Acta Chirurgica Belgica最新文献

{"title":"Neck paragangliomas: a case report and literature review.","authors":"Thaïs De Witte, Klaas Van Den Heede, Nele Brusselaers, Sam Van Slycke","doi":"10.1080/00015458.2024.2392349","DOIUrl":"10.1080/00015458.2024.2392349","url":null,"abstract":"<p><strong>Objective: </strong>Thyroid-originated paragangliomas are very uncommon, and there is a lack of established guidelines regarding their management.</p><p><strong>Methods: </strong>A case study was presented, and a review of the literature was conducted.</p><p><strong>Results: </strong>Diagnosing a paraganglioma requires multiple diagnostic methods, including a 24-h measurement of metanephrines or catecholamines, anatomical imaging using magnetic resonance or computed tomography (CT) scans, and functional imaging using metaiodobenzylguanidine or ¹⁸F-DOPA PET/CT scans. Additionally, with the presence of somatostatin receptors on paragangliomas, the use of octreotide scans such as a ⁶⁸Ga DOTATATE PET/CT scan is expected to increase soon. The primary treatment for laryngeal paragangliomas is surgical intervention aimed at achieving optimal tumor removal while retaining the highest possible level of laryngeal function. One should not do elective neck dissection given the low risk of metastasis and recurrence. Although the rate of recurrence and metastasis for paragangliomas is low, continued monitoring through clinic visits, biochemical testing, and imaging is still necessary. Furthermore, follow-up efforts should also consider genetic testing of the critical genes associated with paragangliomas.</p><p><strong>Conclusion: </strong>Although there is still debate regarding the existence of thyroid paraganglioma, it can nonetheless be classified as a subtype of laryngeal paragangliomas. All hypervascular thyroid nodules require the consideration of thyroid-associated paragangliomas.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"508-513"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The bow tie technique for single stapled colorectal anastomosis: technical note.","authors":"Jaro Van Zande, Khozh Magamadov, Yves Van Molhem","doi":"10.1080/00015458.2024.2400800","DOIUrl":"10.1080/00015458.2024.2400800","url":null,"abstract":"<p><strong>Aim: </strong>In this technical note we describe a simplified totally transabdominal technique to perform a single stapled end-to-end colorectal anastomosis without the need for transanal transection, linear stapler line resection, purse string or dog-ear suturing.</p><p><strong>Method: </strong>The rationale and the technique itself are first explained by using a schematic design. Next, step-by-step pictures of one of our cases show the feasibility and advantages of this technique. At the end, the limits of this technique are illustrated.</p><p><strong>Results: </strong>The technique was used for 20 colorectal anastomosis, 9 benign and 11 oncological cases. Median age was 68 years and average BMI was 28 kg/m². Risk factors for anastomotic leakage were reported in 10 cases. The bow tie technique was performed in every case and the linear stapler line was entirely resected in all cases. No positive air leak test or anastomotic leakage was reported.</p><p><strong>Conclusions: </strong>The bow tie technique is a feasible technique to perform an end-to-end single stapled colorectal anastomosis with promising results on anastomotic leakage. Further research with larger prospective data collection is necessary to validate this technique and show its potential benefit on anastomotic leakage.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"532-536"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of thoracic trauma scoring system in thoracic trauma patients with rib fracture.","authors":"Nihat Berk Sarmış, Mustafa Kuzucuoğlu, Keramettin İbrahim Taylan, Ali Cem Yekdeş, Mehmet Ünal, Serdar Şirzai, Bayram Çağrı Sakarıya, Arkın Acar","doi":"10.1080/00015458.2024.2361540","DOIUrl":"10.1080/00015458.2024.2361540","url":null,"abstract":"<p><strong>Objective: </strong>Rib fractures are common in thoracic trauma patients. There are various factors, including flail chest, pulmonary contusion, and accompanying conditions, affecting morbidity and mortality. The study aimed to identify high-risk patients for morbidity and mortality with a scoring system that the authors created.</p><p><strong>Methods: </strong>Cases over the age of 18 admitted due to trauma and diagnosed with rib fractures between 1 January 2019 and 1 March 2023, were included. Trauma scores were determined by applying the new trauma scoring system. Trauma scores and other variables regarding morbidity and mortality were evaluated.</p><p><strong>Results: </strong>A total of 1023 cases were included in the study. The total trauma scores were higher in bilateral and multiple fractures. In those without respiratory failure, the total score was statistically significantly lower than in the groups with respiratory failure. The total score was significantly higher in those who needed surgery, those who were hospitalized, and those who needed intensive care compared to the non-surgical groups. However, there was no correlation between intensive care unit stay and total score. Trauma mechanism, presence of additional extrathoracic pathology, and thoracic trauma-age score were independent predictors of survival.