BMJ Surgery Interventions Health Technologies最新文献

{"title":"Ending nuclear weapons, before they end us.","authors":"Chris Zielinski","doi":"10.1136/bmjsit-2025-000412","DOIUrl":"10.1136/bmjsit-2025-000412","url":null,"abstract":"","PeriodicalId":33349,"journal":{"name":"BMJ Surgery Interventions Health Technologies","volume":"7 1","pages":"e000412"},"PeriodicalIF":2.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095088","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":"Developing an innovative interventional approach for stenting trachea.","authors":"Maryam Mazraehei Farahani, Abdol-Mohammad Kajbafzadeh, Arda Kiani, Hossein Kazemizadeh, Mostafa Baghani","doi":"10.1136/bmjsit-2022-000180","DOIUrl":"10.1136/bmjsit-2022-000180","url":null,"abstract":"<p><strong>Objectives: </strong>Stenting is a method of controlling airway occlusions (CAO) that can be used alone or in combination with other treatments. There are different types of airway stents. One of the most widely used types is silicone stent. These stents are flexible and firm enough cylinders inserted into the airway by a rigid scope to relieve dyspnoea caused by CAO in malignant and non-malignant diseases. We have developed a method that can be applied quickly in remote urgent cases without a rigid scope.</p><p><strong>Design: </strong>We used two endotracheal tubes with a size of 8.5 for stenting.</p><p><strong>Setting: </strong>This research was conducted at Pediatric Urology and Regenerative Medicine Research Center, Children's Medical Center, Pediatric Center of Excellence, Animal Lab Tehran University of Medical Sciences, Tehran, Iran (IR).</p><p><strong>Participants instead of patients or subjects: </strong>Two certified mature sheep (ewes).</p><p><strong>Interventions: </strong>Silicone stent placement for 2 months.</p><p><strong>Main outcome measures: </strong>A method with minimal facilities for stenting without limitation of trachea size.</p><p><strong>Results: </strong>A pilot animal study has been performed on two mature certified sheep to test a stenting procedure. Stenting procedures have been successfully implemented on the animals' trachea.</p><p><strong>Conclusions: </strong>We have developed a new simple, fast and cheap procedure for stenting silicon stents with minimum risk. We can easily place and rotate the stent during the procedure.</p>","PeriodicalId":33349,"journal":{"name":"BMJ Surgery Interventions Health Technologies","volume":"7 1","pages":"e000180"},"PeriodicalIF":2.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102757","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":"Incomplete reperfusion and the presence of distal emboli in predicting clinical outcome after endovascular thrombectomy.","authors":"Amir Molaie, Salvador Miralbes, Bharath Naravetla, Alejandro M Spiotta, Christian Loehr, Mario Martínez-Galdámez, Ryan A McTaggart, Luc Defreyne, Pedro Vega, Osama O Zaidat, Paul Jenkins, Markus Möhlenbruch, Rishi Gupta, David S Liebeskind","doi":"10.1136/bmjsit-2024-000345","DOIUrl":"https://doi.org/10.1136/bmjsit-2024-000345","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the relationship between final expanded treatment in cerebral infarction (eTICI) score and the presence or absence of distal emboli on final angiography on clinical outcome after endovascular thrombectomy (EVT) for acute ischaemic stroke (AIS). Persistent distal emboli on angiography are commonly noted, yet not all patients with intermediate eTICI scores demonstrate clear angiographic emboli, raising the possibility that these angiographic differences may correlate with distinct mechanisms of 'no-reflow'. Therefore, we sought to better understand the potential clinical impact of such angiographic markers in cases of incomplete reperfusion.</p><p><strong>Design: </strong>We performed an exploratory retrospective analysis of a prospectively collected group of AIS patients who underwent EVT for M1 occlusions using the ASSIST Registry.</p><p><strong>Setting: </strong>71 sites in 11 countries participated in the registry.</p><p><strong>Participants: </strong>A total of 650 patients with M1 occlusions were included.</p><p><strong>Main outcome measures: </strong>We compared 90-day modified Rankin scale (mRS) scores based on eTICI score as well as the presence or absence of distal emboli on final angiography.</p><p><strong>Results: </strong>Clinical outcome based only on eTICI score revealed a shift in 90-day mRS, with a significant difference across eTICI scores in predicting 90-day mRS 0-2. In the intermediate eTICI grades 2b67 and 2c, there was a trend towards better 90-day mRS when emboli were present on final angiography than when emboli were absent. However, pairwise comparisons between these levels were non-significant.</p><p><strong>Conclusion: </strong>In patients with final eTICI 2b67 or 2c, those with persistent emboli trended towards better clinical outcomes. With intermediate eTICI reperfusion, identifying the presence or absence of distal emboli on final angiography may be useful in distinguishing patterns of incomplete reperfusion. These findings should be followed by investigations on correlation between angiography and other markers of microcirculatory 'no-reflow'.