{"id":"https://openalex.org/W7205708643","doi":"https://doi.org/10.2147/jpr.s621294","title":"Association of Post-Amputation Stump Infection with Persistent Residual Limb Pain: A Prospective Cohort Study","display_name":"Association of Post-Amputation Stump Infection with Persistent Residual Limb Pain: A Prospective Cohort Study","publication_year":2026,"publication_date":"2026-09-01","ids":{"openalex":"https://openalex.org/W7205708643","doi":"https://doi.org/10.2147/jpr.s621294","pmid":"https://pubmed.ncbi.nlm.nih.gov/42708047","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13549192"},"language":"en","primary_location":{"id":"doi:10.2147/jpr.s621294","doi":"https://doi.org/10.2147/jpr.s621294","is_oa":true,"landing_page_url":"https://doi.org/10.2147/jpr.s621294","pdf_url":"https://www.dovepress.com/article/download/119149","source":{"id":"https://openalex.org/S130650480","display_name":"Journal of Pain Research","issn_l":"1178-7090","issn":["1178-7090"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320348","host_organization_name":"Dove Medical Press","host_organization_lineage":["https://openalex.org/P4310320348","https://openalex.org/P4310320547"],"host_organization_lineage_names":["Dove Medical Press","Taylor & Francis"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Pain Research","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.dovepress.com/article/download/119149","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5093444734","display_name":"Kateryna Ksenchyna","orcid":"https://orcid.org/0009-0008-1506-2673","observed_orcids":["https://orcid.org/0009-0008-1506-2673"]},"institutions":[{"id":"https://openalex.org/I4210131292","display_name":"National Pirogov Memorial Medical University, Vinnytsya","ror":"https://ror.org/03bcjfh39","country_code":"UA","type":"education","lineage":["https://openalex.org/I4210131292"]}],"countries":["UA"],"is_corresponding":true,"raw_author_name":"Kateryna Ksenchyna","raw_affiliation_strings":["Department of Microbiology, National Pirogov Memorial Medical University, Vinnytsya, Vinnytsia, Ukraine"],"raw_orcid":"https://orcid.org/0009-0008-1506-2673","affiliations":[{"raw_affiliation_string":"Department of Microbiology, National Pirogov Memorial Medical University, Vinnytsya, Vinnytsia, Ukraine","institution_ids":["https://openalex.org/I4210131292"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5040766175","display_name":"Oleh Ksenchyn","orcid":"https://orcid.org/0000-0001-8438-5320","observed_orcids":["https://orcid.org/0000-0001-8438-5320"]},"institutions":[{"id":"https://openalex.org/I4210131292","display_name":"National Pirogov Memorial Medical University, Vinnytsya","ror":"https://ror.org/03bcjfh39","country_code":"UA","type":"education","lineage":["https://openalex.org/I4210131292"]}],"countries":["UA"],"is_corresponding":false,"raw_author_name":"Oleh Ksenchyn","raw_affiliation_strings":["Department of Internal and Family Medicine, National Pirogov Memorial Medical University, Vinnytsya, Vinnytsia, Ukraine"],"raw_orcid":"https://orcid.org/0000-0001-8438-5320","affiliations":[{"raw_affiliation_string":"Department of Internal and Family Medicine, National Pirogov Memorial Medical University, Vinnytsya, Vinnytsia, Ukraine","institution_ids":["https://openalex.org/I4210131292"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5129779089","display_name":"Oleksandr Nazarchuk","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210131292","display_name":"National Pirogov Memorial Medical University, Vinnytsya","ror":"https://ror.org/03bcjfh39","country_code":"UA","type":"education","lineage":["https://openalex.org/I4210131292"]}],"countries":["UA"],"is_corresponding":false,"raw_author_name":"Oleksandr Nazarchuk","raw_affiliation_strings":["Department of Microbiology, National Pirogov Memorial Medical University, Vinnytsya, Vinnytsia, Ukraine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Microbiology, National Pirogov Memorial Medical University, Vinnytsya, Vinnytsia, Ukraine","institution_ids":["https://openalex.org/I4210131292"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5055809588","display_name":"Dmytro Dmytr\u0456iev","orcid":"https://orcid.org/0000-0001-6067-681X","observed_orcids":["https://orcid.org/0000-0001-6067-681X"]},"institutions":[{"id":"https://openalex.org/I4405263541","display_name":"Superhumans War Trauma