Khirurgiya最新文献

{"title":"[Effectiveness of local treatment of venous trophic ulcers in gerontological patients].","authors":"M R Kuznetsov, D V Matveev, Kh A Abduvosidov, S M Chudnykh, S D Matveev, A V Snitsar, N V Yasnopolskaya, M V Pyatykh","doi":"10.17116/hirurgia202508145","DOIUrl":"https://doi.org/10.17116/hirurgia202508145","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effectiveness of local treatment of venous trophic ulcers in gerontological patients.</p><p><strong>Material and methods: </strong>We analyzed treatment venous trophic ulcers in 4 groups of elderly and senile patients. All patients received conservative therapy. In the 1^st group (<i>n</i>-74), local injection of 0.1% polyhexanide-betaine gel throughout 7-10 days was followed by liposomal antioxidant-phospholipid complex «Flamena». In the 2^nd group (<i>n</i>-69), immune correction with «Imunofan» was carried out along with local therapy. In the 3^rd group (<i>n</i>-69), local treatment was combined with pulsed high-intensity optical irradiation of the wound. In the 4^th group (<i>n</i>-69), local treatment was combined with immune correction and pulsed high-intensity optical irradiation. Cytological analysis was performed to estimate effectiveness of treatment. Statistical analysis was performed using nonparametric Friedman and Mann-Whitney tests.</p><p><strong>Results: </strong>The number of leukocytes, lymphocytes and macrophages increased by the 7^th day of treatment. Activation of inflammation was more pronounced in groups 2, 3 and 4 (<i>p</i>< 0.0083). By the 15^th day, leukocyte count decreased. The number of macrophages and lymphocytes remains high; the number of fibroblasts increases. Cytograms were mainly inflammatory and inflammatory-regenerative. By the 22^nd day, cytograms corresponded to regenerative-inflammatory and regenerative types with the lowest number of neutrophils, moderate number of lymphocytes, macrophages and fibroblasts.</p><p><strong>Conclusion: </strong>Complex local treatment of venous trophic ulcers with local immunomodulatory therapy and pulsed high-intensity optical irradiation contributes to conversion of chronic inflammation to acute one with initiation of reparation processes and tissue regeneration.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 8","pages":"45-54"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Late complications and quality of life after multivisceral surgeries with pancreatoduodenectomy].","authors":"V I Egorov, A G Kotelnikov, Yu I Patyutko, D V Podluzhny, A N Polyakov, N E Kudashkin, E N Fayazov","doi":"10.17116/hirurgia202507136","DOIUrl":"https://doi.org/10.17116/hirurgia202507136","url":null,"abstract":"<p><strong>Objective: </strong>To investigate late complications after <b>pancreatoduodenectomy</b> (PD) as a part of multivisceral surgeries (MVS) and the impact of these interventions on the quality of life.</p><p><strong>Material and methods: </strong>Analysis of complications in long-term postoperative period included 776 patients (233 cases of MVS with PD (main group) and 543 cases of standard PD (comparison group)). Analysis of the quality of life included 58 patients from the main group and 67 patients from the comparison group. The quality of life was studied using the Russian-language versions of the EORTC QLQ-C30 and EORTC QLQ-PAN26 questionnaires.</p><p><strong>Results. t: </strong>Here were no significant between-group differences in the incidence of long-term postoperative complications (26.2% versus 20.1%, <i>p</i>=0.059). Diabetes mellitus occurred in 26 (15.9%) and 57 (10.8%) patients, respectively (<i>p</i>=0.08). Malnutrition (10.3% versus 3%, <i>p</i><0.001), cholangitis (7.3% versus 2.5%, <i>p</i>=0.003) and edema/ascites (7.3% versus 0.8%, <i>p</i><0.001) were significantly more common in the main group. According to the EORTC QLQ-C30 scores in the main group, general health (58 (58 - 58) versus 66 (58 - 66), <i>p</i><0.001, weak clinical significance) and physical functions (79.5 (73 - 89) versus 86 (73 - 93), <i>p</i>=0.04, weak clinical significance) were significantly worse, and weakness was more pronounced (22 (22 - 33) versus 11 (11 - 22), <i>p</i><0.001, moderate clinical significance). According to the EORTC QLQ-PAN26 scores, weight loss (24.5 (16-33) versus 16 (0-16), <i>p</i><0.001, weak clinical significance), weakness in arms and legs (16 (16-16) versus 0 (0-16), <i>p</i><0.001, moderate clinical significance) and dry mouth (8 (0-16) versus 0 (0-16), <i>p</i>=0.004, weak clinical significance) were more common in the main group.</p><p><strong>Conclusion: </strong>MVS with PD is significantly more often accompanied by cholangitis and symptoms of alimentary failure in long-term period. This determines the worst quality of life after MVS with PD.