</p><p><strong>Trial registration number: </strong>NCT03845491.</p>","PeriodicalId":33349,"journal":{"name":"BMJ Surgery Interventions Health Technologies","volume":"7 1","pages":"e000345"},"PeriodicalIF":2.1,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015305","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":"Early clinical evaluation of the Hugo robotic-assisted surgery (RAS) for performing radical prostatectomy: an IDEAL stage 2 study.","authors":"Andrew Shepherd, Ata Jaffer, Angus Bruce, Daniel Chia, Prokar Dasgupta, Ben Challacombe","doi":"10.1136/bmjsit-2024-000360","DOIUrl":"10.1136/bmjsit-2024-000360","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the feasibility and safety of the new Hugo robotic-assisted surgery (RAS) system for robotic-assisted radical prostatectomy (RARP), describing iterative changes in our operative technique-IDEAL stage 2.</p><p><strong>Design: </strong>Prospective, single-centre series.</p><p><strong>Setting: </strong>Tertiary urological unit in London, UK.</p><p><strong>Participants: </strong>Male patients diagnosed with clinically localised prostate cancer and suitable for RARP from February 2023 to May 2024.</p><p><strong>Main outcome measures: </strong>The primary outcome was to assess the safety of using the device without converting to the existing robotic platform (da Vinci), laparoscopy or open. Secondary outcomes assessed surgical (operative time, blood loss, time to catheter removal, complications), oncologic (surgical pathology and margin status) and early functional (continence) outcomes.</p><p><strong>Results: </strong>50 patients were included in the study. No cases required conversion to an existing robotic platform, laparoscopy or open, and there were no intraoperative surgical complications. Mean age was 60 years and mean prostate-specific antigen was 12.2 ng/mL. The mean operative time was 148 min and estimated blood loss was 168 mL. Mean length of stay was 1.5 days and mean length of catheter duration was 13 days. On final pathology, 18 patients (36%) had T3 disease and four had positive surgical margins (8%). The mean International Consultation on Incontinence Questionnaire-Urinary Incontinence score for urinary continence at 3 months was 7. There were six Clavien-Dindo grade 2 complications and two Clavien-Dindo 3a complications. There were four instances of recoverable, temporary device failure. Iterative improvements were made to docking setup, use of robotic instruments and reduction in robotic arm collisions.</p><p><strong>Conclusions: </strong>We demonstrated feasibility and the safe introduction of the Hugo RAS for RARP into an experienced robotic urological programme. Perioperative, early oncological and functional outcomes were similar to other early series. Further studies will aim to describe the learning curve with this robot and optimisation of surgical quality.</p>","PeriodicalId":33349,"journal":{"name":"BMJ Surgery Interventions Health Technologies","volume":"7 1","pages":"e000360"},"PeriodicalIF":2.1,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804438","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":"Patient perspectives on AI-based decision support in surgery.","authors":"Sara Ben Hmido, Houssam Abder Rahim, Corrette Ploem, Saskia Haitjema, Olga Damman, Geert Kazemier, Freek Daams","doi":"10.1136/bmjsit-2024-000365","DOIUrl":"10.1136/bmjsit-2024-000365","url":null,"abstract":"<p><strong>Background: </strong>Predictive machine learning in healthcare, especially in surgical decisions, is advancing swiftly. Yet, literature on patient views regarding predictive machine learning, specifically its use throughout the clinical course, is scarce. Views among patients who underwent colorectal surgery (CRS) on the use of intra-operative predictive machine learning (IPML) by surgeons, particularly those aiming to predict colorectal anastomotic leakage (CAL), were explored in this study.</p><p><strong>Objective: </strong>This study investigated the views of patients who previously underwent CRS on the implementation of IPML models. Domains of interest were perceptions of IPML, perceived role in decision-making and information provided in the clinical encounter.</p><p><strong>Methods: </strong>A qualitative research design was employed, using focus groups and semi-structured interviews with patients who had undergone CRS. Descriptive thematic analysis was used to analyse data and identify prevailing themes and attitudes. The associations in the code tree were established based on a co-occurrence table. The patient sample size was determined using a saturation analysis.</p><p><strong>Results: </strong>A study with n=19 participants across four focus groups and seven interviews found a generally positive perception regarding the use of IPML models in CRS. Participants recognised their potential to enhance surgical decision-making but stressed the surgeon's role as the primary decision-maker, suggesting IPML models act as advisory tools, with surgeons able to override recommendations. Personalised communication and consideration of quality of life were emphasised, highlighting the need for a balanced integration of IPML models to support clinical judgement and the construction of patient preferences.