bluuebunny/crossref_metadata_2025_split huggingface dataset:
A systematic review of oncoplastic volume replacement breast surgery: oncological safety and cosmetic outcome
Authors: Rutherford CL , Barker S , Romics L 
Published: May 2023

Introduction Oncoplastic breast conserving surgery allows higher volume excision to achieve oncological safety with minimal aesthetic compromise. The primary outcome of this study was to assess the oncological safety in the setting of volume replacement oncoplastic breast conserving surgery. The secondary objective was to assess cosmetic outcome. Methods A systematic literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines to explore the oncological safety of oncoplastic breast conserving surgery, with particular focus on volume replacement. Resection margin rates, re-excision rates, conversion to mastectomy rates, local and distant disease recurrence, volume replacement techniques, cosmetic outcomes and patient-reported outcome measures were assessed. Findings The search criteria identified 155 articles, of which 40 met the inclusion criteria. These studies included 2,497 patients with a mean age of 47.8 years (range 38.4–59.6 years), a body mass index of 24.3kg/m2 (22.1–28.0kg/m2), with a mean follow-up of 37.1 months (6–125 months). A variety of volume replacement techniques were used, most commonly latissimus dorsi and chest wall perforator flaps. Whole mean pathological tumour size was 29.7mm (17–65mm) and mean specimen weight was 123.6g (46.5–220g). Mean re-excision rate was 7.2% and completion mastectomy rate was 2.3%. Locoregional and distant recurrence rate was 2.5% (0–8.1%) and 3.1% (0–14.6%), respectively. There were a variety of patient-reported outcome measures employed, with overall good to excellent outcomes. Conclusions This review demonstrates that volume replacement oncoplastic breast conserving surgery is a safe option in terms of re-excision, completion mastectomy rates, and local and distant recurrence. Available patient-related outcome measures and cosmetic assessment tend towards better outcomes compared with wide local excision and mastectomy. However, data are significantly limited, with a paucity of high-level evidence, and it is therefore necessary to be cautious regarding the strength and interpretation of data in this review. Further prospective studies are required on this subject.
A systematic review of symptomatic hamartomas of the jejunum and ileum
Authors: Farkas N , Conroy M , Baig M 
Published: May 2023

Introduction Gastrointestinal hamartomas are rarely encountered benign growths made of an abnormal mixture of tissues normally found in the body where the growth occurs. Most hamartomas are asymptomatic and diagnosed incidentally. Evidence regarding symptomatic hamartomas of the jejunum and ileum is limited and restricted to anecdotal case reports. We aim to provide a contemporary overview to clarify various aspects linked to symptomatic hamartomas, helping aide management and clinical decision-making. Methods The search terms ‘small bowel’, ‘small intestine’, ‘jejunum’ and ‘ileum’ were combined with ‘hamartoma’. Embase, Medline, PubMed searches and Google Scholar hand-searches were conducted. All English language papers from 1 January 2000 to 1 June 2020 were included. Results In total 39 cases were reviewed: 29 adults and 10 paediatric (0–16 years). Presenting symptoms included abdominal pain (87%), vomiting (56%), gastrointestinal bleeding (20.5%) and weight loss (5%); 36 of 39 cases (92%) presented as emergencies. Diagnostic investigations included: abdominal x-ray (49%), endoscopy (38%), computed tomography (56%), magnetic resonance imaging (5%), contrast study (15%) and video capsule endoscopy (5%). Initial management strategy was either open (30) or laparoscopic (7) surgery or endoscopy (2). All cases required surgery for definitive management. Twenty-five cases recorded hamartoma size, and mean maximum diameter was 3.56cm (1.2–8cm) with stricturing in seven cases. Nine of the 39 cases were associated with hamartomatous syndromes. Two mortalities were recorded. Conclusions This is the first published review addressing symptomatic hamartomas of the jejunum and ileum. New data relating to demographic cohort, symptom profile, investigations, management strategies, and morbidity and mortality provide greater insight to those encountering this challenging clinical finding in the future.
Few UK vascular centres offer a fully NICE-compliant supervised exercise programme: a national audit
Authors: Haque A 
Published: May 2023