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 7","pages":"36-45"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Lumbar muscle density as a prognostic marker of nutritional deficiency in patients with pancreatic necrosis complicated by external duodenal fistulas: a pilot study].","authors":"S S Petrikov, V V Kiselev, M S Zhigalova, R Sh Muslimov, P A Yartsev, L T Khamidova","doi":"10.17116/hirurgia202507146","DOIUrl":"https://doi.org/10.17116/hirurgia202507146","url":null,"abstract":"<p><strong>Objective. t: </strong>O assess severity of catabolism in patients with pancreatic necrosis complicated by external duodenal fistulas considering CT data of lumbar muscle density.</p><p><strong>Material and methods: </strong>A retrospective non-randomized pilot study included 11 patients (7 men (63.6%) and 4 women (36.4%)) diagnosed with severe acute pancreatitis and pancreatic necrosis. Late phase of disease was complicated by external duodenal fistulas in all patients. Mean age of patients ranged from 34 to 88 years (49 (34; 88) years). All patients were retrospectively assessed for lumbar muscle density at the level of the third lumbar vertebra using CT data (HUAC). Study stages: stage 1 - 24 hours after admission; stage 2 - 1.5±0.52 days after external duodenal fistula; stage 3 - 19.4±6.68 days after external duodenal fistula. The following parameters were retrospectively assessed in all patients: RPHU, RPA, LPHU, LPA. After that, mean lumbar muscle density (HUAC) was calculated. To assess prognostic significance of parameters, patients were divided depending on outcomes: group of survivors included 8 patients (<i>n</i>=8; 72.7%) aged 34-62 years; group of deceased included 3 patients (<i>n</i>=3; 27.3%) aged 63-88 years.</p><p><strong>Results: </strong>At the first stage (HUAC 1), values were was 34.69±8.44 (95% CI 26.89-42.50) HU and 31.35±6.76 (95% CI 14.57-48.14) HU, respectively (<i>p</i>=0.565). At the second stage (HUAC 2), mean values were 34.61±7.61 (95% CI 27.57-41.65) HU and 22.04±3.32 (95% CI 13.79-30.30) HU, respectively (<i>p</i>=0.028). Significant differences could indicate important changes in physiological state. At the third stage (HUAC 3), mean values were 37.14±7.21 (95% CI 30.47-43.80) HU and 19.44±3.51 (95% CI 10.71-28.16) HU, respectively (<i>p</i>=0.004).</p><p><strong>Conclusion: </strong>Despite the obvious importance of traditional methods for diagnosing nutritional deficiency, it is necessary to expand the list of perspective and more sensitive methods for prevention of nutritional disorders in patients with external duodenal fistulas. The proposed method for assessing the density of lumbar muscles has an important prognostic value and allows assessing the severity of catabolism upon admission and in follow-up period.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 7","pages":"46-58"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Variant anatomy of the gallbladder].","authors":"A D Aslanov, R M Kalibatov, Kh I Tilov, A A Selyaev, R M Zakhokhov, R V Kalmykova, L Yu Kardanova","doi":"10.17116/hirurgia202507198","DOIUrl":"10.17116/hirurgia202507198","url":null,"abstract":"<p><p>A doubled gallbladder recognized in postoperative period is presented. Intraoperatively, accessory bladder was recognized as a Caroli disease. However, we removed true gallbladder due to unavailable intraoperative cholangiography and risk of iatrogenic complications. Unclearly verified finding required MR cholangiography to confirm additional gallbladder.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 7","pages":"98-102"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Xenopericardial femoral artery surgery in hybrid treatment of critical ischemia of the lower extremities].","authors":"B S Sukovatykh, P M Nazarenko, N V Bolomatov, M B Sukovatykh, M Yu Gordov, A Yu Grigoryan","doi":"10.17116/hirurgia202509112","DOIUrl":"https://doi.org/10.17116/hirurgia202509112","url":null,"abstract":"<p><strong>Objective: </strong>To compare 6- and 12-month results of femoral artery repair with xenopericardial and autologous venous patch in hybrid treatment of critical lower limb ischemia.</p><p><strong>Material and methods: </strong>A retrospective analysis included 60 patients with critical lower limb ischemia who underwent hybrid treatment (balloon angioplasty and stenting of iliac arteries and open reconstruction of femoral arteries). Patients were divided into 2 groups by 30 people depending on femoral artery repair (group 1 - autologous venous patch, group 2 - xenopericardial patch). Postoperative complications, symptoms of critical ischemia, ankle-brachial index and pain-free walking distance were assessed after 6 and 12 postoperative months.</p><p><strong>Results: </strong>Postoperative complications occurred in 3 (5%) patients. In 1 case (pulsating hematoma), they were associated with endovascular intervention, in 2 cases (bleeding and lymphorrhea) - with surgical intervention. After 6 months, resting pain and trophic disorders disappeared. Moreover, pain-free walking distance increased in both groups. The ankle-brachial index increased by 1.8 and 1.9 times compared to preoperative data in each group, respectively. After 12 months, femoral artery restenosis occurred in 2 patients of the 1^st group.</p><p><strong>Conclusion: </strong>After 6 months, there were no significant between-group differences. After 12 months, xenopericardial patch was superior to autologous venous patch.