Individualizing care for patients with gallbladder cancer.

Unlabelled: The rarity and lack of Level I Evidence compromise our ability to care for patients with gallbladder cancer.

Methods: NCDB cohort study of with resected Stage Groups IB-IVA gallbladder adenocarcinoma between 2004 and 2018. Patients were included.

Textbook outcome as a composite measure of quality in hepaticopancreatic surgery.

Background: Textbook outcome (TO) is a valuable metric to assess postoperative outcomes. The aim of this study was to assess TO in patients undergoing hepatopancreatic surgery.

Methods: This was a retrospective cohort NSQIP study from 2015 to 2018.

Minimally invasive distal pancreatectomy for adenocarcinoma of the pancreas.

Introduction: Minimally invasive (MI) surgery has been widely adopted to treat left-sided pancreatic cancer. However, outcomes are not clearly defined.

Materials: Retrospective cohort study utilizing NCDB and NSQIP data.

Improved Overall Survival of Patients with Pancreatic Cancer through Multiagent Chemotherapy and Increased Rates of Surgical Resection.

Background: Seminal trials have demonstrated improved survival in pancreatic adenocarcinoma with novel multiagent chemotherapy regimens. To understand the clinical ramifications of this paradigm shift, we reviewed our institutional experience.

Methods: This retrospective cohort study utilized a prospective database at a single institution to study all patients diagnosed with and treated for pancreatic adenocarcinoma between 2000 and 2020.

Pathologic Tumor Regression is Associated With Improved Survival in Pancreatic Cancer.

Objectives: The advent of effective chemotherapy regimens has increased the use of neoadjuvant multiagent chemotherapy in pancreatic cancer. However, the effect of tumor downstaging with neoadjuvant treatment on survival is unclear.

Methods: Retrospective study included all resected patients with pancreatic adenocarcinoma who underwent neoadjuvant chemotherapy with FOLFIRINOX or gemcitabine/Abraxane.

Predicting loss of independence after high-risk gastrointestinal abdominal surgery: Frailty vs. NSQIP risk calculator.

Background: Loss of independence (LOI) is a significant concern for patients undergoing high-risk abdominal surgery. Although the risk for morbidity and mortality has been well studied, there is a dearth of data on risk for LOI.

Methods: This study utilized NSQIP data from 2015 to 2018 in a retrospective cohort study of patients undergoing high-risk gastrointestinal surgery (e.

Promotion Preparation Tips for Academic Family Medicine Educators.

Background And Objectives: Promotion has historically valued the scholarship of discovery over the scholarship of teaching. The clinician-educator promotion pathway is an attractive option for academic family physicians engaged in significant teaching. However, clinician-educators are less often promoted than peers on other tracks.

"Pulling the Parachute": A Qualitative Study of Burnout's Influence on Emergency Medicine Resident Career Choices.

Objectives: About half of all resident physicians report symptoms of burnout. Burnout negatively influences multiple aspects of their education and training. How burnout may impact residents' career choices remains unclear.

Traveling to Receive Treatment for Extremity Soft Tissue Sarcomas: Is it worth the drive?

Background: Regionalization of sarcoma care may improve outcomes. Concerns exist regarding the burdens of travel and its effects on care. We evaluate the presence of a "distance bias".

"Necessary Compromises": A Qualitative Exploration of the Influence of Burnout on Resident Education.

Objective: Burnout is prevalent among resident physicians and has a negative impact on their well-being and effectiveness at work. How burnout shapes residents' educational experiences, attitudes, habits, and practices is not well understood. There is also a lack of research regarding self-identified mitigation strategies for residents.

Academic Emergency Medicine Faculty Experiences with Racial and Sexual Orientation Discrimination.

Introduction: Despite the increasing diversity of individuals entering medicine, physicians from racial and sexual minority groups continue to experience bias and discrimination in the workplace. The objective of this study was to determine the current experiences and perceptions of discrimination on the basis of race and sexual orientation among academic emergency medicine (EM) faculty.

Methods: We conducted a cross-sectional survey of a convenience sample of EM faculty across six programs.

#MeToo in EM: A Multicenter Survey of Academic Emergency Medicine Faculty on Their Experiences with Gender Discrimination and Sexual Harassment.

