Surgery open science最新文献

{"title":"The application of ERAS in the perioperative period management of patients for lung transplantation","authors":"","doi":"10.1016/j.sopen.2024.09.001","DOIUrl":"10.1016/j.sopen.2024.09.001","url":null,"abstract":"<div><h3>Objective</h3><p>To explore the application of enhanced recovery after surgery (ERAS) in the perioperative period of lung transplantation.</p></div><div><h3>Methods</h3><p>We retrospectively collected the clinical data of 27 lung transplant patients who underwent ERAS during the perioperative period, while 12 lung transplant patients receiving routine treatment served as controls. General information was collected, including the specific implementation plan of ERAS, the incidence of complications and survival rate during the perioperative period (&lt;30 d), postoperative hospitalization indicators, the postoperative length of stay, and numerical rating scale (NRS) scores.</p></div><div><h3>Results</h3><p>Comparison of postoperative hospitalization indicators, the ERAS group compared with the control group, there were significant differences in postoperative ICU stay time (2.0(2.0,4.0) vs 4.5(3.0,6.0), <em>p</em> = 0.005), postoperative hospital stay time (18(15,26) vs 24(19.5,32.75), <em>p</em> = 0.016), duration of nasogastric tube (3(2,3) vs 4(2.25,4.75), <em>p</em> = 0.023), and first ambulation time (4(3,5) vs 5.8(4.5,7.5), <em>p</em> = 0.004). There was no significant difference in postoperative invasive mechanical ventilation time, time to eat after surgery, duration of urinary catheter and duration of chest tube between the ERAS group and the control group (p&gt;0.05). The perioperative survival of the ERAS group was 81.5%, which was higher than the control group (66.7%), but there is no statistically significant difference. Comparison of post-extubation NRS scores, the ERAS group had lower NRS scores at 12 h (5.30 ± 0.14 vs 6.25 ± 0.75), 24 h (3.44 ± 0.64 vs 5.58 ± 0.9), 48 h (2.74 ± 0.66 vs 4.08 ± 0.79) and 72 h (1.11 ± 0.80 vs 2.33 ± 0.49) than the control group, the difference was statistically significant (p&lt;0.01). Intra-group comparison, post-extubation 12 h comparison post-extubation 24 h, 48 h, 72 h, the NRS scores showed a gradual downward trend, the difference was statistically significant (p&lt;0.01). In the comparison of perioperative complications, the ERAS group had a lower postoperative infection incidence than the control group, the difference was statistically significant (44.4% vs 83.3%, <em>p</em> = 0.037). The ERAS group had lower postoperative delirium incidence than the control group, the difference was statistically significant (11.1% vs 50%, <em>p</em> = 0.014). There was no significant difference in the incidence of acute rejection, primary graft loss (PGD), gastrointestinal (GI) complications and airway complications between two groups (p&gt;0.05).</p></div><div><h3>Conclusion</h3><p>The ERAS can be applied to lung transplant patients to relieve postoperative pain, shorten postoperative tube time, and shorten postoperative stay. Perioperative pulmonary rehabilitation exercises are beneficial to reducing the occurrence of postoperative pulmonary complications.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024001155/pdfft?md5=a61cf345e9a21a88faaf156e518f38aa&pid=1-s2.0-S2589845024001155-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239398","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 neoadjuvant therapy effect on 30-day postoperative outcomes in gallbladder cancer","authors":"","doi":"10.1016/j.sopen.2024.08.001","DOIUrl":"10.1016/j.sopen.2024.08.001","url":null,"abstract":"<div><h3>Background</h3><p>The role of neoadjuvant therapy (NAT) in gallbladder cancer (GBC) is not well established. We sought to evaluate the effect of NAT on postoperative outcomes following surgical resection of GBC. We hypothesized that patients receiving NAT would have similar rates of 30-day mortality, readmission, and postoperative complications (e.g. bile leakage and liver failure) compared to those who did not receive NAT.</p></div><div><h3>Methods</h3><p>The 2014–2017 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Procedure-Targeted Hepatectomy database was queried for patients that underwent surgery for GBC. Propensity scores were calculated to match patients in a 1:2 ratio based on age, comorbidities, functional status, and tumor staging.</p></div><div><h3>Results</h3><p>A total of 37 patients undergoing NAT were matched to 74 patients without NAT. There was no difference in any matched characteristics. Compared to the NAT group, the no NAT cohort had similar rates of postoperative bile leakage (NAT 13.5 % vs. no NAT 10.8 %, <em>p</em> = 0.31), postoperative liver failure (5.4 %, vs. 8.1 %, <em>p</em> = 0.60), 30-day readmission (10.8 % vs. 10.8 %, <em>p</em> = 1.00), and 30-day mortality (10.8 % vs. 2.7 %, <em>p</em> = 0.075). All 30-day complications were similar except for a higher rate of postoperative blood transfusion (NAT 32.4 % vs. no NAT 10.8 %, <em>p</em> = 0.005).