</p><p><strong>Conclusion: </strong>The present study demonstrated that the number of rib fractures and the presence of pulmonary contusion did not have an effect on mortality and morbidity. The presence of extrathoracic pathology and age significantly affect survival.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"487-491"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141160068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baron Antoine Dubois and the difficult childbirth of Napoleon I's second wife the Empress Marie Louise on 20 March 1811.","authors":"Jan Bosteels, Yves Jacquemyn","doi":"10.1080/00015458.2024.2350803","DOIUrl":"10.1080/00015458.2024.2350803","url":null,"abstract":"<p><strong>Background: </strong>History has paid little attention to the childbirth of Marie Louise, second wife to the Emperor Napoleon I. Most historians state that the obstetrician Antoine Dubois needed to use his forceps during a difficult breech delivery. As practicing obstetricians we aimed to reconstruct the likely course of events using a forensic approach.</p><p><strong>Methods: </strong>We have consulted historical documents and key witness accounts as primary sources. We have followed the clinical guidance of the 1807 edition of 'l'Art des Accouchemens'. We have tested a new hypothesis of the possible course of the childbirth through a simulation using the Assisted Vaginal Birth Module PROMPT Flex CDE® as an obstetrical model and an authentic Levret forceps.</p><p><strong>Discussion: </strong>A transverse lie with hip presentation is the most plausible diagnosis of the foetal malposition that complicated the delivery of Marie Louise by Antoine Dubois. The long duration of the delivery of the entrapped foetal head and the insistence on the presence of his colleague Corvisart by Antoine Dubois can be explained through our hypothesis that the occiput of the entrapped foetal head was very likely in a transverse position. The seemingly impossible application of a forceps in this position, had already been described in the nineteenth century both in France and outside.</p><p><strong>Conclusion: </strong>Our simulation confirmed the practicability of the application of the forceps as assumed by our hypothesis. Definitive proof that this scenario actually happened, cannot be given because there are no written first-hand accounts by Dubois on the delivery.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"523-531"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140849790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of artificial intelligence in minimally invasive right adrenalectomy: recognition of anatomical landmarks with deep learning.","authors":"Berke Sengun, Yalin Iscan, Ziya Ata Yazici, Ismail Cem Sormaz, Nihat Aksakal, Fatih Tunca, Hazim Kemal Ekenel, Yasemin Giles Senyurek","doi":"10.1080/00015458.2024.2363599","DOIUrl":"10.1080/00015458.2024.2363599","url":null,"abstract":"<p><strong>Background: </strong>The primary surgical approach for removing adrenal masses is minimally invasive adrenalectomy. Recognition of anatomical landmarks during surgery is critical for minimizing complications. Artificial intelligence-based tools can be utilized to create real-time navigation systems during laparoscopic and robotic right adrenalectomy. In this study, we aimed to develop deep learning models that can identify critical anatomical structures during minimally invasive right adrenalectomy.</p><p><strong>Methods: </strong>In this experimental feasibility study, intraoperative videos of 20 patients who underwent minimally invasive right adrenalectomy in a tertiary care center between 2011 and 2023 were analyzed and used to develop an artificial intelligence-based anatomical landmark recognition system. Semantic segmentation of the liver, the inferior vena cava (IVC), and the right adrenal gland were performed. Fifty random images per patient during the dissection phase were extracted from videos. The experiments on the annotated images were performed on two state-of-the-art segmentation models named SwinUNETR and MedNeXt, which are transformer and convolutional neural network (CNN)-based segmentation architectures, respectively. Two loss function combinations, Dice-Cross Entropy and Dice-Focal Loss were experimented with for both of the models. The dataset was split into training and validation subsets with an 80:20 distribution on a patient basis in a 5-fold cross-validation approach. To introduce a sample variability to the dataset, strong-augmentation techniques were performed using intensity modifications and perspective transformations to represent different surgery environment scenarios. The models were evaluated by Dice Similarity Coefficient (DSC) and Intersection over Union (IoU) which are widely used segmentation metrics. For pixelwise classification performance, accuracy, sensitivity and specificity metrics were calculated on the validation subset.