Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Moving the Needle: Program Directors' Views on the Recruitment of Diverse Trainees to Plastic Surgery Residency.","authors":"Natalie B Baxter, Timothy C Guetterman, Noelle Thompson, Mary L Byrnes, Gurjit Sandhu, Rachel C Hooper","doi":"10.1097/GOX.0000000000006915","DOIUrl":"10.1097/GOX.0000000000006915","url":null,"abstract":"<p><strong>Background: </strong>The plastic surgery workforce lacks racial and ethnic diversity. Traditionally, United States Medical Licensing Examination scores have been used as the initial screening tool for most residency programs; however, this can lead to interview selection bias against underrepresented in medicine (URiM) applicants. Understanding the barriers and facilitators to diversifying the specialty from the perspectives of program directors (PDs) may reveal strategies for improvement.</p><p><strong>Methods: </strong>In this mixed methods study, we invited integrated plastic surgery PDs to participate in an online survey and one-on-one semistructured interviews to understand their perspectives on the application process, interview day, and strategies to improve recruitment and retention of URiM trainees. Descriptive statistics were used to analyze the survey data. Interviews were deidentified, transcribed, and analyzed inductively to generate themes based on patterns observed across narratives.</p><p><strong>Results: </strong>Of 108 PDs and assistant PDs, 29 (26.9%) responded to the survey and 8 participated in semistructured interviews. We identified 3 broad themes: (1) resident diversity is important for patient care and education, (2) lack of exposure and longitudinal mentorship are barriers to matriculation, and (3) program culture change can shift trends in the recruitment of URiM trainees.</p><p><strong>Conclusions: </strong>PDs value the racial and ethnic diversity of trainees and are in favor of efforts to increase representation in the field. Improving mentorship and reducing bias in the application process are necessary strategies to increase representation in plastic surgery.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6915"},"PeriodicalIF":1.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12190121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Assessment of the Longitudinal Impact of Gender-affirming Care in an Adolescent and Young Adult Transmasculine and Nonbinary Patient Population.","authors":"Emily Ewing, Gabriela Sendek, Miriam Becker, Edna Montes, RocNeil Nguyen, Rachel Jenkins, Clara Lee, Andrew Richardson, Bixby Marino-Kibbee, David Inwards-Breland, Amanda Gosman","doi":"10.1097/GOX.0000000000006911","DOIUrl":"10.1097/GOX.0000000000006911","url":null,"abstract":"<p><strong>Background: </strong>Gender-affirming care (GAC) during adolescence is associated with decreased adverse gender dysphoria-related outcomes and steadily improved psychological functioning into young adulthood. This single-institution, longitudinal study examined the impact of GAC on various treatment outcomes for transgender and nonbinary adolescents and young adults. Participants included 110 transmasculine and nonbinary adolescents and young adults who were referred for gender-affirming top surgery through the Center for Gender-Affirming Care and Plastic Surgery multidisciplinary clinic at Rady Children's Hospital, San Diego.</p><p><strong>Methods: </strong>Outcomes were assessed via the Patient Health Questionnaire-2, chest and gender dysphoria scales, and surgical satisfaction scales, which were administered at various time points throughout treatment. Multilevel modeling was used to evaluate the impact of GAC on depressive symptoms, chest and gender dysphoria, and surgical satisfaction over time.</p><p><strong>Results: </strong>Significant reductions were observed in patient-reported depressive symptoms, gender dysphoria, and chest dysphoria before and after surgery. On average, survey results indicated that patients reported positive perceptions of their surgical experience, were satisfied with their surgical outcome, and had a positive recovery experience.</p><p><strong>Conclusions: </strong>Results suggest that GAC appears to have a measurable and beneficial impact on patients' mental health.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6911"},"PeriodicalIF":1.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Penetrating Injuries to the Sciatic Nerve, Highlighting Insights From Sudan.","authors":"Albra Kamal, Momen M Mohamed, Amin M Yassin, Hozifa Mohamed, Mohamed Dirar","doi":"10.1097/GOX.0000000000006901","DOIUrl":"10.1097/GOX.0000000000006901","url":null,"abstract":"<p><strong>Background: </strong>Sciatic nerves extend a considerable distance through the thigh and are near bone, which increases their risk of injury. This vulnerability can result in long-lasting morbidity and disability. Injuries caused by high-energy weapons can affect neural tissue through multiple pathways, and the effectiveness of subsequent interventions is often unpredictable.