Clinics and research in hepatology and gastroenterology最新文献

{"title":"Does Antibiotic therapy for anal abscess reduce the risk of fistula surgery? A retrospective study.","authors":"Amine Antonin Alam, Nadia Fathallah, Manuel Aubert, Paul Benfredj, Elise Pommaret, Vincent de Parades","doi":"10.1016/j.clinre.2025.102706","DOIUrl":"https://doi.org/10.1016/j.clinre.2025.102706","url":null,"abstract":"<p><strong>Background: </strong>Management of first-time perianal abscesses remains controversial. While the French school of proctology systematically investigates fistulas, other approaches advocate simple incision, given that over 60% of patients do not develop recurrence. The role of post-incision antibiotic therapy is also debated. This study aimed at evaluating our department's approach to managing first perianal abscesses and identifying predictive factors for recurrence.</p><p><strong>Methods: </strong>We retrospectively included all patients presenting in 2019 with a first perianal abscess treated by incision under local anesthesia, with or without antibiotic therapy post-incision. Patients with evident fistulas underwent surgery. Recurrence was defined as a new abscess or purulent opening. The primary outcome was the rate of patients requiring fistula surgery and/or experiencing abscess recurrence; secondary outcomes included identification of recurrence predictors.</p><p><strong>Results: </strong>Among the 336 patients who consulted for an abscess, 109 were included. Among 109 patients (mean age 43 ± 13 years; 74% male), 55 had incision alone, and 54 underwent fistula surgery. The mean follow-up for patients with incision alone was approximately 30 months, during which 18% (10 patients) experienced abscess recurrence. Univariate logistic regression analysis revealed smoking and absence of antibiotic therapy post-incision as predictive of recurrence with (OR 0.44) were predictive of recurrence. Gender, age, BMI, diabetes, Crohn's disease, HIV infection, prior NSAID use, and abscess location were not predictive. Multivariate analysis was not conducted due to insufficient data.</p><p><strong>Conclusion: </strong>This study demonstrates that 41% of patients who underwent incision for a first perianal abscess did not experience recurrence during the follow-up period. Additionally, the administration of antibiotic therapy post-incision was associated with a reduced likelihood of recurrence. However, randomized trials are warranted to validate these findings and specify the optimal antibiotic regimen.</p>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":" ","pages":"102706"},"PeriodicalIF":2.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231443","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":"Development of a cross-species model to predict clinical outcomes based on efficacy in mouse models of non-alcoholic fatty liver disease.","authors":"Haoxiang Zhu, Jiesen Yu, Jieren Luo, Zihao Cai, Lujin Li, Qingshan Zheng","doi":"10.1016/j.clinre.2025.102702","DOIUrl":"10.1016/j.clinre.2025.102702","url":null,"abstract":"<p><strong>Background and aim: </strong>Drug development for non-alcoholic fatty liver disease (NAFLD) is frequently hampered by the poor translation of preclinical findings into clinical efficacy. To address this critical challenge, we developed a quantitative cross-species model designed to predict human clinical outcomes from efficacy data in mouse models.</p><p><strong>Methods: </strong>We performed a model-based meta-analysis (MBMA) of 18 NAFLD drugs, integrating data from published clinical trials with corresponding preclinical mouse studies identified through a systematic search of the Embase and PubMed databases. Using the change in alanine aminotransferase (ΔALT) as the primary biomarker, we constructed an exponential model to define the relationship between ALT reduction in mice and the placebo-corrected response in humans (ΔΔALT). The model's predictive performance was then externally validated using an independent dataset from a study of Linggui Zhugan Tang (LGZGT).</p><p><strong>Results: </strong>The analysis yielded a robust exponential model, which revealed that a reduction in mouse ΔALT of at least 53.3 U/L is required for a drug to show superiority over placebo in human trials. A more substantial decrease of 128.3 U/L in mice predicted a clinical efficacy exceeding that of Resmetirom, the first FDA-approved therapy for this condition. The model's predictive power was successfully confirmed through external validation with the LGZGT data.</p><p><strong>Conclusions: </strong>This study developed a cross-species efficacy model from NAFLD clinical and mouse data, revealing an exponential relationship between human and mouse ALT levels. This provides quantitative thresholds for preclinical screening to improve drug development success rates.