</p><p><strong>Results: </strong>Out of 20 videos, 1000 images were extracted, and the anatomical landmarks (liver, IVC, and right adrenal gland) were annotated. Randomly distributed 800 images and 200 images were selected for the training and validation subsets, respectively. Our benchmark results show that the utilization of Dice-Cross Entropy Loss with the transformer-based SwinUNETR model achieved 78.37%, whereas the CNN-based MedNeXt model reached a 77.09% mDSC score. Conversely, MedNeXt reaches a higher mIoU score of 63.71% than SwinUNETR by 62.10% on a three-region prediction task.</p><p><strong>Conclusion: </strong>Artificial intelligence-based systems can predict anatomical landmarks with high performance in minimally invasive right adrenalectomy. Such tools can later be used to create real-time navigation systems during surgery in the near future.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"492-498"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141260517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of short‑term outcomes and 3-year overall survival between robotic and laparoscopic gastrectomy for gastric cancer: a propensity score matching analysis.","authors":"Li Zhang, Jingli Cui, Mingzhi Cai, Bin Li, Gang Ma, Xuejun Wang, Yong Liu, Jingyu Deng, Rupeng Zhang, Han Liang, Jilong Yang","doi":"10.1080/00015458.2024.2348256","DOIUrl":"10.1080/00015458.2024.2348256","url":null,"abstract":"<p><strong>Background: </strong>Despite the increasing use of robotic gastrectomy (RG) as an alternative to laparoscopic gastrectomy (LG) in treating gastric cancer, controversy remains over the advantages of RG compared to LG and there is a paucity of studies comparing the two techniques regarding patient survival.</p><p><strong>Methods: </strong>In this retrospective cohort study, 675 patients undergoing minimally invasive gastrectomy were recruited from January 2016 to January 2018 (LG: <i>n</i> = 567; RG: <i>n</i> = 108). A one-to-one propensity score matching (PSM) analysis was applied to minimize the selection bias due to confounding factors, yielding 104 patients in each of the RG and LG groups. After matching, the short-term outcomes and 3-year overall survival were compared in the two groups.</p><p><strong>Results: </strong>The PSM cohort analysis showed a similar 3-year overall survival between RG and LG groups (<i>p</i> = .249). Concerning the short-term outcomes, the RG compared to LG resulted in lower blood loss (<i>p</i> = .01), lower postoperative complications (<i>p</i> = .001), lower postoperative pain (<i>p</i> = .016), earlier initiation of soft diet (<i>p</i> = .011), shorter hospital stay ‌(<i>p</i> = .012), but higher hospitalization expenses (<i>p</i> = .001).</p><p><strong>Conclusion: </strong>Our findings suggest that RG may offer advantages in terms of blood loss, surgical complications, recovery time, and pain management compared to LG while maintaining similar overall survival rates. However, RG is associated with higher hospital costs, potentially limiting its wider adoption. Further research, including large, multi-center randomized controlled trials with longer patient follow-up, particularly for advanced gastric cancer, is needed to confirm these findings.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"478-486"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Memoriam.","authors":"Charlotte Vercauteren","doi":"10.1080/00015458.2024.2419206","DOIUrl":"10.1080/00015458.2024.2419206","url":null,"abstract":"","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"1-2"},"PeriodicalIF":0.6,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival difference between patients with single versus multiple metastatic lymph nodes and the role of histology in pathological stage II-N1 non-small cell lung cancer.","authors":"Julianne Ruiter, Adrianus de Langen, Kim Monkhorst, Alexander Veenhof, Houke Klomp, Jasper Smit, Egbert Smit, Ronald Damhuis, Koen Hartemink","doi":"10.1080/00015458.2024.2322243","DOIUrl":"10.1080/00015458.2024.2322243","url":null,"abstract":"<p><strong>Background: </strong>Previous studies investigating whether metastatic lymph node count is a relevant prognostic factor in pathological N1 non-small cell lung cancer (NSCLC), showed conflicting results. Hypothesizing that outcome may also be related to histological features, we determined the prognostic impact of single versus multiple metastatic lymph nodes in different histological subtypes for patients with stage II-N1 NSCLC.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using data from the Netherlands Cancer Registry, including patients treated with a surgical resection for stage II-N1 NSCLC (TNM 7th edition) in 2010-2016. Overall survival (OS) was assessed for patients with single (pN1a) and multiple (pN1b) metastatic nodes. Using multivariable analysis, we compared OS between pN1a and pN1b in different histological subtypes.</p><p><strong>Results: </strong>After complete resection of histologically proven stage II-N1 NSCLC, 1309 patients were analyzed, comprising 871 patients with pN1a and 438 with pN1b. The median number of pathologically examined nodes (N1 + N2) was 9 (interquartile range 6-13). Five-year OS was 53% for pN1a versus 51% for pN1b. In multivariable analysis, OS was significantly different between pN1a and pN1b (HR 1.19, 95% CI 1.01-1.40). When stratifying for histology, the prognostic impact of pN1a/b was only observed in adenocarcinoma patients (HR 1.44, 95% CI 1.15-1.81).