</p><p><strong>Methods: </strong>This is a descriptive retrospective analysis of a multicenter, cross-sectional hospital-based study focused on the evaluation and reconstruction of sciatic nerve injuries in Sudan from January 2022 to January 2024. The study encompassed all patients who had sciatic nerve injuries due to penetrating mechanisms and subsequently received reconstructive surgery. Patients with severe injuries leading to death and those with traumatic limb amputations have been excluded from the analysis.</p><p><strong>Results: </strong>Among the 34 patients studied, a significant majority, 85.3%, were men, whereas women constituted 14.7%. The highest representation was the 20- to 30-year-old group, which accounts for 50%. The primary cause of the injuries was gunshot wounds. Sciatic nerve injuries were associated with femoral fractures in 26.5%. The predominant surgical approach used was neurolysis (41.2%), with primary repair (35.3%) and nerve graft repair (23.5%). Deep sensation was restored within 6 months following surgery, except in 2.9% who did not recover sensation.</p><p><strong>Conclusions: </strong>The sciatic nerve is frequently injured due to penetrating wounds in the lower limbs, leading to potentially severe disabilities. Although surgical options can be beneficial, particularly for sensory restoration and managing neuropathic pain, it is vital to engage in rehabilitation as muscle recovery progresses.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6901"},"PeriodicalIF":1.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Russian Experience of Pediatric Subtotal Facial Tissue Replantation.","authors":"Alexey S Dikarev, Seyran A Vartanyan, Alexander A Martirosyan, Ivan A Zemlin, Kazbek U Kudzaev, Igor S Sergeev, Robert S Vartanyan, Daniel U Dryga, Irina O Vlasova, Elen V Gorgoma, Anna V Bilyak, Spartak S Anthoniadis, Daniel U Rudenok, Elena I Kletshenko","doi":"10.1097/GOX.0000000000006906","DOIUrl":"10.1097/GOX.0000000000006906","url":null,"abstract":"<p><p>Treatment and rehabilitation of patients with posttraumatic, contaminated, lacerated wounds present a complex challenge. The concept of delayed, multistage treatment, as well as the rehabilitation protocols for pediatric patients is associated with a series of reconstructive procedures, one of which is face transplantation; however, it remains an unresolved issue to date due to the development of immunologic tissue intolerance by the recipient, as well as various psychosocial rehabilitation challenges. The challenge of successful pediatric replantation creates interest in the global medical community to develop generalized algorithms for managing patients with posttraumatic subtotal facial defects. This case report demonstrated the experience of the first posttraumatic subtotal facial replantation less than 12 hours after injury in a pediatric patient in Russia. The goal of this work was to show the algorithm used in the case of a pediatric posttraumatic subtotal facial defect in hopes of aiding the future development of such guidelines.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6906"},"PeriodicalIF":1.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic Reconstruction of a Surgically Absent Rectum Using AlloDerm.","authors":"Reade Otto-Moudry, Elijah Castle, Gaines Blasdel, Kirtishri Mishra, Jeffery Lin, Rachel Bluebond-Langner, Lee Zhao","doi":"10.1097/GOX.0000000000006919","DOIUrl":"10.1097/GOX.0000000000006919","url":null,"abstract":"<p><p>This case report and accompanying technique video demonstrate the robotically assisted reconstruction of a surgically absent rectum following prior proctectomy to facilitate receptive anal sex. This novel technique uses AlloDerm to provide the full extent of soft tissue coverage without donor site morbidity and provides a promising avenue for anal canal reconstruction.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6919"},"PeriodicalIF":1.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Costs in Plastic Surgery: A Systematic Review of Time-driven Activity-based Costing Applications.","authors":"Emily L Isch, Gabrielle Kozlowski, D Mitchell Self, Theodore E Habarth-Morales, Sydney Somers, Ahilan Sivaganesan, David Kim, Heather McMahon, Andrew Newman, Matthew Jenkins","doi":"10.1097/GOX.0000000000006865","DOIUrl":"10.1097/GOX.0000000000006865","url":null,"abstract":"<p><strong>Background: </strong>The rising complexity and cost of healthcare in plastic surgery, particularly in resource-intensive procedures like free flap and breast reconstruction, pose significant financial challenges. Time-driven activity-based costing (TDABC) offers a method to accurately assess these costs by mapping each step of the care cycle based on time and resources consumed. Although TDABC has been utilized in high-cost fields such as neurosurgery and spine surgery, its application in plastic surgery remains underexplored. This systematic review evaluates the literature on TDABC use in plastic surgery to identify key cost drivers and propose strategies for cost-efficiency.