Introduction To determine the current (pre-COVID-19) provision of supervised exercise training (SET) for patients with peripheral arterial disease (PAD) in UK Vascular Centres. Methods Hospital Trusts delivering vascular care to patients with PAD were identified from the National Vascular Registry and asked to complete an online questionnaire on their provisions for SET. If a centre offered SET, they were asked questions to determine whether the programme was compliant with NICE guidelines and the difficulties they faced delivering the service. If centres did not offer SET, they were asked what obstacles prevented them implement SET. Results Of the 78 UK vascular centres, 59 (76%) responded and were included in the audit. Of these, 27 (46%) were able to offer SET but only 21 (36%) could offer it to all their patients with PAD. Only four (6.8%) offered SET that was fully compliant with current NICE guidelines. Reasons identified included insufficient funding, lack of resource and poor patient compliance. Conclusions The benefits of SET are well established yet the availability of the service in the UK is poor. The reasons for this are readily identified but have not yet been overcome. Research on novel methods of delivering supervised exercise that mitigates existing barriers, such as home exercise with remote monitoring, should be prioritised to facilitate optimal management for our patients with PAD.
Can one-step nucleic acid amplification assay predict four or more positive axillary lymph node involvement in breast cancer patients: a single-centre retrospective study
Authors: Kenny R , Wong G , Gould L , Odofin O , Bowyer R , Sotheran W 
Published: May 2023

Background One-step nucleic acid amplification (OSNA) assay is a proven, accurate, intraoperative method for the detection of lymph node (LN) metastases. The aim of this study was to assess if the total tumour load (TTL) as calculated by OSNA could be used to predict N2 stage disease, ie ≥4 LN containing metastases, in invasive breast cancer patients. Methods Between 2011 and 2019 at St Richard’s Hospital, Chichester, all macro-metastasis-positive OSNA cases for invasive breast cancer were retrospectively reviewed. The association between clinicopathological variables and ≥4 LNs containing metastases was analysed using regression analysis. Results In total, 134 patients with positive sentinel lymph node (SLN) on OSNA undergoing axillary node clearance were analysed, 53% of whom had no further positive LN, 25% had ≥4 lymph nodes positive. TTL was calculated as the aggregate of cytokeratin-19 mRNA copy count of all SLN tissue analysed via OSNA. TTL ≥1.1×105copies/μl and lymphovascular invasion (LVI) were both significant predictors of N2 stage disease on both univariate (TTL p=0.04, LVI p=0.005) and multivariate (TTL p=0.008, LVI p=0.039) regression analysis. Conclusion Our findings show that SLN TTL via intraoperative OSNA assay can predict four or more positive axillary LN involvement in invasive breast cancer. This is important in that it may be used intraoperatively by surgeons to decide on whether to proceed with a full axillary node clearance in order to stage the axilla. Further research is required to shape future guidance.
Patient characteristics and refusal to participate in a head and neck cancer intervention trial: experience of two tertiary UK head and neck cancer centres
Authors: Rogers SN , Lowe D , Highet V , Dukanovic G , Lowies C , Thomas S , Kanatas A 
Published: May 2023

Introduction Randomised clinical trials are an essential component for robust clinical evaluation. They are expensive to deliver but can fail to achieve the required outcomes. This paper reports details of trial recruitment in a head and neck Patient Concerns Inventory intervention trial from two UK head and neck tertiary centres. Materials and methods Data were collected for a pragmatic cluster preference randomised control trial with 15 consultants recruiting patients treated with curative intent after a diagnosis of head and neck cancer (all sites, disease stages, treatments). Ethical approval was given to report on those not recruited by the following characteristics: trial site, trial arm, age, sex, tumour site, overall stage, index of multiple deprivation quintile, timeframe. Results There were 368 patients approached who remained eligible and 80 (22%) declined to participate. Logistic regression suggested that age group (p = 0.008) and index of multiple deprivation quintile group (p = 0.003) were independent predictors of refusal. Conclusions Although recruitment to the trial was very good, it raised the issue of lower recruitment in the more deprived older group and lower social economic strata. Innovative ways need to be explored to facilitate the ‘hard to reach’ group contributing to, and benefiting from, clinical trials.
The effect of strap muscle transection on voice and swallowing changes after thyroidectomy in patients without laryngeal nerve injury
Authors: Aygun N , Celayir MF , Isgor A , Uludag M 
Published: May 2023

