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Key Points Question What are the projected estimates of the number of African American students who would have graduated from historically Black medical schools that were closed during the period surrounding the publication of the 1910 Flexner report? Findings In this economic evaluation of 13 historically Black medical schools that were closed and 4 historically Black medical schools that remained open after the 1910 Flexner report, an extrapolation based on data from the medical schools that remained open indicated that 5 of the closed medical schools might have collectively provided training to an additional 35 315 graduates by 2019. If these 5 closed schools had remained open, they could have produced a 29% increase in the number of graduating African American physicians in 2019 alone. Meaning The study’s findings suggest that consideration should be given to the creation of medical education programs at historically Black colleges and universities in an effort to increase the number of African American graduates from medical schools and the number of African American physicians in the workforce.

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Pediatric patients awaiting heart transplant face high mortality rates due to donor organ shortages, including non-use of marginal donor hearts. We examined national trends in pediatric marginal donor heart use over time. UNOS data were queried for heart donors <18 years from 2005 to 2014. The proportion of donor hearts considered marginal was determined using previously cited marginal characteristics: left ventricular ejection fraction (LVEF) <50%, use of ≥2 inotropes, cerebrovascular death, CDC high-risk status, and eGFR < 30 mL/min/1.73 m . Disposition of donor hearts was determined and stratified by marginal donor status. Of 6778 pediatric hearts offered from 2005 to 2014, 2373 (35.0%) were considered marginal. Non-use of marginal donor hearts was significantly higher than that of donor hearts without any marginal characteristics (59.5% vs 20.3%, P < .001). In particular, LVEF < 50% and donor inotropes were associated with high rates of organ non-use among pediatric donors. Yet, non-use of marginal donor organs decreased from 67% to 48% from 2005 to 2014 (P < .001). Although the proportion of pediatric donor hearts used for pediatric patients has increased, more than half of donor hearts are declined for use in pediatric recipients due, in part, to perceived marginal status.

We document patterns of intermarriage between immigrants and natives during a period of unprecedented growth in the size and diversity of America’s foreign-born population. Roughly one in six U.S. marriages today involve immigrants and a large share includes U.S.-born partners. Ethno-racial background clearly shapes trajectories of immigrant social integration. White immigrants are far more likely than other groups to marry U.S.-born natives, mostly other whites. Black immigrants are much less likely to marry black natives or out-marry with other groups. Intermarriage is also linked with other well-known proxies of social integration—educational attainment, length of time in the country, and naturalization status. Classifying America’s largest immigrant groups (e.g., Chinese and Mexican) into broad panethnic groups (e.g., Asians and Hispanics) hides substantial diversity in the processes of marital assimilation and social integration across national origin groups.

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With the dosing regimens in the current study, the only benefit noted with methadone was a decrease in perioperative opioid requirements. However, given the potential for hyperalgesia with the intraoperative use of remifentanil, adjunctive use of methadone appears warranted.