Annals of surgery最新文献

{"title":"Randomized Controlled Trial of New Oral Anticoagulants Versus Warfarin for Post Cardiac Surgery Atrial Fibrillation: The NEWAF Trial.","authors":"Philicia Moonsamy,Yunong Zhao,Adham Makarem,Dane C Paneitz,Stanley Wolfe,Isabella Turco,Katia M Colon,Breanna R Ethridge,Selena S Li,Gregory Leya,Serena Verma,David A D'Alessandro,Arminder S Jassar,Nathaniel B Langer,George Tolis,Mauricio A Villavicencio,Serguei I Melnitchouk,Jordan P Bloom,Eriberto Michel,Antonia Kreso,Seyed Alireza Rabi,Oluwaseun Akeju,Thoralf M Sundt,Asishana A Osho","doi":"10.1097/sla.0000000000006853","DOIUrl":"https://doi.org/10.1097/sla.0000000000006853","url":null,"abstract":"OBJECTIVETo determine whether anticoagulation for new onset atrial fibrillation (AF) with rivaroxaban decreases length of stay compared to warfarin.SUMMARY OF BACKGROUND DATADirect Oral Anticoagulants (DOACs) have been shown to be noninferior to warfarin for stroke prevention in nonsurgical patients with atrial fibrillation. There are no published randomized trials comparing DOACs to warfarin in cardiac surgery patients, and DOACs are yet to be widely adopted in this population.METHODSIn a pragmatic, prospective, clinical trial, 100 patients with new-onset AF after cardiac surgery were randomized to receive rivaroxaban (n=50) or warfarin (n=50). Patients were followed for 30 days post-discharge, with patient-reported outcomes assessed two weeks after discharge using the Perception of Anticoagulant Treatment Questionnaire and the EuroQol-5D-3L survey.RESULTSThe primary endpoint, length of stay (LOS) from day of surgery to discharge (days, IQR), was 7 (6-9) for rivaroxaban and 8 (6-9) for warfarin (P=0.460). LOS from initiation of anticoagulation to discharge was 2 (1-4) days for rivaroxaban and 2 (1-3) days for warfarin (P=0.738). The mean INR at discharge in the warfarin group was 1.68 (SD 0.5). No major bleeding events, strokes, or other arterial thromboembolism events occurred in either group. Minor bleeding events were reported in 3/50 (6%) patients in the rivaroxaban group versus 1/50 (2%) in the warfarin group (P=0.617), none of which required blood transfusion. One patient (2%) in the rivaroxaban group developed a pericardial effusion requiring drainage, compared to none in the warfarin group (P=1.000). Patients taking rivaroxaban reported significantly higher scores for convenience (P<0.001) and better overall perception of their anticoagulation experience (P=0.006), though both groups reported similar treatment satisfaction (P=0.494). Mobility issues were reported by 42.2% of patients taking rivaroxaban compared to 18.6% of those taking warfarin (P=0.021). All outcomes were consistent in both the intention-to-treat and as-treated populations.CONCLUSIONSTreatment with rivaroxaban in new-onset atrial fibrillation after cardiac surgery did not decrease length of stay compared to warfarin. However, patients treated with rivaroxaban reported significantly better convenience and a more favorable overall perception of their anticoagulation experience compared to warfarin. Given similar safety profiles, these findings support incorporating rivaroxaban as an option for shared-decision-making when selecting anticoagulation therapy for this patient population.","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":"17 1","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Conceptual Framework on Integrating a Large and Growing Academic Health System.","authors":"Akhil Chawla,Fabian M Johnston,Michael J Rosen","doi":"10.1097/sla.0000000000006850","DOIUrl":"https://doi.org/10.1097/sla.0000000000006850","url":null,"abstract":"","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":"673 1","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision Medicine in Surgery: Immunomodulation and Cellular Regeneration Strategies for Immunologic and Surgical Diseases.","authors":"Mingyang Ma,Preeti Chhabra,Jack H Cook,Gordon W Laurie,Kenneth L Brayman","doi":"10.1097/sla.0000000000006849","DOIUrl":"https://doi.org/10.1097/sla.0000000000006849","url":null,"abstract":"OBJECTIVEThis