Introduction Voice and swallowing symptoms are frequently reported after thyroidectomy even without laryngeal nerve injury. We aimed to evaluate the effect of strap muscle transection on voice and swallowing outcome after thyroidectomy. Methods Group 1 (G1) consisted of 17 patients who had their strap muscles transected during thyroidectomy and group 2 (G2) consisted of 17 patients who had their strap muscles preserved during thyroidectomy. None of the patients had laryngeal nerve injury. Voice impairment scores (VIS) and swallowing impairment scores (SIS) were obtained preoperatively and at 1 week and 1, 3 and 6 months postoperatively. Pre- and postoperative vocal cord examinations were performed for all patients. The external branch of the superior laryngeal nerve (EBSLN) was evaluated by intraoperative cricothyroid muscle electromyography. Results There was no significant difference in VIS and SIS between the two groups. At postoperative week 1, the VIS and SIS for each group were above preoperative values (G1: p = 0.005 and p = 0.035; G2: p = 0.031, p = 0.346, for VIS and SIS respectively). The VIS and SIS scores at 6 months postoperatively were significantly lower than those of the first week postoperatively (G1: p = 0.04 and p = 0.001; G2: p = 0.022 and p = 0.034 respectively) and similar to preoperative values (G1: p = 0.924 and p = 0.086; G2: p = 0.822 and p = 0.187 respectively). Conclusion Although voice and swallowing complaints increased in the early postoperative period even without recurrent laryngeal nerve and EBSLN injuries, these symptoms are not related with the strap muscle transection.
Idiopathic granulomatous mastitis: experience at a New York hospital
Authors: Bhattarai P , Srinivasan A , Valenzuela CD , Sulzbach C , Wallack MK , Mariadason JG 
Published: May 2023

Introduction Idiopathic granulomatous mastitis (IGM) often mimics breast cancer. Presentation includes pain, palpable mass, suppuration or suspicious imaging. Widely reported in Asia and the Middle East, IGM is diagnosed after excluding specific granulomatous mastitis (SGM). Aetiology remains unknown. Lactation, prolactinaemia, ethnicity, autoimmune disease and Corynebacteria are associated. Treatment is controversial and the prevalence rising. Surgery and non-operative treatments including antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), steroids, methotrexate and observation have advocates. Methods A retrospective chart review of 63 patients with IGM from 2008 to 2018 was undertaken focusing on birthplace, age, clinical presentation, wound cultures, imaging, treatments and outcomes. Results Sixty-one of 63 patients were Hispanic; 53 were Mexican-born women aged 23–46. Clinical presentation included pain, painful mass, painless mass, suppuration and abnormal imaging. Some 31/61 ultrasound examinations and 17/33 mammograms were deemed Breast Imaging Reporting and Data System (BI-RADS) score 4 or 5. Management included antibiotics (43), incision and drainage (24), NSAIDs (29), steroids (8), lumpectomy (18) and observation (12). Some 12/20 patients with painless masses resolved with observation, 3 received NSAIDs, 2 received steroids and 3 underwent lumpectomies. Antibiotics resolved 8/43 cases, 5 needed incision and drainage, 26 received NSAIDs, 6 received steroids and 5 underwent lumpectomies. Nineteen patients had indolent disease or recurrence. Conclusions Excluding malignancy is critical, treatment challenging and recurrence common in IGM. A preponderance of patients were Mexican-born, similar to other reports from the USA. Over 50% of IGM cases had suspicious BI-RADS scores. Best management remains a challenge and ranges from observation to lumpectomy.
A survey of UK and Irish surgeons’ attitudes, behaviours and barriers to change for environmental sustainability
Authors: Harris H , Bhutta MF , Rizan C 
Published: May 2023

