Clinics and research in hepatology and gastroenterology最新文献

{"title":"Evaluation of long-term changes in liver function and structure in patients exposed to SARS-CoV-2 infection: A prospective study","authors":"Erkin Saeed Saifi ,&nbsp;Francesco Faita ,&nbsp;Matteo Nardin ,&nbsp;Paola Orizio ,&nbsp;Alessandra Arrigoni ,&nbsp;Bianca Maria Roccon ,&nbsp;Beatrice Accordini ,&nbsp;Stefania Cecchinel ,&nbsp;Paolo Poisa ,&nbsp;Giovanni Pelizzari ,&nbsp;Anna Paini ,&nbsp;Massimo Salvetti","doi":"10.1016/j.clinre.2025.102606","DOIUrl":"10.1016/j.clinre.2025.102606","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) binds to Angiotensin Converting Enzyme – 2 (ACE2) receptor targeting various organs including liver. Liver injury is a common feature of SARS-CoV-2 acute infection. A few studies have also described chronic hepatic alterations in patients with previous COVID-19. We hypothesize that steatosis seen in COVID-19 patients reflects their metabolic profile and is not caused by persistent inflammation sustained by SARS-CoV-2.</div></div><div><h3>Methods</h3><div>We conducted a prospective study to evaluate long-term changes in liver function and structure in patients hospitalized for COVID-19. Patients without a prior known hepatic disease with mild to moderate COVID-19 were enrolled during hospitalization and reevaluated during a follow-up visit at a medium 16 months. Complete blood panels with metabolic profile, BMI, alcohol consumption and physical activity were compared between baseline and follow-up. Specific ultrasound scans were obtained during hospital stay and at follow-up to quantify steatosis using Steatoscore2.0.</div></div><div><h3>Results</h3><div>Among 55 eligible patients, 33 were included in the analysis and only 3 (9 %) had a new diagnosis of steatosis at follow-up. Steatoscore2.0 did not change significantly from baseline to follow-up (1.7 vs 1.73, <em>p</em> = 0.348), while changes occurred in body mass index and physical activity estimated by IPAQ questionnaire (26.3 vs 26.6 kg/m², <em>p</em> = 0.005; 540 vs. 480, <em>p</em> = 0.015, respectively). There was a statistically significant increase in total cholesterol (144.5 vs 187.0 mg/dl, <em>p</em> = 0.003) and low-density lipoprotein-cholesterol (73.8 vs 113.9 mg/dl, <em>p</em> = 0.003). Inflammatory markers normalized at follow-up, including C-reactive protein (41.1 vs. 0.8 mg/L, <em>p</em> &lt; 0.001), and ferritin (410.0 vs. 91.0 ng/dl, <em>p</em> &lt; 0.001). Four patients had a 3-time rise in liver transaminase levels at baseline, and this was not confirmed at follow-up. Change in Steatoscore2.0 correlated significantly with Triglyceride-glucose index as a surrogate of insulin resistance.</div></div><div><h3>Conclusions</h3><div>In our study, long term functional and structural changes were not observed in patients with previous SARS-CoV-2 infection. There was a significant deterioration of metabolic profile post COVID-19</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 6","pages":"Article 102606"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927419","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":"Evaluating the influence of maternal anti-HBs status on the antibody levels in vaccinated children","authors":"Naim Abu-Freha ,&nbsp;Safa Shibli ,&nbsp;Ohad Etzion ,&nbsp;Yaser Afianish ,&nbsp;Johnny Amer ,&nbsp;Heba Abu Kaf ,&nbsp;Nachum Zohar ,&nbsp;David Yardeni ,&nbsp;Rifaat Safadi","doi":"10.1016/j.clinre.2025.102608","DOIUrl":"10.1016/j.clinre.2025.102608","url":null,"abstract":"<div><div>Background and Aims: The mother's Hepatitis B Virus (HBV) vaccination status may impact the child's response. We aimed to investigate the children's vaccine response based on the mother's vaccination status. Methods: In a retrospective study, we included children ≤10 years old born to HBsAg negative mothers, with available maternal and children anti-HBs antibodies. Children of vaccinated and unvaccinated mothers were compared and categorized based on anti-HBs titers: 0–9.9, 10–100, 101–500, 501–1000, and ≥1001 mlU/ml. Results: 14,485 children were included. No significant difference in the anti-HBs positivity rate was found among the children of vaccinated and unvaccinated mothers (70.4 % vs. 69.7 %, <em>p</em> = 0.337). Vaccine response in vaccinated vs. unvaccinated mothers was 93.5 % vs. 92.1 % for the first year of age, 87.7 % vs. 87.3 % for age 3 years, and 82.5 % vs. 82.2 % for age 5 years, respectively. Young children (7–36 months) had higher protective titer rates than older children. A higher proportion of the ≥1001 mlU/ml category was recorded among children of mothers with negative or low anti-HBs antibodies in the first year of age, reaching 40.9 %. With age, the proportion of children with 10–100 mlU/ml increased, corresponding to the mother's titer. Conclusion: The maternal HBV vaccination status does not impact the children's response, but the mother's anti-HBs titers may affect the child's antibody level. Maternal anti-HBs antibody titers may neutralize the vaccine HBsAg to impair the reponse.