Center","ror":"https://ror.org/02hw7a871","country_code":"UA","type":"nonprofit","lineage":["https://openalex.org/I4405263541"]}],"countries":["UA"],"is_corresponding":false,"raw_author_name":"Dmytro Dmytriiev","raw_affiliation_strings":["Superhumans War Trauma Center, Lviv, Ukraine"],"raw_orcid":"https://orcid.org/0000-0001-6067-681X","affiliations":[{"raw_affiliation_string":"Superhumans War Trauma Center, Lviv, Ukraine","institution_ids":["https://openalex.org/I4405263541"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5093444734"],"corresponding_institution_ids":["https://openalex.org/I4210131292"],"apc_list":{"value":2836,"currency":"USD","value_usd":2836},"apc_paid":{"value":2836,"currency":"USD","value_usd":2836},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"Volume 19","issue":null,"first_page":"1","last_page":"10"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11840","display_name":"Pain Management and Treatment","score":0.8881999850273132,"subfield":{"id":"https://openalex.org/subfields/2703","display_name":"Anesthesiology and Pain Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11840","display_name":"Pain Management and Treatment","score":0.8881999850273132,"subfield":{"id":"https://openalex.org/subfields/2703","display_name":"Anesthesiology and Pain Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11227","display_name":"Diabetic Foot Ulcer Assessment and Management","score":0.03620000183582306,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11293","display_name":"Orthopedic Infections and Treatments","score":0.019899999722838402,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/residual-limb-pain","display_name":"residual limb pain","score":0.953000009059906},{"id":"https://openalex.org/keywords/amputation","display_name":"amputation","score":0.8069999814033508},{"id":"https://openalex.org/keywords/infection-severity","display_name":"infection severity","score":0.7519999742507935},{"id":"https://openalex.org/keywords/osteomyelitis","display_name":"osteomyelitis","score":0.9440000057220459},{"id":"https://openalex.org/keywords/coinfection","display_name":"co-infection","score":0.8299999833106995},{"id":"https://openalex.org/keywords/gram-negative-bacteria","display_name":"Gram-negative bacteria","score":0.781000018119812},{"id":"https://openalex.org/keywords/multidrug-resistant-organisms","display_name":"multidrug-resistant organisms","score":0.9670000076293945},{"id":"https://openalex.org/keywords/neuropathic-pain","display_name":"neuropathic pain","score":0.9200000166893005},{"id":"https://openalex.org/keywords/pain-intensity","display_name":"pain intensity","score":0.7429999709129333},{"id":"https://openalex.org/keywords/microbiological-profile","display_name":"microbiological profile","score":0.5870000123977661}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9814000129699707},{"id":"https://openalex.org/C188816634","wikidata":"https://www.wikidata.org/wiki/Q2113324","display_name":"Prospective cohort study","level":2,"score":0.7307999730110168},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.5708000063896179},{"id":"https://openalex.org/C2777107010","wikidata":"https://www.wikidata.org/wiki/Q2798704","display_name":"Neuropathic pain","level":2,"score":0.5450000166893005},{"id":"https://openalex.org/C2780551157","wikidata":"https://www.wikidata.org/wiki/Q938983","display_name":"Osteomyelitis","level":2,"score":0.5023000240325928},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.474700003862381},{"id":"https://openalex.org/C81182388","wikidata":"https://www.wikidata.org/wiki/Q353963","display_name":"Complication","level":2,"score":0.4724000096321106},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.43959999084472656},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.3400000035762787},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.3330000042915344},{"id":"https://openalex.org/C2776660947","wikidata":"https://www.wikidata.org/wiki/Q841423","display_name":"Upper limb","level":2,"score":0.3303000032901764},{"id":"https://openalex.org/C50440223","wikidata":"https://www.wikidata.org/wiki/Q1475848","display_name":"Risk factor","level":2,"score":0.31779998540878296},{"id":"https://openalex.org/C23131810","wikidata":"https://www.wikidata.org/wiki/Q818574","display_name":"Observational study","level":2,"score":0.3167000114917755},{"id":"https://openalex.org/C156957248","wikidata":"https://www.wikidata.org/wiki/Q1862216","display_name":"Odds