</p><p><strong>Conclusion: </strong>Among patients with stage II-N1 adenocarcinoma, the presence of multiple metastatic nodes had a significant impact on survival, which was not observed for other histological subtypes. If further refinement as to lymph node count will be considered for incorporation into a new staging system, evaluation of the role of histology is recommended.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"387-395"},"PeriodicalIF":0.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139970575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usage of rotational atherectomy and drug-coated balloon angioplasty for isolated popliteal artery lesions: two-year results of a retrospective study.","authors":"Fatih Gumus, Oguz Arslanturk","doi":"10.1080/00015458.2024.2313266","DOIUrl":"10.1080/00015458.2024.2313266","url":null,"abstract":"<p><strong>Objectives: </strong>In this study, perioperative properties and early and mid-term clinical outcomes of endovascular revascularization with a combined usage of rotational atherectomy (RA) and drug-coated balloon angioplasty (DCB) angioplasty for isolated popliteal artery lesion were reported.</p><p><strong>Methods: </strong>A total of 28 patients with isolated popliteal artery stenosis who underwent combined RA and DCB angioplasty between December 2018 and September 2022 were analyzed retrospectively. Temren atherectomy system (Invamed, Ankara, Turkey) and Extender paclitaxel-coated drug-coated balloon catheter (Invamed, Ankara, Turkey) were used in all cases. The main outcome was primary patency; secondary outcomes were technical success, freedom from amputation, and mortality.</p><p><strong>Results: </strong>The mean age of patients was 64.2 ± 9.1 years and the majority of the patients were male (<i>n</i> = 20; 71.4%). Types of the lesions were total occlusion in 24 limbs and critical stenosis in 4 limbs. The mean total occlusion length was 65.2 ± 14.2 mm. Flow-limiting dissection was seen in lesions of 2 patients (7.1%) and treated with prolonged balloon dilatation without bail-out stenting requirement. Technical success defined as an adequate vascular lumen (less than 30% stenosis) was achieved in 26 (92.8%) with a mean follow-up of 17.2 ± 8.2 months. The mean primary patency rates at 12 months and 24 months were 92.3% ± 3.2 and 81.2% ± 3.2, respectively. Complications included 1 distal embolization following RA, 2 flow-limiting dissections, and 3 puncture site hematomas.</p><p><strong>Conclusions: </strong>Endovascular procedures using combined RA and DCB angioplasty seem to be effective alternative treatment modalities for the treatment of popliteal artery lesions with high rates of primary patency and freedom from TLR.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"365-371"},"PeriodicalIF":0.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An investigation on the compliance of perioperative practices using ERAS protocols and barriers to the implementation of the ERAS protocols in colorectal surgery.","authors":"Turna Özbay, Deniz Şanlı, Jeremy E Springer","doi":"10.1080/00015458.2024.2327813","DOIUrl":"10.1080/00015458.2024.2327813","url":null,"abstract":"<p><strong>Background: </strong>Although ERAS protocols have many benefits, there are some deficiencies in their understanding and implementation by healthcare professionals. The present study was conducted to investigate the compliance of the current perioperative practices of healthcare professional with the ERAS protocols and to assess barriers to the implementation of ERAS protocols in colorectal surgery.</p><p><strong>Methods: </strong>This cross-sectional descriptive study conducted in the surgical clinics and operating rooms of a training and research hospital between January 2020 and September 2020 included 110 physician and nurse members of surgical teams. Data were collected using the Questionnaire for Evaluating the Use of the ERAS Protocol and Identifying Barriers to Implementation in Colorectal Surgery.</p><p><strong>Results: </strong>The compliance of the current perioperative practices by healthcare professionals with the ERAS protocols ranged between 15.5% (routinely leaving nasogastric tubes in situ following colorectal resection) and 61.8% (being aware of the concept of balanced analgesia). Variables such as the healthcare professional's profession, title, years in practice and colorectal surgery experience led to a difference between them in terms of their compliance of the practices with the ERAS protocols (<i>p</i> < 0.05). Based on the healthcare professionals' comments about barriers to the implementation of the ERAS protocol, themes such as education, teamwork, communication and lack of resources were created.</p><p><strong>Conclusion: </strong>Healthcare professionals' compliance level of the current perioperative practices with the ERAS protocols was mostly low. Barriers to the implementation of the ERAS protocols had a multi-factor structure that concerns the multidisciplinary team.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"396-405"},"PeriodicalIF":0.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140038504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}