Journal of the American College of Surgeons
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The Joseph M Donald Endowment for the Archival Collection of the Southern Surgical Association is named for the 73rd President Elect of the Southern Surgical Association (Figure 1), who died in 1961 at age 57 before he had the opportunity to deliver his Presidential Address. Dr Donald's career as a surgeon in Birmingham began in 1931 after the completion of his residency at the Mayo Clinic. He was one of four generations of Donalds to serve Alabama as physicians. ⋯ Two of his sons, Joseph, Jr and Thomas trained as surgeons. From 1854 until the present, twenty-four Donald or Donald-related physicians have practiced in Alabama (personal communication, Dr Thomas T Donald). The present talk is dedicated to the memory of Dr Joseph Marion Donald and his contributions to the field of surgery.
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Neoadjuvant therapy (NT) is increasingly utilized for patients with pancreatic ductal adenocarcinoma (PDAC). Disease progression, toxicity, and failure to undergo surgical resection are common during NT, yet little research has focused on efforts to optimize care delivery. We sought to define and validate a novel composite outcomes metric that characterizes the successful delivery of NT. ⋯ A TNE is infrequently achieved among patients with PDAC undergoing NT but is significantly associated with improved long-term outcomes. Future research aimed at optimizing outcomes of NT delivery should incorporate this novel composite metric that may more accurately reflect patient and provider expectations of treatment.
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Impact of Academic Medical Centers on Surgical Outcomes of Neighboring Non-Academic Medical Centers.
We aimed to investigate the geographic variation of Academic Medical Centers (AMCs) across different healthcare markets and the impact on surgical outcomes in nearby non-AMCs. ⋯ High market presence of AMCs was associated with lower morbidity and mortality rates at nearby non-AMCs. The influence of AMCs on clinical outcomes likely extends beyond direct patient care, indicating spillover effects of AMCs on outcomes for patients in neighboring non-AMCs.
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Artificial intelligence (AI)-powered platforms may be used to ensure that clinically significant lung nodules receive appropriate management. We studied the impact of a commercially available AI natural language processing tool on detection of clinically significant indeterminate pulmonary nodules (IPNs) based on radiology reports and provision of guideline-consistent care. ⋯ At a large tertiary care center, 30% of clinically significant incidental pulmonary nodules that would have otherwise been missed were brought to the attention of lung nodule clinicians by an AI software, allowing for initiation of appropriate follow-up.