Truxinates and truxillates: building blocks for architecturally complex polymers and advanced materials.

Significant advancements in the syntheses of cyclobutane containing small molecules and polymers are described in the last 15 years. Small molecule cyclobutanes are under investigation for their diverse pharmacological activities, while polymers with cyclobutane backbones are emerging as novel mechanophores, stress-responsive materials, and sustainable plastics. Within these chemistries, [2 + 2] photocycloadditions to yield truxinates and truxillates are highly efficient offering a versatile strategy to access complex scaffolds.

Accessing Cyclobutane Polymers: Overcoming Synthetic Challenges via Efficient Continuous Flow [2 + 2] Photopolymerization.

We report an improved and efficient method to prepare well-defined, structurally complex truxinate cyclobutane polymers via a thioxanthone sensitized solution state [2 + 2] photopolymerization. Monomers with varying electron density and structure polymerize in good to excellent yields to afford a library of 42 polyesters. Monomers with internal olefin separation distances of greater than 5 Å undergo polymerization via intermolecular [2 + 2] photocycloaddition readily, as opposed to the intramolecular [2 + 2] photocycloaddition observed in monomers with olefins in closer proximity.

The effect of implementing a transanal minimally invasive surgical programme for the local excision of early rectal neoplasia on outcomes in a tertiary referral rectal cancer centre.

Transanal minimally invasive surgery (TAMIS) is a surgical alternative to proctectomy in the management of complex rectal polyps and early rectal cancers. In 2016, our institution introduced a TAMIS programme. The purpose of this study was to evaluate changes in practice and outcomes in our institution in the 3 years before and after the implementation of TAMIS.

Evaluation of different approaches to define expert benchmark scores for new robotic training simulators based on the Medtronic HUGO™ RAS surgical robot experience.

New robot-assisted surgery platforms being developed will be required to have proficiency-based simulation training available. Scoring methodologies and performance feedback for trainees are currently not consistent across all robotic simulator platforms. Also, there are virtually no prior publications on how VR simulation passing benchmarks have been established.

The role of radiotherapy in the management of nodal disease in breast cancer.

The management of nodal disease in breast cancer has evolved over the last two decades. With minimalist surgical approaches for early breast cancers becoming commonplace, the question of whether radiation can replace surgery to reduce morbidity is an important question in this population, as decision making has become more complex. In more advanced disease, and in patients with significant high-risk clinical and/or pathological features, the dilemma of who should receive regional nodal irradiation has been addressed in large studies but remains controversial.