ratio","level":2,"score":0.3138999938964844},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.29159998893737793},{"id":"https://openalex.org/C205545832","wikidata":"https://www.wikidata.org/wiki/Q17156455","display_name":"Young adult","level":2,"score":0.2888000011444092},{"id":"https://openalex.org/C2775991916","wikidata":"https://www.wikidata.org/wiki/Q2945973","display_name":"Nerve injury","level":2,"score":0.28279998898506165},{"id":"https://openalex.org/C30036603","wikidata":"https://www.wikidata.org/wiki/Q17125150","display_name":"Severity of illness","level":2,"score":0.2775000035762787},{"id":"https://openalex.org/C2777238321","wikidata":"https://www.wikidata.org/wiki/Q876887","display_name":"Cellulitis","level":2,"score":0.26570001244544983},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.26409998536109924},{"id":"https://openalex.org/C2776204877","wikidata":"https://www.wikidata.org/wiki/Q477415","display_name":"Amputation","level":2,"score":0.2619999945163727},{"id":"https://openalex.org/C77350462","wikidata":"https://www.wikidata.org/wiki/Q1125472","display_name":"Confounding","level":2,"score":0.25769999623298645}],"mesh":[],"locations_count":5,"locations":[{"id":"doi:10.2147/jpr.s621294","doi":"https://doi.org/10.2147/jpr.s621294","is_oa":true,"landing_page_url":"https://doi.org/10.2147/jpr.s621294","pdf_url":"https://www.dovepress.com/article/download/119149","source":{"id":"https://openalex.org/S130650480","display_name":"Journal of Pain Research","issn_l":"1178-7090","issn":["1178-7090"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320348","host_organization_name":"Dove Medical Press","host_organization_lineage":["https://openalex.org/P4310320348","https://openalex.org/P4310320547"],"host_organization_lineage_names":["Dove Medical Press","Taylor & Francis"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Pain Research","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13549192","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13549192/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13549192/pdf/JPR-19-621294.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"J Pain Res","raw_type":"Text"},{"id":"pmid:42708047","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42708047","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of pain research","raw_type":"Journal Article"},{"id":"pmh:oai:doaj.org/article:d44eeb25d3c844dfa45676fc694879d8","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/d44eeb25d3c844dfa45676fc694879d8","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"Journal of Pain Research, Vol Volume 19, Iss Issue 1, Pp 1-10 (2026)","raw_type":"article"},{"id":"pmh:oai:dovepress.com/119149","doi":null,"is_oa":true,"landing_page_url":"https://www.dovepress.com/association-of-post-amputation-stump-infection-with-persistent-residua-peer-reviewed-fulltext-article-JPR","pdf_url":null,"source":{"id":"https://openalex.org/S4306401012","display_name":"Dove Medical Press (Taylor and Francis Group)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"info:eu-repo/semantics/article"}],"best_oa_location":{"id":"doi:10.2147/jpr.s621294","doi":"https://doi.org/10.2147/jpr.s621294","is_oa":true,"landing_page_url":"https://doi.org/10.2147/jpr.s621294","pdf_url":"https://www.dovepress.com/article/download/119149","source":{"id":"https://openalex.org/S130650480","display_name":"Journal of Pain Research","issn_l":"1178-7090","issn":["1178-7090"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","norway-1","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320348","host_organization_name":"Dove Medical Press","host_organization_lineage":["https://openalex.org/P4310320348","https://openalex.org/P4310320547"],"host_organization_lineage_names":["Dove Medical Press","Taylor & Francis"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Pain