Articles: outcome.
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Nocturnists are the principal means by which hospital medicine groups currently ensure continuous overnight coverage of hospitalized patients within academic medical centers and community hospitals. Yet despite their involvement in most aspects of overnight care, a comprehensive review of the impact of nocturnists in the hospital is absent. Here we examine the physiologic effects of overnight work on clinicians, the quality of medical care delivered by nocturnists in floor and intensive care units, the impact of nocturnist presence on trainee supervision and graduated autonomy in academic settings, and prevalent staffing models. ⋯ Compensation is typically greater for nocturnists, but the role's sustainability and impact on overall group retention remain unknown. Nocturnist programs are essential to provide continuous care of hospitalized patients and meet trainee supervision mandates, yet their full impact on patient and educational outcomes requires further investigation. Future research should aim to optimize staffing models to enhance patient care, trainee education, and clinician well-being.
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A systematic literature review and consensus using Delphi method. ⋯ The consensus statements created by a collaborative work provide useful information for surgeons treating CM worldwide in order to achieve better surgical outcomes and avoid complications.
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To enhance understanding of the relationships between margin width, recurrence patterns, recurrence-free survival, and salvage therapy following initial hepatectomy for colorectal liver metastases (CRLM). ⋯ Pathologic margin after resection of CRLM is associated with higher rates of overall recurrence that are less amenable to salvage and not just local failure. Margin status may be more of a reflection of underlying tumor characteristics rather than simply a risk factor for local failure.