article presents a methodological framework for studying the effects of lacritin peptide on β-cell proliferation, islet viability, and immune modulation using a combination of in vitro and in vivo models.SUMMARY OF BACKGROUND DATAImmunological and inflammatory diseases, including autoimmune disorders and organ-specific injuries, present significant therapeutic challenges owing to persistent inflammation and limited tissue regeneration. Therapies that combine immunomodulation and cellular regeneration may address this need in conditions such as Crohn's disease, heart failure, pulmonary fibrosis, chronic kidney disease, and neurological injuries. 'Lacritin' displays both immunomodulatory and regenerative activities, and is significantly deficient in T1 diabetics.METHODSPancreatic islet in-vitro testing, mass cytometry (CyTOF), imaging mass cytometry (IMC), and single-cell RNA sequencing (scRNAseq) to assess immune cell interactions. Additionally, in-vivo transplantation of lacritin peptide treated islets into diabetic mouse recipients and immunological studies in the Nonobese Diabetic (NOD) mouse model support the pre-clinical evaluation of lacritin in its therapeutic potential.RESULTSIn this article, we discuss the increasing need for precision medicine for immunological and surgical diseases. Within our experimental framework, we generate valuable insights into immune cell behavior, tissue architecture, and regenerative dynamics with lacritin intervention at the pre-clinical stage.CONCLUSIONThrough this study, we aimed to facilitate further investigations into future precision medicine strategies, including lacritin peptide and other peptide-based therapeutics for immunologic and surgical diseases.","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":"52 1","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Traditional and new Surgical Wait Time Targets and Survival for Curative-intent Colorectal Cancer Surgery: A Population-based Cohort Study.","authors":"Adom Bondzi-Simpson,Rinku Sutradhar,Frances C Wright,Tiago Ribeiro,Wing C Chan,Sheron Perera,Andrea Covelli,Aisha Lofters,Rebecca A Snyder,Callisia N Clarke,Natalie G Coburn,Julie Hallet","doi":"10.1097/sla.0000000000006846","DOIUrl":"https://doi.org/10.1097/sla.0000000000006846","url":null,"abstract":"BACKGROUNDWait time (WT) to surgery is a common quality indicator for colorectal cancer (CRC). However, the definition of WT targets and its association with clinically relevant outcomes remains poorly defined. We assessed the association between WT to CRC surgery and overall survival (OS) for curative-intent surgery.METHODSWe conducted a population-based retrospective cohort study of adults undergoing resection for stage I-III CRC (between 2007-2020), using health administrative data in Ontario, Canada. The exposure was WT, measured as the time from the decision to operate to surgery (in days). The outcome was OS, measured as time from surgery to death. Restricted cubic spline regression (RCS) examined the relationship between WT and hazards of death to identify meaningful WT thresholds. WT was then categorized as a) traditional WT target (≤ 28 days) or b) new data-informed target defined by RCS. Multivariable Cox proportional hazards explored the association between each WT target and the hazards of death after adjusting for confounders established a priori.RESULTSOf 35,533 patients, 27,102 (76.3%) underwent surgery within the traditional WT target. The median WT was 19 days (interquartile range 12-28). RCS revealed an inflection point around 45 days associated with increasing hazards of death. After adjusting for age, sex, co-morbidity, cancer site, stage, neo-adjuvant or adjuvant therapy, and year of surgery, having surgery within the traditional WT target (≤ 28 days) was not associated with OS (Hazards Ratio, [HR] 0.97; 95% confidence interval, [CI] 0.92-1.02). Having surgery within the new WT target (≤ 45 days) was independently associated with superior OS (HR 0.90, 95% CI 0.82-0.99).CONCLUSIONIn patients undergoing curative-intent resection for stage I-III CRC, having