</p>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":" ","pages":"102702"},"PeriodicalIF":2.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205788","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":"Protecting the fetus during hepatic surgery in pregnancy: the role of cavo-caval bypass","authors":"Arthur Marichez ,&nbsp;Nour Aldajani ,&nbsp;Catherine Fleureau ,&nbsp;Jean-Philippe Adam ,&nbsp;Brigitte Le Bail ,&nbsp;Hugo Madar ,&nbsp;Loïc Sentilhes ,&nbsp;Laurence Chiche","doi":"10.1016/j.clinre.2025.102701","DOIUrl":"10.1016/j.clinre.2025.102701","url":null,"abstract":"<div><h3>Background</h3><div>The discovery of a liver mass during pregnancy requires careful etiological assessment.A 29-year-old woman was diagnosed with a 17-cm inflammatory hepatocellular adenoma at 24-weeks of gestation. Given the high risk of spontaneous rupture and bleeding,a multidisciplinary team opted for a right hepatectomy at 26-weeks. To maintain stable maternal hemodynamics and avoid fetal hypoperfusion, a veno-venous cavo-caval bypass was established, allowing liver resection under total vascular exclusion without blood pressure fluctuations. The procedure was uneventful and a healthy child was delivered at term. The use of cavo-caval bypass offers a protective strategy to stabilize maternal circulation and preserve fetal well-being during major hepatectomy.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 9","pages":"Article 102701"},"PeriodicalIF":2.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205791","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":"Effectiveness and safety of third-line advanced therapies in patients with ulcerative colitis: A multicentre retrospective cohort study: Third-line treatment in UC.","authors":"Anaïs Bertrand, Antoine Meyer, Julien Kirchgesner, Mathieu Uzzan, Vered Abitbol, Antoine Assaf, Charlotte Gagnière, Philippe Seksik, Aurelien Amiot","doi":"10.1016/j.clinre.2025.102699","DOIUrl":"10.1016/j.clinre.2025.102699","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of advanced therapies beyond second-line therapies has been poorly described in patients with ulcerative colitis (UC).</p><p><strong>Aim: </strong>To describe the outcomes of third-line advanced therapy in patients with UC in a real-world setting.</p><p><strong>Methods: </strong>We conducted a multicentre retrospective study in patients with UC who received third-line advanced therapy after the failure of a first-line anti-TNF agent and second-line vedolizumab. The primary endpoints were steroid-free clinical remission at weeks 14 and 54.</p><p><strong>Results: </strong>We analysed 237 therapeutic sequences in 150 patients (55 with an anti-TNF agent, 80 with tofacitinib, and 102 with ustekinumab), accounting for 245.3 patient-years. Steroid-free clinical remission at week 14 was achieved in 14 (25.5 %) patients treated with an anti-TNF agent, 40 (50.0 %) with tofacitinib, and 54 (52.9 %) with ustekinumab (RR = 1.96 [1.19-3.25] for tofacitinib and RR = 2.08 [1.28-3.39] for ustekinumab, compared with an anti-TNF agent, respectively). Steroid-free clinical remission at week 54 was achieved in 16 (29.1 %) patients in the anti-TNF group, 37 (46.2 %) in the tofacitinib group and 56 (55.4 %) in the ustekinumab group (RR = 3.07 [0.98-9.60] for tofacitinib and RR = 3.09 [1.01-9.43] for ustekinumab, compared with anti-TNF, respectively). In total, 13.7 % of the patients underwent colectomy. Adverse events occurred in 94 (39.7 %) patients and were less frequent with ustekinumab.</p><p><strong>Conclusion: </strong>In this retrospective study, third-line advanced therapies resulted in a high rate of steroid-free clinical remission at weeks 14 and 54, especially in patients treated with ustekinumab and tofacitinib.</p>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":" ","pages":"102699"},"PeriodicalIF":2.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205768","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":"Residential Proximity to Pesticide-Treated Farmland is Associated with Elevated Liver Enzymes.","authors":"Mahmood Moosazadeh, Zahra Charkazi, Nargess Mirzaei, Reza Alizadeh-Navaei, Akbar Hedayatizadeh-Omran, Motahareh Kheradmand, Amirhossein Hessami","doi":"10.1016/j.clinre.2025.102703","DOIUrl":"https://doi.org/10.1016/j.clinre.2025.102703","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":" ","pages":"102703"},"PeriodicalIF":2.