{"id":"https://openalex.org/W7213790113","doi":"https://doi.org/10.1007/s11695-026-09028-y","title":"Management of Staple\u2011Line Leaks after Laparoscopic Sleeve Gastrectomy: Efficacy of Double Pigtail Stenting and a Practical Algorithm for Early and Late Leaks","display_name":"Management of Staple\u2011Line Leaks after Laparoscopic Sleeve Gastrectomy: Efficacy of Double Pigtail Stenting and a Practical Algorithm for Early and Late Leaks","publication_year":2026,"publication_date":"2026-11-11","ids":{"openalex":"https://openalex.org/W7213790113","doi":"https://doi.org/10.1007/s11695-026-09028-y"},"language":"en","primary_location":{"id":"doi:10.1007/s11695-026-09028-y","doi":"https://doi.org/10.1007/s11695-026-09028-y","is_oa":false,"landing_page_url":"https://doi.org/10.1007/s11695-026-09028-y","pdf_url":null,"source":{"id":"https://openalex.org/S12098962","display_name":"Obesity Surgery","issn_l":"0960-8923","issn":["0960-8923","1708-0428"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-c","doyens","jufo-2","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319900","host_organization_name":"Springer Science+Business Media","host_organization_lineage":["https://openalex.org/P4310319900","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Science+Business Media","Springer Nature"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Obesity Surgery","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.researchsquare.com/article/rs-10398336/latest.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5003582324","display_name":"Saeed Safari","orcid":"https://orcid.org/0000-0001-6127-6359","observed_orcids":["https://orcid.org/0000-0001-6127-6359"]},"institutions":[{"id":"https://openalex.org/I161106909","display_name":"Iran University of Medical Sciences","ror":"https://ror.org/03w04rv71","country_code":"IR","type":"education","lineage":["https://openalex.org/I161106909"]},{"id":"https://openalex.org/I4210097843","display_name":"Firoozgar General Hospital","ror":"https://ror.org/014hy9c40","country_code":"IR","type":"healthcare","lineage":["https://openalex.org/I4210097843"]}],"countries":["IR"],"is_corresponding":false,"raw_author_name":"Saeed Safari","raw_affiliation_strings":["Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran","institution_ids":["https://openalex.org/I161106909","https://openalex.org/I4210097843"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5100916239","display_name":"Mohammad Moradi","orcid":"https://orcid.org/0009-0007-2817-1935","observed_orcids":["https://orcid.org/0009-0007-2817-1935"]},"institutions":[{"id":"https://openalex.org/I161106909","display_name":"Iran University of Medical Sciences","ror":"https://ror.org/03w04rv71","country_code":"IR","type":"education","lineage":["https://openalex.org/I161106909"]},{"id":"https://openalex.org/I4210094544","display_name":"Rasool Akram Hospital","ror":"https://ror.org/00kh76710","country_code":"IR","type":"healthcare","lineage":["https://openalex.org/I4210094544"]}],"countries":["IR"],"is_corresponding":false,"raw_author_name":"Mohammad Moradi","raw_affiliation_strings":["Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran","institution_ids":["https://openalex.org/I161106909","https://openalex.org/I4210094544"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5017860196","display_name":"Erfan Abdiaei","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I161106909","display_name":"Iran University of Medical Sciences","ror":"https://ror.org/03w04rv71","country_code":"IR","type":"education","lineage":["https://openalex.org/I161106909"]}],"countries":["IR"],"is_corresponding":false,"raw_author_name":"Erfan Abdiaei","raw_affiliation_strings":["School of Medicine, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"School of Medicine, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran","institution_ids":["https://openalex.org/I161106909"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5078626558","display_name":"Ali Nadjafi-Semnani","orcid":"https://orcid.org/0000-0002-8801-2588","observed_orcids":["https://orcid.org/0000-0002-8801-2588"]},"institutions":[{"id":"https://openalex.org/I161106909","display_name":"Iran University of Medical Sciences","ror":"https://ror.org/03w04rv71","country_code":"IR","type":"education","lineage":["https://openalex.org/I161106909"]},{"id":"https://openalex.org/I4210094544","display_name":"Rasool Akram