</p></div><div><h3>Conclusion</h3><p>In patients undergoing surgical resection for GBC, those with and without NAT had similar rates of readmission and 30-day mortality, however NAT was associated with an increased risk for transfusion. Despite use of a large national database, this study may be underpowered to adequately assess the effect of NAT on perioperative GBC outcomes and thus warrants further investigation.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024001118/pdfft?md5=9aa8a8ec2d9b1d9f6e321b27db3ed5ec&pid=1-s2.0-S2589845024001118-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122098","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":"Could virtual reality be a solution in surgical trainings in resource-restricted settings? A perspective","authors":"","doi":"10.1016/j.sopen.2024.08.004","DOIUrl":"10.1016/j.sopen.2024.08.004","url":null,"abstract":"<div><p>Surgical conditions account for 11 % of the global burden of disease, with over 313 million surgical procedures performed worldwide each year. This underscores the critical need to train more surgeons, particularly in low- and middle-income countries (LMICs), where disparities in access to surgical services persist due to a limited number of trained professionals. However, in resource-restricted settings, surgical education is often hampered by ethical, logistical, and financial challenges associated with the use of cadavers, leading to significant skill gaps that can negatively impact patient outcomes and exacerbate healthcare disparities. The advent of advanced technologies, such as Virtual Reality (VR), offers a promising alternative for enhancing surgical training. This paper explores the potential of VR to revolutionize surgical education in resource-constrained environments and addresses key considerations for its effective implementation.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024001143/pdfft?md5=3295df3781c5e54575810774055575fb&pid=1-s2.0-S2589845024001143-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142083630","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":"Surgical skill analysis focused on tissue traction in laparoscopic wet lab training","authors":"","doi":"10.1016/j.sopen.2024.08.002","DOIUrl":"10.1016/j.sopen.2024.08.002","url":null,"abstract":"<div><h3>Background</h3><p>Tissue handling is one of the pivotal parts of surgical procedures. We aimed to elucidate the characteristics of experts' left-hand during laparoscopic tissue dissection.</p></div><div><h3>Methods</h3><p>Participants performed tissue dissection around the porcine aorta. The grasping force/point of the grasping forceps were measured using custom-made sensor forceps, and the forceps location was also recorded by motion capture system (Mocap). According to the global operative assessment of laparoscopic skills (GOALS), two experts scored the recorded movies, and based on the mean scores, participants were divided into three groups: novice (&lt;10), intermediate (10≤ to &lt;20), and expert (≤20). Force-based metrics were compared among the three groups using the Kruskal-Wallis test. Principal component analysis (PCA) using significant metrics was also performed.</p></div><div><h3>Results</h3><p>A total of 42 trainings were successfully recorded. The statistical test revealed that novices frequently regrasped a tissue (median total number of grasps, novices: 268.0 times, intermediates: 89.5, experts: 52.0, <em>p</em> &lt; 0.0001), the traction angle became stable against the aorta (median weighted standard deviation of traction angle, novices: 30.74°, intermediates: 26.80, experts: 23.75, <em>p</em> = 0.0285), and the grasping point moved away from the aorta according to skill competency [median percentage of grasping force applied in close zone (0 to 2.0 cm from aorta), novices: 34.96 %, intermediates: 21.61 %, experts: 10.91 %, <em>p</em> = 0.0032]. PCA showed that the efficiency-related (total number of grasps) and effective tissue traction-related (weighted average grasping position in Y-axis and distribution of grasping area) metrics mainly contributed to the skill difference (proportion of variance of first principal component: 60.83 %).</p></div><div><h3>Conclusion</h3><p>The present results revealed experts' left-hand characteristics, including correct tissue grasping, sufficient tissue traction from the aorta, and stable traction angle. Our next challenge is the provision of immediate and visual feedback onsite after the present wet-lab training, and shortening the learning curve of trainees.