surgery within traditional WT target of 28 days was not associated with OS. However, having surgery within a WT target of 45 days was independently associated with superior OS. These data highlight the need to reconsider WT targets for quality monitoring by linking to clinically meaningful outcomes.","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":"14 1","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Super Learner Enhances Postoperative Complication Prediction in Colorectal Surgery.","authors":"Tommaso Violante,Davide Ferrari,Marco Novelli,William R Perry,Kellie L Mathis,Eric J Dozois,David W Larson","doi":"10.1097/sla.0000000000006847","DOIUrl":"https://doi.org/10.1097/sla.0000000000006847","url":null,"abstract":"OBJECTIVETo determine if a Super Learner (SL) machine learning approach could improve the predictive accuracy of the American College of Surgeons Risk Calculator (ACS-RC) for postoperative complications in patients undergoing colorectal surgery.SUMMARY OF BACKGROUND DATAMachine learning (ML) has shown significant potential to advance medical fields, including surgical risk prediction. Current tools, like the ACS-RC which uses logistic regression and extreme gradient boosting, are standard but may be enhanced by more advanced ML ensembles.METHODSThis retrospective study analyzed colorectal surgery cases from the 2018-2022 ACS National Surgical Quality Improvement Program (NSQIP) database. An SL model, which combines multiple ML algorithms, was developed to predict fourteen postoperative outcomes. Its performance was compared against traditional logistic regression (LOG) and extreme gradient boosting (XGB) models. Key performance metrics included discrimination (AUROC, AUPRC) and calibration (Brier score, Hosmer-Lemeshow test).RESULTSThe SL model demonstrated superior performance across all predicted complications when compared to both LOG and XGB. It showed superior discrimination for severe outcomes, achieving an AUROC greater than 0.94 for predicting mortality. The SL model was also more accurate in predicting infectious complications and length of stay, and its calibration metrics indicated a better overall fit and accuracy.CONCLUSIONSThe Super Learner model enhances the accuracy of postoperative risk prediction in colorectal surgery. Its superior performance suggests it is a promising tool for improving personalized patient counseling, aiding clinical decision-making, and optimizing resource allocation.","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":"115 1","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Era of Decision Making in Liver Transplantation: A Prospective Validation and Cost-Effectiveness Analysis of FMN-Guided Liver Viability Assessment During Normothermic Machine Perfusion.","authors":"Chase J Wehrle,Sangeeta Satish,Elizabeth Dewey,Muhammad A Nadeem,Keyue Sun,Chunbao Jiao,Mazhar Khalil,Alejandro Pita,Jaekeun Kim,Federico Aucejo,David Ch Kwon,Masato Fujiki,Antonio D Pinna,Belinda Udeh,Charles Miller,Koji Hashimoto,Andrea Schlegel, ","doi":"10.1097/sla.0000000000006822","DOIUrl":"https://doi.org/10.1097/sla.0000000000006822","url":null,"abstract":"OBJECTIVESFlavin mononucleotide (FMN), a marker of mitochondrial complex 1 injury, has not yet been validated for its predictive value of outcomes and economic impact.SUMMARY OF BACKGROUND DATANormothermic machine perfusion (NMP) is the only ex-situ perfusion technique currently approved for liver transplantation in the US. Optimal graft viability assessment on this approach remains controversial.METHODSAll liver transplants at our center were included, divided into static-cold storage (SCS, n=418), NMP (OrganOx Metra) with traditional viability criteria (10/2022-1/2024, n=213) and prospective viability assessment using FMN (NMP+FMN, 1/2024-87/2024, n=143). Perfusate fluorescence spectroscopy was performed to quantify FMN during NMP. Spectroscopy results were correlated with tissue analyses. Standard risk factors and clinically relevant core outcomes were collected for analysis. Groups were propensity-matched, and posttransplant