Hospital","ror":"https://ror.org/00kh76710","country_code":"IR","type":"healthcare","lineage":["https://openalex.org/I4210094544"]}],"countries":["IR"],"is_corresponding":true,"raw_author_name":"Ali Nadjafi-Semnani","raw_affiliation_strings":["Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran"],"raw_orcid":"https://orcid.org/0000-0002-8801-2588","affiliations":[{"raw_affiliation_string":"Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran","institution_ids":["https://openalex.org/I161106909","https://openalex.org/I4210094544"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5089541314","display_name":"Kimia Jazi","orcid":"https://orcid.org/0000-0001-5198-5709","observed_orcids":["https://orcid.org/0000-0001-5198-5709"]},"institutions":[{"id":"https://openalex.org/I58048189","display_name":"Shahid Beheshti University of Medical Sciences","ror":"https://ror.org/034m2b326","country_code":"IR","type":"education","lineage":["https://openalex.org/I58048189"]}],"countries":["IR"],"is_corresponding":false,"raw_author_name":"Kimia Jazi","raw_affiliation_strings":["Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran"],"raw_orcid":"https://orcid.org/0000-0001-5198-5709","affiliations":[{"raw_affiliation_string":"Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran","institution_ids":["https://openalex.org/I58048189"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5138427683","display_name":"Kimia Vakili","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I58048189","display_name":"Shahid Beheshti University of Medical Sciences","ror":"https://ror.org/034m2b326","country_code":"IR","type":"education","lineage":["https://openalex.org/I58048189"]}],"countries":["IR"],"is_corresponding":false,"raw_author_name":"Kimia Vakili","raw_affiliation_strings":["Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran","institution_ids":["https://openalex.org/I58048189"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5084183328","display_name":"Shahab Shahabi Shahmiri","orcid":"https://orcid.org/0000-0002-8415-2567","observed_orcids":["https://orcid.org/0000-0002-8415-2567"]},"institutions":[{"id":"https://openalex.org/I161106909","display_name":"Iran University of Medical Sciences","ror":"https://ror.org/03w04rv71","country_code":"IR","type":"education","lineage":["https://openalex.org/I161106909"]},{"id":"https://openalex.org/I4210094544","display_name":"Rasool Akram Hospital","ror":"https://ror.org/00kh76710","country_code":"IR","type":"healthcare","lineage":["https://openalex.org/I4210094544"]}],"countries":["IR"],"is_corresponding":true,"raw_author_name":"Shahab Shahabi Shahmiri","raw_affiliation_strings":["Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran","institution_ids":["https://openalex.org/I161106909","https://openalex.org/I4210094544"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":4,"corresponding_author_ids":["https://openalex.org/A5078626558","https://openalex.org/A5084183328"],"corresponding_institution_ids":["https://openalex.org/I161106909","https://openalex.org/I4210094544"],"apc_list":{"value":4590,"currency":"USD","value_usd":4590},"apc_paid":null,"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":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10569","display_name":"Bariatric Surgery and Outcomes","score":0.9980000257492065,"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"}},"topics":[{"id":"https://openalex.org/T10569","display_name":"Bariatric Surgery and Outcomes","score":0.9980000257492065,"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"}},{"id":"https://openalex.org/T12053","display_name":"Minimally Invasive Surgical Techniques","score":0.0013000000035390258,"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"}},{"id":"https://openalex.org/T12173","display_name":"Body Contouring and Surgery","score":0.0,"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/staple-line-leak","display_name":"staple line leak","score":0.996999979019165},{"id":"https://openalex.org/keywords/laparoscopic-sleeve-gastrectomy","display_name":"laparoscopic sleeve gastrectomy","score":0.996999979019165},{"id":"https://openalex.org/keywords/double-pigtail-stent","display_name":"double pigtail stent","score":0.9700000286102295},{"id":"https://openalex.org/keywords/bariatric-surgery-complications","display_name":"bariatric surgery complications","score":0.8330000042915344},{"id":"https://openalex.org/keywords/revisional-surgery","display_name":"revisional