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 9","pages":"12-18"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Laparoendoscopic hybrid treatment of a patient with choledocholithiasis, cholecystitis and large duodenal diverticula].","authors":"Yu G Starkov, A I Vagapov, R D Zamolodchikov, S V Dzhantukhanova, P Sh Arabova","doi":"10.17116/hirurgia202501162","DOIUrl":"10.17116/hirurgia202501162","url":null,"abstract":"<p><p>We present laparoendoscopic hybrid treatment of a patient with choledocholithiasis, cholecystitis and large duodenal diverticula. A 69-year-old patient underwent one-stage hybrid laparoendoscopic intervention. Despite the difficult situation caused by large duodenal diverticula and calculus in terminal part of common bile duct, hybrid technique with rendez-vous procedure allowed successful lithoextraction and cholecystectomy. The follow-up examination found no residual biliary calculi. Hybrid laparoendoscopic intervention in the treatment of a patient with choledocholithiasis, cholecystitis and large duodenal diverticula provided optimal clinical effect, reduced the risk of postoperative complications and shortened in-hospital treatment.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 1","pages":"62-67"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Postoperative peritonitis: epidemiology, diagnosis, surgical treatment and prognosis].","authors":"I A Matveev, A V Dmitriev, K V Abraamyan, S V Lipovoy, A I Matveev, A O Matreninskikh","doi":"10.17116/hirurgia2025061104","DOIUrl":"https://doi.org/10.17116/hirurgia2025061104","url":null,"abstract":"<p><p>Postoperative peritonitis is a rare but dangerous complication of gastrointestinal tract surgeries. Analysis of epidemiology, diagnostics, treatment, and prognosis of postoperative peritonitis was based on 35 manuscripts. Postoperative peritonitis is an uncommon (up to 6-7%) but dangerous complication with mortality rate >30%. Old age, comorbidities, impaired sealing of proximal digestive tract and delayed redo laparotomy are the main factors of high mortality. Late diagnosis of peritonitis is due to no specific signs, and its symptoms are explained by peculiarities of postoperative period and not associated with complication. Surgical treatment consists in eliminating the source of peritonitis or its effective isolating from abdominal cavity, adequate debridement and drainage of the abdominal cavity. The APACHEII scale and the Mannheim Peritonitis Index (MPI) are the most important in assessing the prognosis of peritonitis. The time of the first relaparotomy may be a sign of disease prognosis. The issues of early diagnostics of postoperative peritonitis remain unresolved that necessitates searching for the causes of late relaparotomy and high subsequent postoperative mortality.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 6","pages":"104-111"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Total extraperitoneal inguinal hernia repair under local anesthesia].","authors":"E E Tarasov, E V Nishnevich, V A Bagin, I A Korishch, P L Burtseva, M I Prudkov","doi":"10.17116/hirurgia202506144","DOIUrl":"https://doi.org/10.17116/hirurgia202506144","url":null,"abstract":"<p><strong>Objective: </strong>To study the possibility of total extraperitoneal inguinal hernia repair under local anesthesia in patients with contraindications for general or regional anesthesia.</p><p><strong>Material and methods: </strong>A retrospective clinical trial involved 14 patients who underwent total extraperitoneal inguinal hernia repair under local anesthesia with lidocaine between 2019 and 2022. Potential indications for this surgery under local anesthesia may be certain clinical situations and their combinations: high anesthetic risk, anatomical difficulties for regional anesthesia, coagulopathy, long-term antithrombotic therapy, refusal of patient from general and regional anesthesia.</p><p><strong>Results: </strong>There was ASA grade IV in 13 (92.9%) patients. Mean age of patients was 73.5 (64.0; 84.0) years, Charlson comorbidity index - 5.0 (4.3; 6.0) points. All patients with inguinal hernia successfully underwent total extraperitoneal inguinal hernia repair under local anesthesia. There were no conversions to open surgery or general anesthesia. Three (21.4%) patients developed intraoperative pneumoperitoneum that required intravenous administration of opioid analgesic. After that, endoscopic surgery was successfully continued in all cases. There were no typical postoperative complications of herniation. Patient activation occurred after 2-3 hours after surgery. Narcotic analgesics in postoperative period were not required in any case. Mean hospital-stay was 25.0 (21.7; 42.0) hours. No recurrence of hernias was observed within 7.5 (6.3; 14.3) months.</p><p><strong>Conclusion: </strong>Total extraperitoneal inguinal hernia repair under local anesthesia is a technically feasible intervention in patients with limitations to general or regional anesthesia.