</p><p><strong>Methods: </strong>A systematic review was conducted on studies applying TDABC, activity-based costing, and cost-to-charge ratio in plastic surgery, sourced from PubMed. Inclusion criteria focused on peer-reviewed studies from the last decade assessing costing strategies in aesthetic and reconstructive plastic surgery, resulting in 17 studies that provided empirical data on cost drivers and resource allocation.</p><p><strong>Results: </strong>Operating room time, staffing, and postoperative care are identified as primary cost contributors in complex reconstructive surgery, with TDABC highlighting inefficiencies such as prolonged operating room time and unnecessary intensive care unit stays. Cost-saving opportunities were found in optimizing postoperative care and reallocating tasks to lower-cost personnel.</p><p><strong>Conclusions: </strong>TDABC provides a framework for cost optimization in plastic surgery by offering granular insights into resource utilization, allowing for targeted interventions that reduce expenses without compromising care quality. Future research should explore the application of TDABC to cosmetic procedures and assess its long-term cost-effectiveness in plastic surgery.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6865"},"PeriodicalIF":1.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications After Subpectoral and Prepectoral Tissue Expander Placement in Women Undergoing Postmastectomy Radiation Therapy.","authors":"Seamus Caragher, Alisha Paranzino, Stephen Stearns, Libby Copeland-Halperin, Jessica Erdmann-Sager","doi":"10.1097/GOX.0000000000006867","DOIUrl":"10.1097/GOX.0000000000006867","url":null,"abstract":"<p><strong>Background: </strong>Placement of tissue expanders is a critical tool in breast reconstruction, particularly with postmastectomy radiation. Prepectoral tissue expander placement has rapidly gained popularity. As such, the precise effects of tissue expander plane selection on outcomes following radiotherapy remain a key question.</p><p><strong>Methods: </strong>All patients undergoing mastectomy and tissue expander placement followed by radiation at a single center between 2019 and 2021 were retrospectively examined. Clinical, oncological, surgical, and radiation treatment variables, as well as rate of complications before and after radiation, were collected. Multivariate analysis was performed.</p><p><strong>Results: </strong>The 2 groups had similar baseline clinical and oncological characteristics. Prepectoral placement was more common in bilateral reconstruction and had smaller final tissue expander volume to mastectomy specimen weight ratio. There was no difference in the rate of postoperative or radiation complications based on tissue expander location (17% versus 18%). Multivariable analysis identified acellular dermal matrix as a significant protective factor against perioperative complications (odds ratio [OR]: 0.15; 95% confidence interval [CI]: 0.03-0.78). Increased age and the use of neoadjuvant chemotherapy were significant risk factors for radiation-related complications (age OR: 2.6; 95% CI: 1.02-6.63; Chemo OR: 16.7; 95% CI: 1.55-180).</p><p><strong>Conclusions: </strong>Prepectoral tissue expander placement can be safely used with postmastectomy radiation. These results highlight acellular dermal matrix use as a major protective factor against complications in these patients. Independently, increased age and the use of neoadjuvant chemotherapy increased the risk of radiation-induced complications. The lack of significant risk with other variables can further assure surgeons of the safe use of prepectoral expanders in radiation-bound patients.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6867"},"PeriodicalIF":1.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Sternal Cleft Repair With Rib Graft and SurgiMend.","authors":"Reem Saleh Alrajhi, Qutaiba N M Shah Mardan, Abdullah M AlZahrani, Nora AlSaud, Mohamed Amir Mrad","doi":"10.1097/GOX.0000000000006817","DOIUrl":"10.1097/GOX.0000000000006817","url":null,"abstract":"<p><p>Early in development, driven by mostly unknown factors, a malformed sternum can manifest as a cleft. This is not innocuous, as surgical repair is required to mitigate the deleterious effects of unprotected thoracic organs, impaired respiratory function, and susceptibility to chest infections. We aimed to enrich the literature on this topic by presenting the case of a 10-month-old boy diagnosed with a sternal cleft who underwent reconstruction using a rib cartilage bridging graft supported with fascia and acellular dermal matrix. Management outcomes are expected to improve as surgical approaches evolve from simple primary sternal closure to using cartilaginous or bony grafts and leveraging adjacent soft tissue for added coverage.