</p><p><strong>Conclusion: </strong>IPML in CRS is well-received by participants, provided that surgeons retain the ability to override model recommendations and document their decisions transparently. Trust in the surgeon remains a key factor in patient acceptance of IPML, reinforcing the need for clear explanations during consultation sessions. Regardless of the use of IPML, tailoring patient communication and addressing the quality-of-life impacts of anastomosis vs stoma are also critical.</p>","PeriodicalId":33349,"journal":{"name":"BMJ Surgery Interventions Health Technologies","volume":"7 1","pages":"e000365"},"PeriodicalIF":2.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781538","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":"Middle meningeal artery embolization for chronic subdural hematoma.","authors":"Malgorzata Maciaszek, Brendan Steinfort, Timothy Harrington, Ken Faulder, Nazih Assaad, Mark Dexter, Alice Ma","doi":"10.1136/bmjsit-2024-000290","DOIUrl":"10.1136/bmjsit-2024-000290","url":null,"abstract":"<p><strong>Objectives: </strong>To assess recurrence rates, procedural outcomes and patient outcomes following middle meningeal artery (MMA) embolization for the treatment of chronic subdural hematomas (cSDH).</p><p><strong>Design: </strong>Retrospective case series.</p><p><strong>Setting: </strong>Two tertiary neurosurgical referral centers in Sydney, Australia.</p><p><strong>Participants: </strong>13 adult patients (mean age±SD, 68.5±9.5 years, 11 male) with 17 cSDHs (measuring 13.8±4.5 mm) undergoing MMA embolization alone (8/13) or with surgical evacuation (5/13) for cSDH. There were no exclusion criteria.</p><p><strong>Interventions: </strong>Embolization was performed via femoral access, using either liquid embolic, polyvinyl alcohol particles, coils, or a combination of agents. Embolization was done either as the sole treatment or with surgical evacuation.</p><p><strong>Main outcome measures: </strong>Primary outcomes were recurrence or increase in hematoma size requiring surgical evacuation. Secondary outcomes included procedural complications, hematoma size at follow-up, and patient clinical outcomes.</p><p><strong>Results: </strong>No procedural complications occurred. 12 patients were discharged home at baseline neurological function, and one was discharged to an aged care facility with significant disability. At follow-up (mean=8.7 weeks), combined embolization with surgical evacuation led to hematoma size reduction (14.3±2.6 mm to 5.7±6.5 mm, p<0.01), while embolization alone showed a stable hematoma size (13.3±5.7 mm to 10.0±8.8 mm, p=0.20). Recurrence or increase in hematoma size requiring surgical evacuation occurred in 2/13 (15.4%) patients, one of whom received only unilateral embolization, and the other received partial coiling due to the presence of dangerous collaterals.</p><p><strong>Conclusions: </strong>MMA embolization is a safe procedure that may reduce recurrence rates of cSDH when used as an adjunct to surgery or as a sole treatment. Possible reasons for treatment failure may include unilateral embolization, partial coiling, and absence of distal penetration of embolic agent. Large randomized control trials are currently in progress to assess the safety and efficacy of MMA embolization for this purpose.</p>","PeriodicalId":33349,"journal":{"name":"BMJ Surgery Interventions Health Technologies","volume":"7 1","pages":"e000290"},"PeriodicalIF":2.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754736","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":"Effects of visual guidance and instrument choice on symptom recurrence following adenoidectomy: a systematic review of randomized controlled trials.","authors":"Martin Mølhave, Therese Ovesen, Adnan Madzak","doi":"10.1136/bmjsit-2024-000370","DOIUrl":"10.1136/bmjsit-2024-000370","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the impact of visual guidance and instrument choice on obstructive sleep apnea (OSA) and otitis media with effusion (OME) symptom recurrence and reoperation rates following adenoidectomy in pediatric patients.</p><p><strong>Design: </strong>Systematic review of randomized controlled trials (RCTs).</p><p><strong>Setting: </strong>A comprehensive literature search was conducted in Embase, PubMed/Medline, the Cochrane Library, and Scopus, with the final search on September 23, 2024. Reference lists were also screened.</p><p><strong>Participants: </strong>Eligible studies included RCTs published from 2000 onwards, with ≥25 pediatric patients undergoing adenoidectomy for OSA or OME. Comparisons included visually guided versus blinded and cold versus hot adenoidectomy techniques. Studies involving concurrent procedures, craniofacial abnormalities, or non-primary adenoidectomy cases were excluded.</p><p><strong>Main outcome measures: </strong>The primary outcomes were OSA and OME symptom recurrence and reoperation rates following adenoidectomy. Risk of bias was assessed using Cochrane Risk of Bias tool, and evidence quality was evaluated using Grading of Recommendations Assessment, Development and Evaluation.