Research","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":1.0}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7205708643.pdf","grobid_xml":"https://content.openalex.org/works/W7205708643.grobid-xml"},"referenced_works_count":12,"referenced_works":["https://openalex.org/W2035605437","https://openalex.org/W2113154361","https://openalex.org/W2116230226","https://openalex.org/W2130141996","https://openalex.org/W2154366164","https://openalex.org/W2519128930","https://openalex.org/W2786697307","https://openalex.org/W3185168217","https://openalex.org/W4293900457","https://openalex.org/W4377030409","https://openalex.org/W4394894099","https://openalex.org/W4411186482"],"related_works":["https://openalex.org/W7203503125","https://openalex.org/W2314607762","https://openalex.org/W1995425298","https://openalex.org/W3171344310","https://openalex.org/W2047953046","https://openalex.org/W4399480011","https://openalex.org/W4244977135","https://openalex.org/W3038289728","https://openalex.org/W4400583586","https://openalex.org/W4400979808"],"abstract_inverted_index":{"Background:":[0],"Persistent":[1],"residual":[2,50,108,257,269],"limb":[3,13,51,79,109,258,270],"pain":[4,32,110,116,131,134,146,201,205,213,228,271,291],"(RLP)":[5],"is":[6],"a":[7,121,208],"common":[8],"and":[9,18,30,48,61,92,144,153,160,207,221,245,282,304,319],"disabling":[10],"complication":[11],"following":[12],"amputation.":[14,80],"Although":[15],"nerve":[16],"injury":[17],"neuroma":[19],"formation":[20],"are":[21],"well-established":[22],"contributors,":[23],"the":[24,42,138,296,308,316],"potential":[25,297],"association":[26,43],"between":[27,44,150],"stump":[28,46,151,187,250,262],"infection":[29,47,57,82,152,167,188,195,251,263,277,302],"long-term":[31],"outcomes":[33,129,229],"has":[34],"not":[35],"been":[36],"fully":[37],"elucidated.":[38],"Aim:":[39],"To":[40],"evaluate":[41],"post-amputation":[45],"persistent":[49,107,154,179,256,268],"pain,":[52],"with":[53,98,120,186,199,216,232,255,267,288],"particular":[54],"emphasis":[55],"on":[56],"severity,":[58,278],"microbiological":[59,99,234,280],"profile,":[60],"antimicrobial":[62,283],"resistance.":[63],"Methods:":[64],"This":[65],"prospective":[66,274],"observational":[67],"cohort":[68],"study":[69],"included":[70,130],"430":[71,173],"adult":[72],"patients":[73,174,185],"who":[74],"underwent":[75],"upper":[76],"or":[77,90],"lower":[78],"Stump":[81,166],"was":[83,106,168,181,197,264],"classified":[84],"as":[85,115],"superficial":[86],"infection,":[87,89],"deep":[88],"osteomyelitis":[91],"diagnosed":[93],"using":[94,137,158],"standardized":[95],"clinical":[96,298],"criteria":[97],"confirmation":[100],"when":[101],"available.":[102],"The":[103],"primary":[104],"outcome":[105],"at":[111],"6":[112,177],"months,":[113,178],"defined":[114],"lasting":[117],"\u22653":[118],"months":[119],"Numerical":[122],"Rating":[123],"Scale":[124],"(NRS)":[125],"score":[126],"\u22653.":[127],"Secondary":[128],"intensity,":[132],"neuropathic":[133,212],"features":[135],"assessed":[136],"Douleur":[139],"Neuropathique":[140],"4":[141],"(DN4)":[142],"questionnaire,":[143],"moderate-to-severe":[145],"(NRS":[147],"\u22655).":[148],"Associations":[149],"RLP":[155,180],"were":[156,285],"evaluated":[157],"unadjusted":[159],"multivariable":[161],"logistic":[162],"regression":[163],"analyses.":[164],"Results:":[165],"identified":[169],"in":[170,272],"118":[171],"of":[172,211,300],"(27.4%).":[175],"At":[176],"more":[182],"frequent":[183],"among":[184,190],"than":[189,230],"those":[191,231],"without":[192],"infection.":[193],"Increasing":[194],"severity":[196],"associated":[198,254,266,287],"worse":[200],"outcomes,":[202],"including":[203],"higher":[204],"intensity":[206],"greater":[209],"prevalence":[210],"features.":[214],"Patients":[215],"polymicrobial":[217],"infections,":[218],"Gram-negative":[219],"pathogens,":[220],"multidrug-resistant":[222],"organisms":[223],"(MDRO)":[224],"demonstrated":[225],"less":[226,289],"favorable":[227,290],"uncomplicated":[233],"profiles.":[235],"After":[236],"adjustment":[237],"for":[238,310],"age,":[239],"sex,":[240],"severe":[241],"soft":[242],"tissue":[243],"injury,":[244],"time":[246],"to":[247,314],"wound":[248],"closure,":[249],"remained":[252],"independently":[253,265],"pain.":[259],"Conclusion:":[260],"Post-amputation":[261],"this":[273],"cohort.":[275],"Greater":[276],"increased":[279],"complexity,":[281],"resistance":[284],"also":[286],"outcomes.":[292],"These":[293],"findings":[294],"support":[295],"importance":[299],"early":[301],"recognition":[303],"management":[305],"while":[306],"highlighting":[307],"need":[309],"further":[311],"multicenter":[312],"studies":[313],"clarify":[315],"underlying":[317],"mechanisms":[318],"confirm":[320],"these":[321],"associations.":[322]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-09-02T00:00:00"}