surgery","score":0.6959999799728394},{"id":"https://openalex.org/keywords/treatment-algorithm","display_name":"treatment algorithm","score":0.625}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9592999815940857},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.7657999992370605},{"id":"https://openalex.org/C2780378346","wikidata":"https://www.wikidata.org/wiki/Q1349983","display_name":"Leak","level":2,"score":0.7401000261306763},{"id":"https://openalex.org/C152365676","wikidata":"https://www.wikidata.org/wiki/Q839734","display_name":"Pigtail","level":3,"score":0.5810999870300293},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.4706000089645386},{"id":"https://openalex.org/C2776376669","wikidata":"https://www.wikidata.org/wiki/Q5094647","display_name":"Intensive care unit","level":2,"score":0.4401000142097473},{"id":"https://openalex.org/C116558999","wikidata":"https://www.wikidata.org/wiki/Q4131496","display_name":"Reconstructive surgery","level":2,"score":0.43320000171661377},{"id":"https://openalex.org/C2780706714","wikidata":"https://www.wikidata.org/wiki/Q5376416","display_name":"Endoscopic stenting","level":3,"score":0.4083999991416931},{"id":"https://openalex.org/C2776135927","wikidata":"https://www.wikidata.org/wiki/Q5242559","display_name":"Referral","level":2,"score":0.35040000081062317},{"id":"https://openalex.org/C61434518","wikidata":"https://www.wikidata.org/wiki/Q932510","display_name":"General surgery","level":1,"score":0.31380000710487366},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.31189998984336853},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.3021000027656555},{"id":"https://openalex.org/C2778451229","wikidata":"https://www.wikidata.org/wiki/Q212809","display_name":"Endoscopy","level":2,"score":0.28790000081062317},{"id":"https://openalex.org/C81182388","wikidata":"https://www.wikidata.org/wiki/Q353963","display_name":"Complication","level":2,"score":0.2741999924182892},{"id":"https://openalex.org/C2780073493","wikidata":"https://www.wikidata.org/wiki/Q7523837","display_name":"Single Center","level":2,"score":0.2567000091075897},{"id":"https://openalex.org/C2776341189","wikidata":"https://www.wikidata.org/wiki/Q189470","display_name":"Fistula","level":2,"score":0.2524999976158142}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1007/s11695-026-09028-y","doi":"https://doi.org/10.1007/s11695-026-09028-y","is_oa":false,"landing_page_url":"https://doi.org/10.1007/s11695-026-09028-y","pdf_url":null,"source":{"id":"https://openalex.org/S12098962","display_name":"Obesity Surgery","issn_l":"0960-8923","issn":["0960-8923","1708-0428"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-c","doyens","jufo-2","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319900","host_organization_name":"Springer Science+Business Media","host_organization_lineage":["https://openalex.org/P4310319900","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Science+Business Media","Springer Nature"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Obesity Surgery","raw_type":"journal-article"},{"id":"doi:10.21203/rs.3.rs-10398336/v1","doi":"https://doi.org/10.21203/rs.3.rs-10398336/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10398336/v1","pdf_url":"https://www.researchsquare.com/article/rs-10398336/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","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","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.21203/rs.3.rs-10398336/v1","doi":"https://doi.org/10.21203/rs.3.rs-10398336/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10398336/v1","pdf_url":"https://www.researchsquare.com/article/rs-10398336/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","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","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"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/W7213790113.pdf","grobid_xml":"https://content.openalex.org/works/W7213790113.grobid-xml"},"referenced_works_count":23,"referenced_works":["https://openalex.org/W1963939479","https://openalex.org/W2062180774","https://openalex.org/W2063522857","https://openalex.org/W2069541057","https://openalex.org/W2083469409","https://openalex.org/W2084614807","https://openalex.org/W2088495732","https://openalex.org/W2089324159","https://openalex.org/W2090073911","https://openalex.org/W2126061246","https://openalex.org/W2144256005","https://openalex.org/W2155268116","https://openalex.org/W2181654738","https://openalex.org/W2268403