outcomes including economics were assessed using inverse-probability of treatment weighting (IPTW). Mixed-effects models assessed complications, graft loss and FMN-guided liver utilization. A decision-analytic model was used to assess the cost-benefit of NMP and FMN-testing.RESULTSGraft loss was predicted best by perfusate FMN (&gt;1700 samples; c-statistic AUC 0-4hrs NMP: 0.96, 95%CI:0.93-0.97, P&lt;0.0001) versus traditional viability markers. High FMN grafts demonstrated significantly more mitochondrial injury measured in tissues at the end of NMP. Since implemented prospectively, FMN-based viability assessment during NMP lead to a comparable liver utilization rate of NMP=94 vs. NMP+FMN=90% (P=0.346) despite higher overall donor and recipient risk. Over one-third (n=43, 35%) were livers from donation after circulatory death donors (DCD). Elevated perfusate FMN of &gt;1.75μg/mL at 4hours was independently associated with reduced graft survival and death-censored graft survival. Liver transplants in the FMN-era were independently associated with improved graft survival on cox regression (HR:6.841, 95%CI:1.447-37.300, P&lt;0.001). Risk-adjusted outcomes including biliary and overall complications, major (Clavien&gt;IIIA) complications, liver-related major complications, and graft loss were improved with FMN-based viability testing. Overall morbidity measured by comprehensive complications index (CCI) was reduced with NMP but did significantly decrease with additional FMN-use compared to SCS. Such results were upheld when DBD and DCD grafts were evaluated independently. Liver transplantations with high FMN livers demonstrated greater cumulative costs (P&lt;0.001). On mixed-effects modelling, 44% percent of transplant-related cost variation was explained by FMN in the top quintile (&gt;1.75μg/mL). Risk-matched FMN-tested DBD grafts specifically demonstrated incremental 16% reduction in major complications with net $33,657 saving per graft in the decision-analytic model while DCD grafts demonstrated 30% improvement in major complications and an ","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":"4 1","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Vulnerability Hinders Clinical Trial Participation in Gastrointestinal Cancer Surgery Patients.","authors":"Shruthi R Perati,Sana M Mohayya,Henry A Pitt,Ernie Shippey,Howard S Hochster,Steven K Libutti,Mariam F Eskander","doi":"10.1097/sla.0000000000006843","DOIUrl":"https://doi.org/10.1097/sla.0000000000006843","url":null,"abstract":"OBJECTIVEThis study examines how neighborhood social vulnerability impacts clinical trial participation for gastrointestinal (GI) cancer surgery patients.SUMMARY BACKGROUND DATAClinical trials are critical to cancer care but often exclude disadvantaged groups.METHODSThe Vizient Clinical Database (CDB), which captures 98% of academic medical centers, 110+cancer hospitals and 700+community hospitals, was queried for gastroesophageal, pancreatic, and colorectal cancer patients who underwent surgical resection from July 2018-June 2023. The Vizient Vulnerability Index (VVI), comprised of 9 census tract-level domains, was used to study the association between social vulnerability and trial participation.RESULTS399,446 patients were identified, 7,680 (1.9%) of whom participated in a clinical trial. Clinical trial participants were less likely to be socially vulnerable (OR 0.71, P<0.0001), particularly in the VVI domains of economic and education, and to have undergone resection at a community hospital (OR 0.38, P<0.0001). High social vulnerability decreased the odds of enrollment for patients who underwent surgery at community hospitals by a greater degree than those who underwent surgery at academic/specialized centers (OR 0.52 vs. 0.75; P<0.0001 for interaction). Trial participants were less likely to be female (OR 0.84, P<0.0001), Black (OR 0.69, P=0.0002), and have Medicaid insurance (OR 0.81, P<0.0001).CONCLUSIONSAmong gastrointestinal cancer surgery patients, female sex, Black race, Medicaid insurance, and neighborhood social vulnerability, particularly