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 6","pages":"Article 102608"},"PeriodicalIF":2.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927420","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":"Lack of prior screening for advanced liver fibrosis in patients with newly diagnosed hepatocellular carcinoma: Results from a prospective multicentre study","authors":"Nour Ben Yedder ,&nbsp;Paul Girot ,&nbsp;Carelle Koudougou ,&nbsp;Matthieu Schnee ,&nbsp;Sylvie Métairie ,&nbsp;Annie Lim ,&nbsp;Kouceila Soualah ,&nbsp;Samuel Andrault ,&nbsp;Maëva Salimon ,&nbsp;Yann Touchefeu","doi":"10.1016/j.clinre.2025.102607","DOIUrl":"10.1016/j.clinre.2025.102607","url":null,"abstract":"<div><h3>Introduction</h3><div>Hepatocellular carcinoma (HCC) most commonly occurs in a cirrhotic liver. In France, a screening rate of 20 % to 35 % has been reported in clinical cohorts. In these studies, patients were generally enrolled in centers of the same category (university or general hospitals). The aim of this study was to prospectively investigate the circumstances of HCC diagnosis and the causes of HCC screening failure in a cohort of patients from a regional network.</div></div><div><h3>Methods</h3><div>This prospective multicenter study enrolled patients with newly diagnosed HCC from October 2022 to July 2024. Investigators were from one university hospital, two private clinics, and three general hospitals.</div></div><div><h3>Results</h3><div>Two hundred patients were included. Diagnosis was made by screening in 31.0 % of cases. Most patients had comorbidities that could lead to screening for liver fibrosis: current or past history of alcohol consumption (74.6 %), diabetes (51.4 %), hypertension (75.7 %), dyslipidemia (47.4 %). The FIB-4 score was ≥ 2.67 in 74.5 % of patients in the “in screening” group and 63.9 % in the “not in -screening” group. Among the 138 patient in the ”not in screening” group, 115 (83.3 %), 34 (24.6), 23 (16.7 %) and 13 (9.4 %) declared they had visited a general practionner, a cardiologist, a gastroenterologist, and/or an endocrinologist within the 12 months prior to HCC diagnosis, respectively.</div></div><div><h3>Conclusion</h3><div>Recognition by general practitioners of patients at risk of chronic liver disease and identification of advanced fibrosis are major areas for optimization of HCC screening.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 6","pages":"Article 102607"},"PeriodicalIF":2.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916216","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":"Clinical outcomes in patients with autoimmune hepatitis and primary biliary cholangitis overlap syndrome in the United States","authors":"Ritik M. Goyal ,&nbsp;Bhavik Bansal ,&nbsp;Mohammed Ayyad ,&nbsp;Aagamjit Singh ,&nbsp;Esli Medina Morales ,&nbsp;Imran Qureshi ,&nbsp;Muhammad Hassaan Arif Maan ,&nbsp;Paul J. Gaglio","doi":"10.1016/j.clinre.2025.102598","DOIUrl":"10.1016/j.clinre.2025.102598","url":null,"abstract":"<div><h3>Background</h3><div>There is evidence of overlap between autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC), two autoimmune hepatobiliary diseases. This retrospective analysis aimed to investigate extra-hepatic auto-immune diseases and compare outcomes of hospitalized patients with AIH-PBC overlap with AIH and PBC. We hypothesize that there are differences in rates of major adverse liver outcomes (MALO’s) when comparing these groups.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using National Inpatient Sample 2016–2020. Patients with AIH, PBC and AIH-PBC were identified using respective ICD-10 codes. We performed weighted logistic and linear regression for predicting complications of cirrhosis, hospitalization outcomes, among AIH-PBC overlap cases when compared separately to AIH and PBC only populations as controls.