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6817"},"PeriodicalIF":1.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-in-human Testing of a Novel Sutureless Drain Securement Device: A Randomized Clinical Trial.","authors":"Mary L Duet, Eric Zeng, Michael K Boyajian, Donald T Browne, Abigail Peoples, Marion Tapp, Robert Siska, Thomas Steele, Bennett W Calder, Christopher Runyan, Lisa R David","doi":"10.1097/GOX.0000000000006888","DOIUrl":"10.1097/GOX.0000000000006888","url":null,"abstract":"<p><strong>Background: </strong>Suture-based drain securement is nonstandardized and causes discomfort, particularly at the site of fixation as drain movement is transmitted to a focal point. Patients may experience skin irritation, pain, skin tugging, and loosening or unintended loss of the drain. A novel sutureless drain securement device, K-LOCK, was designed with patient safety and comfort in mind to reduce risks associated with drain displacement and loss, potentially leading to complications or additional interventions.</p><p><strong>Methods: </strong>After institutional review board approval, 21 patients were enrolled in a randomized control trial after obtaining informed consent. Inclusion criteria required patients to be 18 years of age or older and undergoing a surgery involving placement of bilateral drains. Those with adhesive allergies were excluded. Patients were randomized to receive a right or left K-LOCK with the contralateral site undergoing suture-based drain securement. Outcomes included time to secure drains, adverse outcomes, patient satisfaction, and a blinded evaluation of skin sites at drain removal. Analysis was performed using paired <i>t</i> tests.</p><p><strong>Results: </strong>No drain securement failure was encountered. The average duration of drain placement was 9 days. Securement of the K-LOCK was significantly faster (<i>P</i> = 0.0008) when compared with traditional suture. Blinded skin site evaluations concluded there was no significant difference in erythema and blistering (<i>P</i> = 0.9384, <i>P</i> = 0.6058, respectively). Patients overwhelmingly favored the K-LOCK in all surveyed categories.</p><p><strong>Conclusions: </strong>The K-LOCK enhances the patient experience with surgical drains and offers a reliable, standardized alternative to traditional drain securement. Although these findings are promising, larger multicenter trials with long-term follow-up will be necessary to comprehensively assess the device.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6888"},"PeriodicalIF":1.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Efficacy of Endoscopic Carpal Tunnel Repair Versus Open Surgery: A Systematic Review and Meta-analysis of Randomized Control Trials.","authors":"Yazeed A Almojel, Hussam A Alhathlol, Yazeed A Asery, Nawaf K Nahhas, Mohammed I Alhumaidan, Maan Almaghrabi, Mohammed D Alqarni, Alaa Alsahli, Turki S Alhassan","doi":"10.1097/GOX.0000000000006887","DOIUrl":"10.1097/GOX.0000000000006887","url":null,"abstract":"<p><strong>Background: </strong>Surgical decompression of carpal tunnel syndrome by the standard open carpal tunnel release (OCTR) technique was associated with postoperative pain and tenderness. Thus, the endoscopic carpal tunnel release (ECTR) has been introduced to reduce the complications of open surgery through a shorter incision to decrease scar pain and achieve rapid recovery. In this study, we aimed to compare the outcomes between OCTR and ECTR, according to randomized controlled trial evidence.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Web of Science, EBSCO, and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Meta-analysis was performed using Comprehensive Meta-analysis software. Standard mean difference and a 95% confidence interval were used for continuous outcomes, whereas odds ratio with 95% confidence intervals were utilized for dichotomous outcomes.</p><p><strong>Results: </strong>A total of 34 studies were included. ECTR has shown significant lower rates of scar pain and significant shorter recovery compared OCRT. However, we could not find any significant difference between the groups in terms of complication rates, incidences of local pain, mean pain scores, subjective complete or near complete symptom relief rate, subjective complete satisfaction rate, mean satisfaction scores, mean scores of symptom severity, mean scores of functional status, and mean time of operation.</p><p><strong>Conclusions: </strong>Both ECTR and OCTR are safe and effective in management of carpal tunnel syndrome. However, ECTR may be slightly superior in terms of scar pain and postoperative recovery, although other factors not included in this study, including cost and convenience, must be considered.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6887"},"PeriodicalIF":1.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}