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 6","pages":"44-50"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Treatment of acute hemorrhoids according to the results of a multicenter observational study].","authors":"V S Groshilin, V K Shvetsov, A A Kolesnichenko, A B Alnikin, M I Sultanmuradov, V E Bardakhchyan, V D Kuznecov, A S Arkhipov","doi":"10.17116/hirurgia2025031112","DOIUrl":"10.17116/hirurgia2025031112","url":null,"abstract":"<p><strong>Background: </strong>The issue of improving hemorrhoid treatment outcomes in outpatient practice is one of the most pressing in the daily work of coloproctologists today. Advances in the treatment of hemorrhoidal disease, the most common pathological condition in general proctology, in recent decades have been associated not only with the adoption of minimally invasive surgical techniques but also with the enhancement of pharmacological therapy. A key component of systemic pharmacotherapy for chronic and acute hemorrhoids is the use of venotonic drugs, including flavonoids which are included in the clinical guidelines. Therefore, a comprehensive and reliable evaluation of the clinical efficacy of diosmin is an important area of research, especially in cases of acute hemorrhoids.</p><p><strong>Objective: </strong>The study aimed to assess the effectiveness of using Phlebodia 600 and evaluate the dynamics of patients' quality of life with acute hemorrhoids of grades I-II in outpatient practice without employing minimally invasive surgical methods.</p><p><strong>Material and methods: </strong>A Russian multicenter prospective observational study was conducted involving an adult population of patients with grade I-II acute hemorrhoids in the city of Rostov-on-Don and the Rostov region. Outpatients (both men and women) aged 18 to 64 with a confirmed diagnosis of grade I-II acute hemorrhoids (thrombosis of external or internal hemorrhoidal nodes, including those with bleeding) established through standardized clinical examination were included. Therapy with Phlebodia 600 (diosmin) commenced no later than three days after the onset of clinical symptoms, which included a dominant set of symptoms such as enlarged hemorrhoidal nodes, pain, bleeding, anal itching, burning, or discomfort. The total sample size analyzed was 220 patients, and the medication was administered for at least 36 days.</p><p><strong>Results: </strong>The use of Phlebodia 600 for grade I-II acute hemorrhoids allowed for the resolution of complaints and stabilization of all key clinical parameters within the timeframes set by the study design. Following the proposed treatment regimen, early resolution and reduction of complaints such as pain, discomfort, itching, and blood streaks during defecation were observed by the control visit after seven days of therapy, compared to baseline. In 73% of cases, a reduction in the size of hemorrhoidal nodes was noted within this period. The proposed treatment regimen can be considered rational since, after 30 days, not only was there consistent resolution of complaints in the majority of patients, but there was also a significant improvement in quality of life (SF-36). No cases of intolerance to Phlebodia 600 or adverse reactions associated with its use were identified, indicating a high safety profile.</p><p><strong>Conclusions: </strong>A 35-40 day course of Phlebodia 600 administered continuously according to the manufacturer's recomm","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 3","pages":"112-123"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Extracervical approach for retrosternal goiter].","authors":"A A Pechetov, N V Gulova, D A Volchansky, A N Lednev, A I Baeva, T N Khlan, I S Gruzdev","doi":"10.17116/hirurgia202505144","DOIUrl":"https://doi.org/10.17116/hirurgia202505144","url":null,"abstract":"<p><strong>Objective: </strong>To analyze treatment outcomes in patients with retrosternal goiter.</p><p><strong>Material and methods: </strong>There were 13 patients aged 32-77 years with retrosternal goiter between 2016 and 2024. The ratio of men and women was 2:11.</p><p><strong>Results: </strong>Twelve patients underwent thyroidectomy, one patient - video-assisted thoracoscopic thymectomy with resection of aberrant goiter. Among 12 patients, thyroidectomy through collotomy was performed in 6 patients, sternotomy was performed in 5 patients. Aberrant goiter was removed through thoracotomy in one patient with recurrent retrosternal goiter. Complicated postoperative period was observed in 4 patients. Two patients underwent postoperative tracheostomy (prevention of respiratory failure following high risk of bilateral paresis of recurrent laryngeal nerves in one case and laryngeal edema in the second case). There were no deaths in long-term period.</p><p><strong>Conclusion: </strong>Preoperative planning should include CT-based analysis of intrathoracic component of thyroid gland and volume of chest cavity. This is valuable to plan the optimal surgical approach and reduces the risk of intraoperative complications.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 5","pages":"44-50"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}