Data were leveraged from the Czech Myeloma Group Registry of Monoclonal Gammopathies (RMG). Key outcomes included progression-free survival from SMM diagnosis to active MM diagnosis or death (PFS), progression-free survival from SMM diagnosis to progression on first line (1 L) MM treatment or death (PFS2), and overall survival (OS). Of 498 patients, 174 (34.9%) were classified as high risk and 324 (65.1%) as non–high risk. Median follow-up was approximately 65 months. During follow-up, more patients in the high-risk vs non–high-risk group received 1 L MM treatment (76.4% vs 46.6%, p < 0.001). PFS, PFS2, and OS were significantly shorter in high-risk vs non–high-risk patients (13.2 vs 56.6 months, p < 0.001; 49.9 vs 84.9 months, p < 0.001; 93.2 vs 131.1 months, p = 0.012, respectively). The results of this study add to the growing body of evidence that patients with high-risk vs non–high-risk SMM have significantly worse outcomes, including OS. [ABSTRACT FROM AUTHOR]

In multiple myeloma (MM), malignant plasma cells infiltrate the bone marrow. In some cases, plasma cells migrate out of the bone marrow creating either para-skeletal plasmacytomas (PS) or infiltrating soft tissues as extramedullary plasmacytomas (EMD). The aim of this study was to define risk groups in newly diagnosed MM (NDMM) patients with PS and EMD plasmacytomas. In total, 523 NDMM patients with PS plasmacytomas and 196 NDMM patients with EMD plasmacytomas were diagnosed in the Czech Republic between 2004 and 2021 using modern imaging methods. Patients' data were analyzed from the Registry of Monoclonal Gammopathies of the Czech Myeloma Group. In NDMM patients with PS plasmacytomas, we found a subgroup with <5% of bone-marrow plasma cells to have the best prognosis (mPFS: 58.3 months (95% CI: 33.0–NA); mOS: not reached). The subgroup with >5% of bone-marrow plasma cells and ≥3 plasmacytomas had the worst prognosis (mPFS: 19.3 months (95% CI: 13.4–28.8), p < 0.001; mOS: 27.9 months (95% CI: 19.3–67.8), p < 0.001). Our results show association between tumor burden and prognosis of NDMM patients with plasmacytomas. In the case of PS plasmacytomas, NDMM patients with low BM PC infiltration have an excellent prognosis. [ABSTRACT FROM AUTHOR]

Summary: Multiple myeloma (MM) is characterized by malignant plasma cell infiltration of the bone marrow. In extramedullary multiple myeloma (EMD), a subclone of these cells migrates out of the bone marrow. Out of 4 985 MM patients diagnosed between 2005 and 2017 in the Czech Republic, we analyzed 234 secondary EMD patients to clarify risk factors of secondary EMD development. We found younger age [<65 years; odds ratio (OR) 4·38, 95% confidence interval (CI): 2·46–7·80, P < 0·0001], high lactate dehydrogenase (LDH) levels (>5 μkat/l; OR 2·07, 95% CI: 1·51–2·84, P < 0·0001), extensive osteolytic activity (OR 2·21, 95% CI: 1·54–3·15, P < 0·001), and immunoglobulin A (IgA; OR 1·53, 95% CI: 1·11–2·11, P = 0·009) or the non‐secretory type of MM (OR 2·83; 95% CI: 1·32–6·04, P = 0·007) at the time of MM diagnosis to be the main risk factors for secondary EMD development. Newly diagnosed MM (NDMM) patients with subsequent EMD had inferior median progression‐free (PFS) and overall (OS) survival when compared to NDMM patients without future EMD [mPFS: 13·8 months (95% CI: 11·4–16·3) vs 18·8 months (95% CI: 17·7–19·9), P = 0·006; mOS: 26·7 months (95% CI: 18·1–35·4) vs 58·7 months (95% CI: 54·8–62·6), P < 0·001]. We found that NDMM patients with specific risk factors associated with secondary EMD development have a more aggressive disease course before secondary EMD develops. [ABSTRACT FROM AUTHOR]

Real-world data on regimens for relapsed/refractory multiple myeloma (RRMM) represent an important component of therapeutic decision-making. This multi-centric, retrospective, observational study conducted by the treating physicians evaluated the effectiveness and safety of ixazomib-lenalidomide-dexamethasone (IRd) in 155 patients who received ixazomib via early access programs in Greece, the UK, and the Czech Republic. Median age was 68 years; 17% had an Eastern Cooperative Oncology Group performance status ≥ 2; median number of prior therapies was 1 (range 1–7); 91%, 47%, and 17% had received prior bortezomib, thalidomide, and lenalidomide, respectively. Median duration of exposure to ixazomib was 9.6 months. Overall response rate was 74%, including 35% very good partial response or better (16% complete response). Median progression-free survival (PFS) was 27.6 months (27.6 and 19.9 months in patients with 1 or > 1 prior lines, respectively). IRd treatment for ≥ 6 months was associated with longer PFS (hazard ratio 0.06). Fourteen patients (9%) discontinued IRd due to adverse events/toxicity in the absence of disease progression. Peripheral neuropathy was reported in 35% of patients (3% grades 3–4). These findings support the results of the phase III TOURMALINE-MM1 trial in a broader real-world RRMM population. [ABSTRACT FROM AUTHOR]

Lenalidomide (LEN) is an immunomodulator with clinical activity against myeloma cells. Based on the pivotal phase 3 trials MM-009 and MM-010, the combination of lenalidomide and dexamethasone(DEX) was approved for patients with multiple myeloma who received at least one prior therapy. Here, we evaluated LEN/DEX therapy in whole population and subsequently in selected sub-groups of patients with relapsed/refractory multiple myeloma followed in the Monoclonal Gammopathy Registry of the Czech Myeloma Group. 858 patients were treated with LEN/DEX in Czech Republic and Slovakia until end of 2017. The analyzed sub-groups were defined as patients with high-risk cytogenetic aberrations and patients with relapsed and refractory MM. The ORR (response better than PR) in whole group of patients was 46.3% for all lines of therapy, 26.4% for high-risk group and 32.1% for relapsed and refractory group. Overall survivals (OS) in the same sets were as follows: 25.6, 15.7 and 18.5 months respectively, progression free survival (PFS) was 11.2, 6.4 and 9.0 months, respectively. The most common adverse events were hematologic and infectious. In conclusion, we found our results correlated with those in other studies in terms of OS, PFS and also of treatment toxicity. [ABSTRACT FROM AUTHOR]

This article discusses the impact of the Czech Republic's accession to the European Union. Special emphasis is given to effects that have resulted from implementing the Common Agricultural Policy. Two approaches are applied. First, in an ex post analysis we address how accession has thus far influenced structural changes and the income situation. Second, in an ex ante analysis we apply the agent-based model AgriPoliS to simulate the impact of decoupling top-up payments on structural change, farm income and payment redistribution. In the ex post analysis, it is observed that structural change is still influenced by the transformation process. Farm income partially follows the increase of payments, but there is also a capitalisation of payments into factor prices for land, labour and other inputs. Furthermore, simulations support empirical findings that accession slows down structural change compared to a scenario without accession, while decoupling top-ups in 2009 has no significant impact on structural change. However, depending on the type of decoupling, a redistribution of payments among farmers can be observed. [ABSTRACT FROM AUTHOR]