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S258984502400112X/pdfft?md5=13bde8195065c48c12bdb4ef1663f2eb&pid=1-s2.0-S258984502400112X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142076203","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":"Appendectomy: Cross-sectional study of the effects of COVID-19 in a hospital in South Brazil","authors":"","doi":"10.1016/j.sopen.2024.08.003","DOIUrl":"10.1016/j.sopen.2024.08.003","url":null,"abstract":"<div><h3>Background</h3><p>COVID-19 has further burdened the Brazilian healthcare system, especially emergencies. Patients may have delayed seeking care for surgical abdominal pain. Delays in the approach may have impacted clinical evolution and outcomes. This study evaluated appendectomies and their complications performed by the public system during one-year follow-up of COVID-19 in a hospital in southern Brazil.</p></div><div><h3>Materials and methods</h3><p>In this hospital-based cross-sectional study, we included adult patients who underwent appendectomy from March 2019 to April 2021 (n = 162). Patients were divided into pre-pandemic (n = 78) and pandemic (n = 84) groups based on the surgery date. The analyzed variables included hospitalization duration, intensive care unit (ICU) admission, surgical approach, histopathological findings, COVID-19 testing, patient outcomes, and 30-day survival rate.</p></div><div><h3>Results</h3><p>The cohorts exhibited similar epidemiology, with the sex ratio and average age being maintained. No statistical difference was found in the 30-day survival rate and clinical outcomes. Of the four patients admitted to the ICU, three belonged to the pandemic cohort and tested negative for COVID-19. Only 47.6 % of the patients in the pandemic cohort underwent COVID-19 polymerase chain reaction examination; one tested positive (2.5 %).</p></div><div><h3>Conclusion</h3><p>This study demonstrated that there was no increased risk for appendectomies during the first wave of the pandemic. Surgeries were safe during this period. Patients continued to access the emergency service despite surgical abdominal pain and restrictive measures imposed by health authorities. The similar results observed across cohorts are attributed to the readiness of the teams and the availability of medical surgical equipment in safe quantities.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024001131/pdfft?md5=c5271b6fd984bfdd1db3b3a7eff21fa4&pid=1-s2.0-S2589845024001131-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044986","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 adoption of robotic lung resection in an established video assisted thoracic surgery practice","authors":"","doi":"10.1016/j.sopen.2024.07.004","DOIUrl":"10.1016/j.sopen.2024.07.004","url":null,"abstract":"<div><h3>Background</h3><p>Reported advantages to robotic thoracic surgery include shorter length of stay (LOS), improved lymphadenectomy, and decreased complications. It is uncertain if these benefits occur when introducing robotics into a well-established video-assisted thoracoscopy (VATS) practice. We compared the two approaches to investigate these advantages.</p></div><div><h3>Materials and methods</h3><p>IRB approval was obtained for this project. Patients who underwent segmentectomy or lobectomy from May 2016–December 2018 were propensity-matched 2: 1 (VATS: robotic) and compared using weighted logistic regression with age, gender, Charlson Comorbidity Index, surgery type, stage, Exparel, and epidural as covariates. Complication rates, operation times, number of sampled lymph nodes, pain level, disposition, and LOS were compared using Wilcoxon rank-sum and with Rao-Scott Chi-squared tests.</p></div><div><h3>Results</h3><p>213 patients (142 VATS and 71 robot) were matched. Duration of robotic cases was longer than VATS (median 186 min (IQR 78) vs. 164 min (IQR 78.75); <em>p</em> &lt; 0.001). Significantly more lymph nodes (median 11 (IQR 7.50) vs. 8 (IQR 7.00); <em>p</em> = 0.004) and stations were sampled (median 4 (IQR 2.00) vs. 3 (IQR 1.00); <em>p</em> &lt; 0.001) with the robot. Interestingly, robotic resections had higher 72-hour pain scores (median 3 (IQR 3.25) vs. 2 (IQR 3.50); <em>p</em> = 0.04) and 48-hour opioid usage (median 37.50 morphine milligram equivalents (MME) (IQR 45.50) vs. 22.50 MME (IQR 37.50); <em>p</em> = 0.01). Morbidity, LOS, and disposition were similar (all <em>p</em> &gt; 0.05).</p></div><div><h3>Conclusions</h3><p>The robotic approach facilitates better lymph node sampling, even in an established VATS practice.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024001027/pdfft?md5=dcac75967ffdd2b466f25ece1122c1dc&pid=1-s2.0-S2589845024001027-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141843389","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":"Improving adrenalectomies: Safe outcomes of partial adrenalectomies and suitable characteristics","authors":"","doi":"10.1016/j.sopen.2024.07.001","DOIUrl":"10.1016/j.sopen.2024.07.001","url":null,"abstract":"<div><h3>Background</h3><p>Partial adrenalectomy (PA) is increasingly used to treat benign tumors to lower the probability of adrenal insufficiency and reduce need for lifetime hormone replacement therapy. Currently, two major concerns are increased bleeding and non-functioning adrenal remnants. This paper examines these concerns and compares surgical approaches with novel findings.