Introduction: Gender-based discrimination and sexual harassment of female physicians are well documented. The #MeToo movement has brought renewed attention to these problems. This study examined academic emergency physicians' experiences with workplace gender discrimination and sexual harassment.

GSK-3: An important kinase in colon and pancreatic cancers.

In this review, the role of glycogen synthase kinase 3 (GSK-3) in pancreatic and colon cancers will be explored. GSK-3 plays a fundamental role in many metabolic processes, primarily as the final enzyme in glycogen synthesis. Active β-catenin represents the final step for the transcription of Wnt target genes.

Better Defining the Role of Total Neoadjuvant Radiation: Changing Paradigms in Locally Advanced Pancreatic Cancer.

Background: This study was designed to better define the role of radiation (Neo-Rad) in addition to neoadjuvant multiagent chemotherapy (NAT) for the treatment of locally advanced pancreatic cancer.

Methods: Retrospective cohort study using the NCDB. Individuals with AJCC clinical T3/T4 pancreatic carcinoma who underwent resection and multiagent chemotherapy were included.

Research Priorities for Physician Wellness in Academic Emergency Medicine: Consensus from the Society of Academic Emergency Medicine Wellness Committee.

Background: Physicians and trainees in academic health care settings face unique challenges to maintaining and enhancing their well-being compared to their community practice counterparts.

Objective: Our objective was to develop a research agenda focused on well-being, resilience, and career longevity issues specific to practicing emergency medicine in an academic setting.

Methods: We convened an expert group of academic emergency physicians prior to the 2018 annual meeting of the Society for Academic Emergency Medicine to determine a set of uniformly accepted research priorities in the field by consensus.

Emergency Medicine Trainee Burnout Is Associated With Lower Patients' Satisfaction With Their Emergency Department Care.

Introduction: Emergency medicine (EM) physicians and trainees report high levels of burnout. Burnout negatively impacts physician well-being and career satisfaction but it remains unclear how burnout may influence patient care. We examined the degree to which EM trainee burnout at one institution was associated with patients' satisfaction with their emergency department (ED) care.

Tumor mitotic rate is an independent predictor of survival for nonmetastatic melanoma.

Background: Tumor mitotic rate is a known prognostic variable in Stage I melanoma; however, its importance is unclear in Stages II and III.

Methods: Patients diagnosed with nonmetastatic cutaneous melanoma from 2010 to 2014 were identified from the National Cancer Institute's Surveillance, Epidemiology, and End Results registry.

Results: Of a total of 71,235 patients, the majority were white (94.

Frailty Predicts Failure to Rescue after Thoracoabdominal Operation.

Background: An association between frailty and mortality exists; we hypothesized this is secondary to failure to rescue (F2R).

Study Design: Data were obtained from the NSQIP (2005 to 2012) for patients undergoing thoracoabdominal operations. Using the Modified Frailty Index, patients were classified as not (0 points), mildly (1 point), moderately (2 points), and severely (≥3) frail.

Is It Time for Entrustable Professional Activities for Residency Program Directors?

Residency program directors (PDs) play an important role in establishing and leading high-quality graduate medical education programs. However, medical educators have failed to codify the position on a national level, and PDs are often not recognized for the significant role they play. The authors of this Commentary argue that the core entrustable professional activities (EPAs) framework may be a mechanism to further this work and define the roles and responsibilities of the PD position.

Emergency Medicine Faculty Are Poor at Predicting Burnout in Individual Trainees: An Exploratory Study.

Objective: Burnout is common among emergency medicine (EM) physicians, and it is prevalent even among EM trainees. Recently proposed Accreditation Council for Graduate Medical Education requirements encourage faculty to alert residency leadership when trainees display signs of burnout. It remains uncertain how trainees experiencing burnout can be reliably identified.

An Investigation of the Relationship Between Emergency Medicine Trainee Burnout and Clinical Performance in a High-fidelity Simulation Environment.

Objective: Burnout is prevalent among emergency medicine (EM) physicians, with physicians experiencing burnout more likely to report committing medical errors or delivering suboptimal care. The relationship between physician burnout and identifiable differences in clinical care, however, remains unclear. We examined if EM trainee burnout was associated with differences in clinical performance using high-fidelity simulation as a proxy for patient care.