835","https://openalex.org/W2344825225","https://openalex.org/W2520460255","https://openalex.org/W2749749310","https://openalex.org/W2783324876","https://openalex.org/W2915948028","https://openalex.org/W2923948020","https://openalex.org/W3015495378","https://openalex.org/W3137442060","https://openalex.org/W4393352681"],"related_works":["https://openalex.org/W2069541057","https://openalex.org/W7169783144","https://openalex.org/W2904711376","https://openalex.org/W4294860275","https://openalex.org/W2090073911","https://openalex.org/W2186716206","https://openalex.org/W2752900196","https://openalex.org/W116743458","https://openalex.org/W1971284423","https://openalex.org/W2244991837"],"abstract_inverted_index":{"Abstract":[0],"Background:":[1],"Staple-line":[2],"leak":[3,40,104,135,284,318],"(SLL)":[4],"remains":[5,42],"one":[6],"of":[7,46,55,60,112,246,283],"the":[8,52,58,138],"most":[9],"severe":[10],"complications":[11],"following":[12,91,191],"laparoscopic":[13],"sleeve":[14],"gastrectomy":[15],"(LSG).":[16],"Although":[17],"endoscopic":[18,120],"internal":[19,129],"drainage":[20,213],"using":[21],"double":[22],"pigtail":[23,261],"stents":[24],"(DPS)":[25],"has":[26],"emerged":[27],"as":[28],"an":[29,264],"effective":[30,265],"minimally":[31,266],"invasive":[32,267],"treatment,":[33],"evidence":[34],"comparing":[35],"its":[36],"efficacy":[37],"according":[38,316],"to":[39,50,82,317],"timing":[41,319],"limited.":[43],"The":[44,227],"aim":[45],"this":[47],"study":[48,77],"was":[49,123,133,184,193,233],"evaluate":[51],"clinical":[53,176],"outcomes":[54,145],"DPS":[56,122,182,192],"for":[57,128,140,229,269],"management":[59,110,303],"SLL":[61,90,163],"after":[62,272],"LSG":[63],"and":[64,70,100,119,156,169,175,219,251,299,307],"compare":[65],"treatment":[66,268],"success":[67],"between":[68,180,257],"early":[69,97,167,200,238],"late":[71,101,171,197,278],"leaks.":[72],"Methods:":[73],"This":[74],"retrospective":[75],"cohort":[76],"included":[78,146,165],"consecutive":[79],"patients":[80,107,161,276],"referred":[81],"a":[83,321],"tertiary":[84],"bariatric":[85,323],"referral":[86],"center":[87],"with":[88,162,277],"confirmed":[89],"LSG.":[92],"Patients":[93],"were":[94,164,178],"categorized":[95],"into":[96],"(<7":[98],"days)":[99,103],"(\u22657":[102],"groups.":[105,181,258],"All":[106],"underwent":[108],"multidisciplinary":[109,322],"consisting":[111],"resuscitation,":[113],"nutritional":[114],"support,":[115],"antibiotics,":[116],"radiologic":[117,212],"assessment,":[118],"evaluation.":[121],"used":[124],"whenever":[125],"technically":[126],"feasible":[127],"drainage.":[130],"Primary":[131],"outcome":[132],"successful":[134],"closure":[136],"without":[137],"need":[139,228],"definitive":[141,230],"reconstructive":[142,231],"surgery.":[143,293],"Secondary":[144],"additional":[147],"interventions,":[148],"hospital":[149,247],"stay,":[150,155,248,250],"intensive":[151],"care":[152],"unit":[153],"(ICU)":[154],"mortality.":[157],"Results":[158],":":[159],"Fifty":[160],"(26":[166],"leaks":[168,198,201,208,239,271,295],"24":[170],"leaks).":[172],"Baseline":[173],"demographic":[174],"characteristics":[177],"comparable":[179],"placement":[183],"attempted":[185],"in":[186,196,237,275],"41":[187],"patients.":[188],"Leak":[189],"resolution":[190,285],"significantly":[194,235,256],"higher":[195],"than":[199],"(80.0%":[202],"vs.":[203,215,223,241],"52.4%,":[204],"P":[205,217,225,243],"=0.031).":[206],"Early":[207,294],"more":[209,297],"frequently":[210,300],"required":[211],"(84.6%":[214],"54.2%,":[216],"=0.030)":[218],"surgical":[220,308],"intervention":[221],"(80.8%":[222],"25.0%,":[224,242],"=0.001).":[226],"surgery":[232],"also":[234],"greater":[236],"(53.8%":[240],"=0.048).":[244],"Length":[245],"ICU":[249],"mortality":[252],"did":[253],"not":[254],"differ":[255],"Conclusions:":[259],"Double":[260],"stenting":[262],"is":[263],"staple-line":[270],"LSG,":[273],"particularly":[274],"leaks,":[279],"where":[280],"high":[281],"rates":[282],"can":[286],"be":[287,314],"achieved":[288],"while":[289],"avoiding":[290],"major":[291],"revisional":[292],"remain":[296],"challenging":[298],"require":[301],"multimodal":[302],"combining":[304],"endoscopic,":[305],"radiologic,":[306],"approaches.":[309],"Treatment":[310],"strategies":[311],"should":[312],"therefore":[313],"individualized":[315],"within":[320],"program.":[324]},"counts_by_year":[],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2026-09-21T00:00:00"}