</p></div><div><h3>Methods</h3><p>Between 1993 and 2023, 72 patients underwent PA for primary adrenal disorders. Demographic, clinicopathologic and outcome data were analyzed for summary statistics, confidence intervals, and heteroscedastic <em>t</em>-test statistics.</p></div><div><h3>Results</h3><p>The patients were 17–76 years-old and were 59.7 % female. The PA was on the left 54.2 % and bilaterally 4.2 %. The indications were adrenal adenoma, pheochromocytoma, cyst, hyperplasia, and other. The mean tumor diameter was 2.7 cm (range 0.7-10 cm). 23 were performed open, 43 laparoscopically, and 6 with an intended robotic approach. Median follow-up was 9.3 years.</p><p>Robotic had the shortest length of stay (LOS) (<em>p</em>-value 0.01), then laparoscopic (p-value 0.00004), then open. The estimated blood loss (EBL) ranged from 5 to 500 mL (median 50 mL). The median LOS was two days.</p><p>Intra-operative complication rate was 1.4 % and readmission within 30 days occurred in 2.8 %. Out of 72 patients, 6.8 % needed hormone replacement; of the 14 patients with contralateral adrenalectomy, 28.6 % needed replacement.</p></div><div><h3>Conclusion</h3><p>PA appears to be safe with both laparoscopic and robotic-assisted techniques with superior perioperative outcomes. The functional results of PA prevent most patients from requiring ongoing steroid replacement treatment and recurrence rates were low. PA should be advised for more frequent use as the preferred treatment method of choice.</p></div><div><h3>Key message</h3><p>Partial adrenalectomies' perioperative and long-term outcomes over a median 9.3 year follow-up emphasized its safety and efficacy with 95 % CI of (2.7 cm, 3.6 cm) for masses with adrenal sufficiency post-resection. Additionally, as healthcare institutions decide whether to invest in surgical robots, robotic approach's outperformance of laparoscopic and open on LOS may be counterbalanced by laparoscopic's strong performance in low EBL.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024000988/pdfft?md5=dc3a6ff388c0d5d6d6da2938bdaaaf6b&pid=1-s2.0-S2589845024000988-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141692801","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":"Evidence-based management of the patient with synchronous colorectal cancer and liver metastases","authors":"","doi":"10.1016/j.sopen.2024.07.006","DOIUrl":"10.1016/j.sopen.2024.07.006","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024001040/pdfft?md5=b93c6ba59f851f51f857cf8430253658&pid=1-s2.0-S2589845024001040-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844136","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":"Where are they now? An analysis of integrated cardiothoracic surgery residency applicants","authors":"","doi":"10.1016/j.sopen.2024.07.011","DOIUrl":"10.1016/j.sopen.2024.07.011","url":null,"abstract":"<div><p>Changes in cardiothoracic surgery (CTS) workforce trends have affected training paradigms to include the establishment of integrated six-year CTS residency (I6) programs. This study aimed to determine commitment of selected I6 program applicants to the specialty.</p><p>Internal archives at a single institution were accessed to identify applicants interviewed for an I6 position from 2014 to 2016. A systematic internet search of publicly available information was performed to identify the trainee's current specialty. Descriptive analysis was performed.</p><p>Forty-seven applicants were identified. Successful search results were achieved for 97.9 % of the applicants. One applicant was excluded, resulting in a cohort of 45. 48.9 % of the applicants successfully matched into I6 programs. Of the 23 who did not match into an I6 program, 91.3 % began a General Surgery (GS) residency. When looking solely at the GS trainees, 71.4 % sought and matched into a traditional or 4/3 CTS residency. In total, 77.8 % of the cohort are currently pursuing careers in cardiothoracic surgery.</p><p>The study identified a strong continued interest in the field of CT Surgery among those interviewed for integrated residency. The methodology used in this study provided an effective way to follow career choice of applicants interviewed and could be applied by additional programs to further elucidate career choice and levels of commitment.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024001076/pdfft?md5=4c23789a3a8bbddcef6a498cc61491b9&pid=1-s2.0-S2589845024001076-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141950777","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":"Editorial Board Page","authors":"","doi":"10.1016/S2589-8450(24)00110-6","DOIUrl":"10.1016/S2589-8450(24)00110-6","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024001106/pdfft?md5=3b8ddd283f2bc5155979890e514282c0&pid=1-s2.0-S2589845024001106-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141979409","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}