Introduction Surgery is a major contributor to the large environmental impact of healthcare, demanding urgent attention. To date there are no data on the attitudes and behaviours of surgeons towards climate change, or perceived barriers towards sustainable practice. Methods We invited surgeons and surgical trainees in the UK and Ireland to participate in an online survey (developed in accordance with the CHERRIES checklist) conducted between June and November 2020 and disseminated via the Royal College of Surgeons of England, Edinburgh and Ireland, the Association of Surgeons in Training and through local communication. Results We received 130 responses, across 14 surgical specialties. The majority of respondents (122/130; 94%) were concerned about the threat of climate change. Most respondents had instigated more sustainable practices in their personal lives (113/130; 87%) and, to a lesser extent, at work (73/130; 56%). Surgeons were willing to make changes to their clinical practice (107/130; 82%), but the main perceived barrier to improving sustainability was a lack of leadership (92/130; 70%). Surgeons welcomed greater leadership and guidance from national bodies (118/130; 91%) and more monitoring and regulation (113/130; 87%). Conclusions The surgeons who responded to our survey are concerned about climate change and willing to engage in efforts to transition to more sustainable practice, but would welcome greater support, guidance and leadership.
Optical trapping of gold microparticles using linearly polarized, centrally obstructed Gaussian beams
Authors: Yun Xue , Liang Yansheng , He Minru , Zhao Tianyu , Wang Shaowei , Lei Ming 
Published: May 2023

Metallic microparticles larger than the illumination wavelength are commonly considered poor optical trapping candidates due to their high extinction coefficient. This paper presents a numerical and experimental study on the three-dimensional (3D) trapping of gold microparticles using a centrally obstructed Gaussian beam based on the T-matrix method. The range of particle size for stable optical trapping is determined. For the trapping numerical aperture of 1.32 and illumination wavelength of 1.064 µm, numerical analysis proves that 3D trapping of gold microparticles with a radius bigger than 1.0 µm can be readily achieved. By imprinting a digital lens to the spatial light modulator, we slightly defocus the centrally obstructed Gaussian beam to shift the trapping location to the focal plane for clear observation. Experimental results demonstrate stable trapping of gold microparticles with a radius greater than 1.4 µm at high-power illumination, agreeing well with the theoretical predictions. The presented work should be of interest to the community applying metallic microparticles to relevant research.
Reduction formula for cross-spectral purity of nonstationary light fields
Authors: Laatikainen Jyrki , Luo Meilan , Halder Atri , Koivurova Matias , Setälä Tero , Turunen Jari , Friberg Ari T. 
Published: May 2023

We examine cross-spectral purity of random, nonstationary (pulsed), scalar light fields with arbitrary spectral bandwidth. In particular, we derive a reduction formula in terms of time-integrated coherence functions, which ensures cross-spectral purity of interfering fields having identical normalized spectra. We further introduce fields that are cross-spectrally pure in either a global or local sense. Our analysis is based on an ideal field superposition realizable with all-reflective wavefront-shearing interferometers. Such devices avoid certain problems related to Young’s interferometer, which is the framework customarily employed in assessing cross-spectral purity. We show that any partially coherent beam can be transformed into a locally cross-spectrally pure beam whose cross-spectral density is specular. On the other hand, lack of space–frequency (and space–time) coupling ensures cross-spectral purity in the global sense, i.e., across an entire transverse plane, regardless of the spectral bandwidth or the temporal shape of the pulses.
Socioeconomic inequalities in employees’ health-enhancing physical activity: Evidence from the SHAHWAR cohort study in Iran
Authors: Khoramrooz Maryam , Zare Fariba , Sadeghian Farideh , Dadgari Ali , Chaman Reza , Mirrezaie Seyed Mohammad 
Published: May 2023

Background
Increasing level of physical activity (PA) among working population is of particular importance, because of the high return of investment on employees’ PA. This study was aimed to investigate socioeconomic inequalities in Health-Enhancing Physical Activity (HEPA) among employees of a Medical Sciences University in Iran.

Methods
Data were extracted from the SHAHWAR Cohort study in Iran. Concentration index (C) and Wagstaff decomposition techniques were applied to determine socioeconomic inequality in the study outcomes and its contributors, respectively.