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205818","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":"Impact of histological healing on ulcerative colitis disease course among patients with endoscopic healing: results of a prospective study","authors":"Clara Yzet ,&nbsp;Camille Robert ,&nbsp;Franck Brazier ,&nbsp;Erica Meudjo ,&nbsp;Capucine Moreau ,&nbsp;Denis Chatelain ,&nbsp;Mathurin Fumery","doi":"10.1016/j.clinre.2025.102700","DOIUrl":"10.1016/j.clinre.2025.102700","url":null,"abstract":"<div><h3>Background</h3><div>The STRIDE II guidelines recognize endoscopic healing (EH) as one of the main therapeutic goals in ulcerative colitis (UC). Nevertheless, histological healing (HH) could reduce the risk of long-term complications in UC. The aim of this study was to assess the risk of relapse in UC depending on the degree of remission achieved.</div></div><div><h3>Methods</h3><div>We conducted a prospective study including all consecutive UC patients in clinical remission and EH (MES 0 or 1) between January 2021 and January 2024. The primary endpoint was UC relapse, defined as the need for treatment intensification and/or corticosteroids initiation and/or UC-related hospitalization and/or colectomy. Patients were followed up every 6 months for two years. HH was defined as a Nancy index ≤ 1 (blinded double reading).</div></div><div><h3>Results</h3><div>A total of 75 patients were included. The median disease duration was 12 years (IQR [7.5–19.0]) and 66 (82 %) patients had a left side colitis (E2) or pancolitis (E3). Patients were treated for a median of 3 years (IQR [1.2 - 6.9]) prior to colonoscopy, 49 (65 %) patients had MES 0. Fifty-nine (79 %) patients of the cohort had HH. After a median follow-up of 21.0 months (IQR [12.0 - 26.5]), relapse was observed in 13 patients (17 %) after a median delay of 11 months (IQR [6.0 - 18.0]). There was no difference in the risk of relapse between patients with MES 1 and MES (13.6 % vs. 30.7 % respectively <em>p</em> = 0.275). The risk of relapse in patient with MES 1 was significantly higher among patient with absence of HH (39.7 % versus 20.1 % respectively <em>p</em> = 0.04). Similarly, in patients with MES 0, the risk of relapse was significantly higher among patients without HH (70.0 % versus 27.4 % respectively, <em>p</em> = 0.023). No UC-related hospitalizations or colectomy were reported during follow-up. In multivariate analysis, absence of HH was the only factor associated with disease relapse (HR 4.55 [1.69; 12.22], <em>p</em> = 0.0118).</div></div><div><h3>Conclusion</h3><div>In this prospective cohort, histological healing was the only associated with improved long-term outcome in UC patients whatever the degree of endoscopic mucosal healing.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 9","pages":"Article 102700"},"PeriodicalIF":2.4,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197861","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":"Persistent Portal Hypertension in Alcohol-Associated Hepatitis: A Mirror of Inflammation Rather Than Mortality Predictor.","authors":"Saqlain Haider","doi":"10.1016/j.clinre.2025.102693","DOIUrl":"https://doi.org/10.1016/j.clinre.2025.102693","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":" ","pages":"102693"},"PeriodicalIF":2.4,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181812","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":"Impact of Dynamic Changes in Multiple Serum Tumor Markers During Neoadjuvant Therapy on Clinical Outcome in Gastrointestinal Cancer.","authors":"Fengchun Wang, Xiande Feng, Jianxiang Sun, Xiaoxin Fan, Jian Geng, Yu Leng, Hechao Tang","doi":"10.1016/j.clinre.2025.102692","DOIUrl":"https://doi.org/10.1016/j.clinre.2025.102692","url":null,"abstract":"<p><strong>Background: </strong>Dynamic shifts in serum tumor markers during neoadjuvant therapy could refine prognostication in gastrointestinal (GI) cancers, but supporting evidence is limited.</p><p><strong>Methods: </strong>We prospectively followed 200 patients with gastric (55%) or colorectal (45%) cancer who received neoadjuvant chemotherapy ± radiotherapy and curative-intent surgery (2016-2025). Carcinoembryonic antigen (CEA), CA19-9, CA72-4 and CA125 were assayed at baseline and pre-surgery. Three-year disease-free survival (DFS) and overall survival (OS) were primary endpoints. Multivariable Cox models assessed associations between marker dynamics and outcomes.</p><p><strong>Results: </strong>Baseline positivity rates were 40% for CEA and 30% for CA19-9; 31% of patients had ≥ 2 markers elevated. Therapy converted 45% of CEA-positive and 53% of CA19-9-positive cases to negative. Major pathological response (Tumor Regression Grade 0-1) occurred in 30% overall and was higher in marker converters than non-converters (45% vs 18%, p < 0.001). Persistent positivity correlated with lower R0 resection (78% vs 91%, p = 0.04), more complications (26% vs 12%, p = 0.03) and poorer 3-year DFS (42% vs 69%). On multivariable analysis, persistence of ≥ 2 positive markers independently predicted shorter DFS (HR 1.9, 95% CI 1.2-3.0) and OS (HR 2.1, 95% CI 1.3-3.3). Sensitivity analyses using alternative cut-offs, multiple imputation and exclusion of borderline metastatic cases yielded consistent results.