</p><p><strong>Results: </strong>Of 2302 screened articles, 35 underwent full-text review, and 4r studies (373 participants) met inclusion criteria. All studies compared hot and cold techniques, with hot techniques being visually guided. Only one study directly compared both hot and cold techniques under visual guidance, reporting lower OSA recurrence rates with the hot technique, though with a high risk of bias. Other studies found no significant differences, and none reported reoperation rates. Study heterogeneity prevented meta-analysis. Overall risk of bias and evidence quality were moderate.</p><p><strong>Conclusions: </strong>There is insufficient evidence to determine whether visual guidance reduces symptom recurrence following adenoidectomy. Further high-quality RCTs are needed to provide more sound conclusions.</p><p><strong>Prospero registration number: </strong>CRD42024513408.</p>","PeriodicalId":33349,"journal":{"name":"BMJ Surgery Interventions Health Technologies","volume":"7 1","pages":"e000370"},"PeriodicalIF":2.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754834","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":"At the cutting edge: the potential of autonomous surgery and challenges faced.","authors":"Raghav Khanna, Nicholas Raison, Alejandro Granados Martinez, Sebastien Ourselin, Francesco Montorsi, Alberto Briganti, Prokar Dasgupta","doi":"10.1136/bmjsit-2024-000338","DOIUrl":"10.1136/bmjsit-2024-000338","url":null,"abstract":"","PeriodicalId":33349,"journal":{"name":"BMJ Surgery Interventions Health Technologies","volume":"7 1","pages":"e000338"},"PeriodicalIF":2.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754831","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":"Comparative study of ICG and non-ICG-guided laparoscopic gastrectomy for gastric cancer: a propensity score-matched analysis at a single center.","authors":"Nguyen Van Du, Nguyen Anh Tuan, Luong Ngoc Cuong","doi":"10.1136/bmjsit-2024-000313","DOIUrl":"10.1136/bmjsit-2024-000313","url":null,"abstract":"<p><strong>Abstract: </strong></p><p><strong>Objectives: </strong>To investigate the effectiveness of indocyanine green (ICG) lymphography in improving lymph nodes (LNs) harvesting during laparoscopic radical distal gastrectomy for gastric cancer.</p><p><strong>Design: </strong>Non-randomized trial, prospective study compared ICG and non-ICG group using 1:1 propensity score matching (PSM) method.</p><p><strong>Setting: </strong>Preoperative clinical characteristics, operative outcomes, and follow-up results.</p><p><strong>Participants: </strong>242 patients who underwent laparoscopic distal gastrectomy with D2 lymphadenectomy for gastric cancer between 2019 and 2023. After exclusion and PSM, 160 patients (Pts) were included, paired in two groups: ICG (80 Pts) and non-ICG (80 Pts).</p><p><strong>Interventions: </strong>Patients in the ICG group underwent ICG injection submucosal via endoscopy 1 day before surgery.</p><p><strong>Main outcome measures: </strong>Comparison of the number of retrieved LNs and complications between the ICG and non-ICG group.</p><p><strong>Results: </strong>There were no significant differences in age, sex, height, tumor size, pathological Tumor-stage, histological differentiation, and complications between the two groups. There was a shorter operative time in the ICG group compared with the non-ICG group (median: 118 mins (IQR, 105-135) vs 146 mins (IQR, 120-180), respectively). Regarding the effectiveness of LN dissection: the ICG group had a higher median of retrieved LNs than the non-ICG group (36 LNs (IQR, 29-46) vs 27 LNs (IQR, 21-31); p<0.001). The mean number of metastatic LNs in the ICG group was significantly higher than in the non-ICG group, with 2.6±5.4 LNs compared with 0.9±3.1 LNs, respectively (p=0.018). The proportion of patients with more than 25 and 30 retrieved LNs was higher in the ICG group compared with the non-ICG group, with rates of 86% and 71% versus 64% and 31%, respectively (p<0.001).</p><p><strong>Conclusions: </strong>Using ICG fluorescence-guided LNs dissection has increased both the number of total LNs and metastatic LNs dissection without increasing complications in laparoscopic distal gastrectomy for gastric cancer.</p>","PeriodicalId":33349,"journal":{"name":"BMJ Surgery Interventions Health Technologies","volume":"7 1","pages":"e000313"},"PeriodicalIF":2.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574154","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":"Allocation of seed-stage investments for paediatric health technology.","authors":"Juliana R Perl, Marta Arenas-Jal, Janene H Fuerch, James Kennedy Wall","doi":"10.1136/bmjsit-2024-000368","DOIUrl":"10.1136/bmjsit-2024-000368","url":null,"abstract":"","PeriodicalId":33349,"journal":{"name":"BMJ Surgery Interventions Health Technologies","volume":"7 1","pages":"e000368"},"PeriodicalIF":2.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574091","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}