Results
Nearly half of the university employees (44.6%) had poor HEPA, and employees with high socioeconomic status (SES) suffered more from it (C = 0.109; 95% CI: 0.075, 0.143). Also, we found while poor work-related PA (C = 0.175; 95% CI: 0.142, 0.209) and poor transport-related PA (C = 0.081, 95% CI: 0.047, 0.115) were more concentrated among high-SES employees, low-SES employees more affected by the poor PA at leisure time (C = -0.180; 95% CI: -0.213, -0.146). Shift working, and having higher SES and subjective social status were the main factors that positively contributed to the measured inequality in employees’ poor HEPA by 33%, 31.7%, and 29%, respectively, whereas, having a married life had a negative contribution of -39.1%. The measured inequality in poor leisure-time PA was mainly attributable to SES, having a married life, urban residency, and female gender by 58.1%, 32.5%, 28.5%, and -32.6%, respectively. SES, urban residency, shift working, and female gender, with the contributions of 42%, 33.5%, 21.6%, and -17.3%, respectively, were the main contributors of poor work-related PA inequality. Urban residency, having a married life, SES, and subjective social status mainly contributed to the inequality of poor transport-related PA by 82.9%, -58.7%, 36.3%, and 33.5%, respectively, followed by using a personal car (12.3%) and female gender (11.3%).

Conclusions
To reduce the measured inequalities in employees’ PA, workplace health promotion programs should aim to educate and support male, urban resident, high-SES, high-social-class, and non-shift work employees to increase their PA at workplace, and female, married, rural resident, and low-SES employees to increase their leisure-time PA. Active transportation can be promoted among female, married, urban resident, high-SES, and high-social-class employees and those use a personal car.
Central Banking in Perilous Times: An Open-Ended Chronicle
Authors: Biondi Yuri 
Published: May 2023

AbstractConventional understanding relegates the role of central banking to benchmark interest rate guidance which is supposed to have direct and straightforward impact on real economy. Accordingly, central banks are praised for and supposed to stay independent from treasuries and money markets while indirectly influencing both of them by that guidance. This article provides hints for an alternative explanation by investigating central bank dual connection with treasuries and private finance, especially money markets. It recounts the main financial episodes of the last decades from this institutional monetary economic perspective through a dynamic systems analysis covering money and financial aggregates, pointing to the peculiar ways in which this connection has been organised under the market-based (asset-based) finance regime and its systemic failure since 2007.
Transcending artistic boundaries – pre-war Japanese avant-gardes through the lens of two migrant artists: David Burliuk and Varvara Bubnova
Authors: Isaeva Olga 
Published: May 2023

Abstract
This paper problematizes the role two migrant artists David Davidovich Burliuk and Varvara Dmitrejenva Bubnova played in (re)defining the Japanese pre-war avant-gardes during the Taishō period (1912–1926). Careful consideration is given to the contextually based artistic practice in relation to the specific Japanese history of modernization, the establishment of art institutions, and state-controlled exhibition systems on one hand. On the other hand, however, an argument is made for complicating this context with multipolar and yet entangled avant-gardes composed of many histories that connect and diverge at the same time. The primary focus lies on closely describing and highlighting these profound connections, encounters, and exchanges, regardless their length or intensity. The article aims to trace and discuss the experiences of the two migrant artists who redefined themselves within the local context, based on the choices they made and the barriers they faced.
Revisiting SFA stent technology: an updated overview on mechanical stent performance
Authors: Schmidt Wolfram , Brandt-Wunderlich Christoph , Behrens Peter , Kopetsch Christoph , Schmitz Klaus-Peter , Andresen Julian Ramin , Grabow Niels 
Published: May 2023

Abstract

Objectives
The study investigated mechanical parameters of stent systems indicated for treatment of femoropopliteal (FP) arterial disease to support interpretation of clinical results and the related causalities.

Methods
Eight stent system types of same dimensions were investigated (n=2). Parameters were the profile of stent delivery system (SDS), radiopacity, trackability and pushability, bending stiffness (flexibility) and axial stiffness of expanded stents, length change during expansion, radial force, crush resistance, strut thickness and general surface condition.

Results
The trackability ranged from 0.237 to 0.920 N and the pushability was 47.9–67.6 %. The bending stiffness of SDS was between 108.42 and 412.68 N mm2. The length change during stent release to 5 mm was low, with one exception. The bending stiffness of the expanded stents was 2.73–41.67 N mm2. The normalized radial forces at 5 mm diameter ranged from 0.133 N/mm to 0.503 N/mm. During non-radial compression by 50 %, the forces were 3.07–8.42 N, with one exception (58.7 N). The strut thickness was 153–231 µm.

Conclusions
Large differences occurred for flexibility, radial force and length change during expansion. The data should be used when choosing the proper device for restoring vascular function.