</p><p><strong>Conclusion: </strong>Failure of serum tumor markers to normalize after neoadjuvant therapy signals inferior pathological response and survival. Serial marker assessment can enhance perioperative risk stratification and guide surgical decisions in GI cancers.</p>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":" ","pages":"102692"},"PeriodicalIF":2.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173694","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":"Detection of occult Hepatitis B infection among the blood donors in Pune, India","authors":"Anuradha S Tripathy ,&nbsp;Meenal Sharma ,&nbsp;Neeta Thorat ,&nbsp;Prasad Babar ,&nbsp;Nalini Kadgi ,&nbsp;Leena Nakate","doi":"10.1016/j.clinre.2025.102694","DOIUrl":"10.1016/j.clinre.2025.102694","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 9","pages":"Article 102694"},"PeriodicalIF":2.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173597","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":"Trends in esophageal cancer mortality in the United States (1999–2024): Disparities by sex, race/ethnicity, region, and urbanization","authors":"Mohamed Elnaggar ,&nbsp;Ibrahim Hassan ,&nbsp;Ahmed Bahnasy ,&nbsp;Hatem Eltaly ,&nbsp;Houman Rezaizadeh","doi":"10.1016/j.clinre.2025.102691","DOIUrl":"10.1016/j.clinre.2025.102691","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Esophageal carcinoma is the seventh most common cancer worldwide and poses a significant public health concern due to its poor overall survival rates. Although treatment advances, including multimodal approaches and enhanced surgical techniques, have emerged, their effect on national mortality trends remains unclear. Understanding the temporal changes in esophageal cancer mortality and potential disparities across demographic and geographic subgroups is crucial for guiding targeted interventions and resource allocation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We obtained mortality data for esophageal cancer from the CDC WONDER database covering the years 1999 to 2020, using the ICD-10 code (C15) for malignant neoplasm of the esophagus. Annual mortality rates were age-adjusted to the 2000 U.S. standard population and expressed per 10,000 and 100,000 persons. Analyses were stratified by sex (male, female), race/ethnicity (Non-Hispanic Black or African American, Non-Hispanic White, Hispanic), U.S. Census region (Northeast, Midwest, South, West), and urbanization status (rural versus urban). Joinpoint regression identified periods with distinct trends and estimated annual percent changes (APC); the average annual percent change (AAPC) summarized the overall trend.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;From 1999 to 2020, there were 374,000 recorded deaths from esophageal cancer across a population of over 8 billion. The overall AAMR declined from 4.36 (95 % CI: 4.28–4.44) in 1999 to 3.69 (3.63–3.75) in 2020 (AAPC:0.8 %). Sex disparities were observed, as males had significantly higher mortality (6.43 per 100,000) compared to females (1.38 per 100,000) in 2020, though both showed declining trends (AAPC:0.84 % and -1.12 %, respectively). By race/ethnicity, Black or African American individuals experienced the most pronounced decline, from 6.61 to 2.73 (AAPC:3.82 %), with particularly steep declines after 2018 (APC:1.58 %). Hispanic populations showed moderate decreases from 2.54 to 1.99 (AAPC:1.32 %), while White populations showed minimal change from 4.3 to 4.28 (AAPC:0.05 %).&lt;/div&gt;&lt;div&gt;Regionally, the West experienced the greatest decline from 4.17 to 3.36 (AAPC:1.08 %), followed by the Northeast which fell from 4.61 to 3.57 (AAPC:1.07 %), the South from 4.23 to 3.56 (AAPC:0.89 %), and the Midwest displaying the smallest decrease from 4.46 to 4.37 (AAPC:0.31 %). Urban areas demonstrated a consistent decline (AAPC:1.09 %), while rural areas showed a modest increase from 4.16 to 4.52 (AAPC: 0.48 %).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Mortality due to esophageal cancer in the U.S. has declined modestly from 1999 to 2020, showing substantial variation across demographic and geographic subgroups. Black or African American populations experienced a significant decline in mortality rates compared to other racial groups, while rural areas exhibited concerning increases in mortality rates. Persistent disparities by sex, race/ethn","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 9","pages":"Article 102691"},"PeriodicalIF":2.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136717","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}