</div></div><div><h3>Results</h3><div>A total of 2454 AIH, 1464 PBC, and 276 AIH-PBC overlap patients were identified, corresponding to weighted totals of 12,270, 7320 and 1380 patients, respectively. On multivariate analysis, we found that patients with AIH-PBC are more likely to have ascites (OR 3.03; <em>p</em> &lt; 0.001) and portal hypertension (OR 3.75; <em>p</em> &lt; 0.001) compared to AIH; whereas no significant difference was found out compared to PBC. There was no difference in the mortality and liver transplant needs in AIH-PBC overlap group. Overall higher rheumatological disease was present in the AIH-PBC overlap patients compared to AIH (26.45 % vs 8.96 %, <em>p</em> =&lt; 0.001) and PBC (26.45 % vs 9.08 %, <em>p</em> =&lt; 0.001). Specifically, AIH-PBC patients had higher prevalence of Sjogren’s syndrome (<em>p</em> &lt; 0.001), SLE (<em>p</em> &lt; 0.001), and systemic sclerosis (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>AIH-PBC Overlap syndrome is associated with increased rates of certain cirrhotic complications when compared to patients with AIH only. They do not differ in terms of clinical outcomes such as mortality when adjusted for demographics and comorbidities. Patients with AIH-PBC had a higher prevalence of rheumatological disorders; especially Sjogren’s, SLE, and systemic sclerosis.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 6","pages":"Article 102598"},"PeriodicalIF":2.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894928","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":"Endoscopic reduction of a large antro-pyloric lipoma with exuberant ulceration due to transpyloric prolapse (with videos)","authors":"Vincent Zimmer","doi":"10.1016/j.clinre.2025.102600","DOIUrl":"10.1016/j.clinre.2025.102600","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 6","pages":"Article 102600"},"PeriodicalIF":2.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882290","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":"Clinical use of per ERCP bile aspiration in patients with cholangitis: The aspibile study","authors":"Mathilde Sanavio ,&nbsp;Marine Camus ,&nbsp;Jean Paul Nammour ,&nbsp;Alexandre Godmer ,&nbsp;Jean Luc Meynard ,&nbsp;Ulriikka Chaput ,&nbsp;Aymeric Becq","doi":"10.1016/j.clinre.2025.102599","DOIUrl":"10.1016/j.clinre.2025.102599","url":null,"abstract":"<div><h3>Background and study aims</h3><div>Bile aspiration during endoscopic retrograde cholangiopancreatography (ERCP) for cholangitis is not systematic and data on its clinical relevance remain limited. The aim of this study was to evaluate the clinical contribution of biliary aspiration in the setting of cholangitis.</div></div><div><h3>Methods</h3><div>Consecutive patients with ERCP performed for cholangitis were included. The primary outcome was the rate of adaptation of antibiotic therapy to biliary aspirations. Secondary outcomes were length of hospitalization, mortality, cholangitis recurrence at 30 days, duration of antibiotic therapy, antibiotic change, agreement between antibiotic therapy and biliary aspiration.</div></div><div><h3>Results</h3><div>A total of 140 patients were included, 103 (73.6 %) had blood cultures before ERCP. The rate of empiric and adjusted antibiotics effectively targeting bacteria found in bile was 82.1 % and 85.4 %, respectively. The mean length of hospital stay was 15.7 days, cholangitis recurrence rate was 3.2 % and the mortality rate was 5.5 %. The mean duration of antibiotic therapy was 11.3 days with an antibiotic modification rate of 45 %.</div></div><div><h3>Conclusions</h3><div>Bile aspiration during ERCP for acute cholangitis is a valuable complement to blood culture providing a higher diagnostic yield and enabling targeted antibiotic therapy. The rate of antibiotics effectively targeting bacteria found in bile is higher than 80 %.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 6","pages":"Article 102599"},"PeriodicalIF":2.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870767","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 of medical treatments depending on Crohn’s disease location. That is the question","authors":"Philippe Marteau","doi":"10.1016/j.clinre.2025.102597","DOIUrl":"10.1016/j.clinre.2025.102597","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 6","pages":"Article 102597"},"PeriodicalIF":2.6,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878746","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":"MASLD progression in India: A growing concern in the world's diabetes capital","authors":"Devaraj Ezhilarasan","doi":"10.1016/j.clinre.2025.102596","DOIUrl":"10.1016/j.clinre.2025.102596","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 6","pages":"Article 102596"},"PeriodicalIF":2.6,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864101","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":"Efficacy and safety of intravenous vedolizumab treatment in Chinese patients with moderate-to-severe Crohn's disease","authors":"Minhu Chen ,&nbsp;Xiang Gao ,&nbsp;Qian Cao ,&nbsp;Guillermo Rossiter ,&nbsp;Tadayuki Kitagawa ,&nbsp;Yue Sun ,&nbsp;Lili Yang","doi":"10.1016/j.clinre.2025.102591","DOIUrl":"10.1016/j.clinre.2025.102591","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Vedolizumab is a gut-selective monoclonal anti-α₄β₇ integrin antibody treatment for Crohn's disease (CD). A multicenter, randomized, double-blind, placebo-controlled, phase 3 trial (NCT03234907) assessed vedolizumab efficacy and safety in Chinese patients with moderate-to-severe CD and inadequate/loss of response/intolerance to previous conventional or anti-tumor necrosis factor-α therapy.