economic and education vulnerability, were associated with lower odds of clinical trial enrollment. The factor that most inhibited trial enrollment was surgery at a community hospital, and this influence was compounded by social vulnerability.","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":"52 1","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noninvasive Deep Learning System for Preoperative Diagnosis of Follicular-Like Thyroid Neoplasms Using Ultrasound Images: A Multicenter, Retrospective Study.","authors":"Hui Shen,Yue Huang,Wenxiao Yan,Chifa Zhang,Ting Liang,Dan Yang,Xiaoxiao Feng,Shuyi Liu,Yu Wang,Weihan Cao,Ying Cheng,Hongyan Chen,Qiujie Ni,Fei Wang,Jingjing You,Zhe Jin,Wenle He,Jie Sun,Dexing Yang,Lijuan Liu,Boling Cao,Xiao Zhang,Yingjia Li,Shufang Pei,Shuixing Zhang,Bin Zhang","doi":"10.1097/sla.0000000000006841","DOIUrl":"https://doi.org/10.1097/sla.0000000000006841","url":null,"abstract":"OBJECTIVETo propose a deep learning (DL) system for the preoperative diagnosis of follicular-like thyroid neoplasms (FNs) using routine ultrasound images.SUMMARY BACKGROUND DATAPreoperative diagnosis of malignancy in nodules suspicious for an FN remains challenging. Ultrasound, fine-needle aspiration cytology, and intraoperative frozen section pathology cannot unambiguously distinguish between benign and malignant FNs, leading to unnecessary biopsies and operations in benign nodules.METHODSThis multicenter, retrospective study included 3634 patients who underwent ultrasound and received a definite diagnosis of FN from 11 centers, comprising thyroid follicular adenoma (n=1748), follicular carcinoma (n=299), and follicular variant of papillary thyroid carcinoma (n=1587). Four DL models including Inception-v3, ResNet50, Inception-ResNet-v2, and DenseNet161 were constructed on a training set (n=2587, 6178 images) and were verified on an internal validation set (n=648, 1633 images) and an external validation set (n=399, 847 images). The diagnostic efficacy of the DL models was evaluated against the ACR TI-RADS regarding the area under the curve (AUC), sensitivity, specificity, and unnecessary biopsy rate.RESULTSWhen externally validated, the four DL models yielded robust and comparable performance, with AUCs of 82.2%-85.2%, sensitivities of 69.6%-76.0%, and specificities of 84.1%-89.2%, which outperformed the ACR TI-RADS. Compared to ACR TI-RADS, the DL models showed a higher biopsy rate of malignancy (71.6% -79.9% vs 37.7%, P<0.001) and a significantly lower unnecessary FNAB rate (8.5% -12.8% vs 40.7%, P<0.001).CONCLUSIONThis study provides a noninvasive DL tool for accurate preoperative diagnosis of FNs, showing better performance than ACR TI-RADS and reducing unnecessary invasive interventions.","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":"109 1","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Scientific Rationale for Diversity, Equity and Inclusion: Nature-inspired Design.","authors":"John C Alverdy,Selwyn O Rogers,James E Bowman","doi":"10.1097/sla.0000000000006842","DOIUrl":"https://doi.org/10.1097/sla.0000000000006842","url":null,"abstract":"While the concept of Diversity, Equity and Inclusion (DEI) has become a political charged issue, its scientific premise remains unchanged. In this piece, we review mechanisms in nature whereby natural selection has evolved systems to be diverse, equitable and inclusive with the goal of cooperation, productivity and sustainability. While DEI mandates may evolve over time, productivity, profits and efficiency prevail as behavioral economics align with the tenants of DEI across all scales of life and across all markets.","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":"10 1","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Leadership Potential Through a Development Lens: What and Who.","authors":"Nicole M Mott,Lesly A Dossett","doi":"10.1097/sla.0000000000006844","DOIUrl":"https://doi.org/10.1097/sla.0000000000006844","url":null,"abstract":"","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":"15 1","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}