</div></div><div><h3>Methods</h3><div>Eligible patients aged ≥18 to ≤80 years with moderate-to-severe CD (CD Activity Index [CDAI] total score 220–400) were randomized 2:1 to vedolizumab 300 mg intravenous infusion or placebo at Weeks 0, 2, 6 of induction, and every 4/8 weeks during Week 14–58 maintenance treatment. Primary and secondary endpoints at Week 10 were enhanced clinical response (≥100-point decrease from baseline CDAI score), and clinical remission (CDAI score ≤150), respectively. Additional Week 10 and/or Week 60 assessments included endoscopic and biomarker (C-reactive protein and fecal calprotectin) measurements.</div></div><div><h3>Results</h3><div>The study was conducted at 30 centers (August 2017 through August 2020). Enrolled patients (<em>n</em> = 215) were randomized to vedolizumab (<em>n</em> = 144) or placebo (<em>n</em> = 71). By Week 10, 19.4 % vedolizumab-treated versus 24.3 % placebo-treated patients achieved an enhanced clinical response. The Cui-Hung-Wang-adjusted p-value for the primary endpoint was 0.347. After maintenance treatment at Week 60, rates of enhanced clinical response, clinical remission, endoscopic response, mucosal healing, and biomarker improvements appeared greater for vedolizumab-treated than placebo-treated patients.</div></div><div><h3>Conclusions</h3><div>There were no new safety findings for vedolizumab treatment of Chinese patients with CD. Although the primary endpoint was not met, vedolizumab-treated patients showed improvements in other disease activity measures at Weeks 10 and 60.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 6","pages":"Article 102591"},"PeriodicalIF":2.6,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870768","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":"Global status of research on quality of life in pancreatic cancer patients: A bibliometric and network analysis from 2005-2024","authors":"Adeboye Azeez,&nbsp;Colin Noel","doi":"10.1016/j.clinre.2025.102595","DOIUrl":"10.1016/j.clinre.2025.102595","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic cancer (PC) is a major global health challenge, with rising incidence and mortality rates, particularly in high-socio-demographic index regions. Given its high mortality and significant morbidity, research on patient quality of life (QoL) has gained momentum, addressing symptom burdens, psychological distress, and treatment-related outcomes. Bibliometric analysis provides a valuable approach to mapping research trends, identifying key contributors, and forecasting future directions.</div></div><div><h3>Objective</h3><div>This study aimed to map global research on QoL in pancreatic cancer patients, highlighting key findings, challenges, and future directions through bibliometric analysis over the past two decades.</div></div><div><h3>Methods</h3><div>Data for this study were collected from the Web of Science Core Collection (WoSCC) database, using specific search strategies to retrieve relevant documents on the quality of life in pancreatic cancer patients. The data were analysed using the Bibliometrix R package to create knowledge maps and visualize research trends, collaborations, and emerging hotspots in the field.</div></div><div><h3>Results</h3><div>A total of 819 articles on pancreatic cancer and quality of life were identified, with an average citation count of 47.13 per article, highlighting moderate academic impact. The research revealed a growing trend in collaborative efforts, with an average of 9.42 co-authors per article and 16 % international collaborations. The United States emerged as the leading contributor, with 203 publications and the highest citation count, followed by France and the United Kingdom.</div></div><div><h3>Conclusion</h3><div>This bibliometric analysis highlights the growing volume of pancreatic cancer and quality of life research, with a steady annual growth rate of 6.9 % and increasing collaboration, especially from the United States. However, despite the rising number of publications, a decline in citation impact for recent studies suggests a need for continued innovation in therapeutic strategies to improve clinical outcomes.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 5","pages":"Article 102595"},"PeriodicalIF":2.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820696","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}