Digestive Diseases and Sciences最新文献

{"title":"A Residual Laterally Spreading Tumor that Regressed After Chemotherapy Following Surgical Resection of Sigmoid Cancer.","authors":"Hai-Lin Yan, Wei-Na Jing, Jin-Lin Yang, Zhu Wang","doi":"10.1007/s10620-025-08858-7","DOIUrl":"https://doi.org/10.1007/s10620-025-08858-7","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064422","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":"Results of Endoscopic Treatment of Recurrent Malignant Biliary Obstruction in Patients with Self-Expanding Metal Stents.","authors":"Lara Coutinho Machado, Bruno Costa Martins, Marcelo Simas de Lima, Sebastian Geiger, Luciano Lenz, Gustavo Andrade de Paulo, Adriana Safatle-Ribeiro, Ulysses Ribeiro, Fauze Maluf-Filho","doi":"10.1007/s10620-025-08853-y","DOIUrl":"https://doi.org/10.1007/s10620-025-08853-y","url":null,"abstract":"<p><strong>Background and aim: </strong>Endoscopic biliary drainage with placement of a self-expanding metal stent (SEMS) is the preferred palliative treatment of malignant biliary obstruction. Recent advances in the treatment have prolonged survival, thus, increasing the chance of recurrent biliary obstruction (RBO) after SEMS placement. The aim of this study was to compare different endoscopic approaches in patients with a SEMS and RBO, regarding clinical success and time to RBO.</p><p><strong>Methods: </strong>This retrospective study included all patients with a SEMS placed because of malignant biliary strictures who underwent endoscopic retrograde cholangiopancreatography between January 2011 and December 2018. We evaluated the results of different endoscopic interventions to RBO, including insertion of a new SEMS, stent cleaning, and insertion of a plastic stent (PS).</p><p><strong>Results: </strong>From January 2011 to December 2018, 70 (22.4%) patients developed RBO requiring endoscopic reintervention (n = 105 sessions). From the 105 ERCPs, technical success, clinical success, and adverse events rates were 91,4%, 71,8%, and 7,8%, respectively. Younger age (OR = 1.11 95%CI: 1.03-1.19) and the finding of a patent SEMS (OR = 0.17 95%CI: 0.04-0.08) were predictors of clinical failure (P = 0.006 and P = 0.024, respectively). The mean patency time (in days) after endoscopic reintervention was greater for SEMSs than for PSs (417.2 [95% CI: 250.0-584.4] vs 175.2 [95% CI: 124.0-226.5], P = 0.002).</p><p><strong>Conclusions: </strong>Correct identification and treatment of the causal factor of RBO typically lead to technical and clinical success. Placement of a second SEMS provides longer patency compared to a plastic stent if ingrowth (overgrowth) occurs.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064470","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":"Are Non-invasive Multi-cancer Early Cancer Detection Tests the Future?","authors":"William M Grady","doi":"10.1007/s10620-024-08839-2","DOIUrl":"https://doi.org/10.1007/s10620-024-08839-2","url":null,"abstract":"<p><p>Current cancer screening methods are effective for detecting early stage cancers and even preventing some cancers, but their effectiveness has only been demonstrated for a handful of cancers, and for many cancers, there are no screening tests clinically available. In addition, the majority of the screening methods are not ideal, resulting in suboptimal compliance and the occurrence of preventable cancers. A screening test that is convenient, safe, accurate and that can screen for multiple cancers is an ideal screening test that would address many of the shortcomings of the current tests. Multi-cancer detection tests (MCD) have the potential to meet these challenges and have engendered substantial enthusiasm in light of this. Using advances in DNA sequencing technology, cancer epigenetics and artificial intelligence, they are able to detect a large number of cancers predominantly via the patterns of methylated DNA alterations, DNA sequence alterations, and DNA fragment patterns of cell free DNA in the plasma and can accurately distinguish the cancer site of origin. Of note, some of the tests also combine circulating free DNA (cfDNA) with protein-based markers. However, for the majority of early stage cancers, the sensitivity is modest and below that of most of the current standard of care cancer screening tests. Furthermore, the clinical utility of screening for many of the cancers detectable by MCD tests remains to be proven. Here we describe the features of MCD tests, review the current data supporting their potential to be used in the clinic for cancer screening, and discuss the knowledge gaps surrounding understanding their clinical utility, with a focus on GI cancer screening.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064459","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":"Cholangioscope-Assisted Endoscopic Retrograde Appendicitis Therapy in the Management of Chronic Abdominal Pain Related to the Appendix: A Single-Center Retrospective Study.","authors":"Qianlong Li, Tianyu Liu, Ting Qin","doi":"10.1007/s10620-024-08795-x","DOIUrl":"https://doi.org/10.1007/s10620-024-08795-x","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis and treatment of chronic abdominal pain related to the appendix have always been challenging. In the past, an appendectomy was the main approach for suspected chronic abdominal pain related to the appendix, but there was an associated risk of negative appendectomy. In recent years, cholangioscope-assisted endoscopic retrograde appendicitis therapy (ERAT) has been used to view the appendiceal cavity directly for flushing, stone removal, biopsy, and other operations, thereby achieving precise treatment.</p><p><strong>Aims: </strong>The aim of this study was to investigate the safety and efficacy of cholangioscope-assisted ERAT in the management of chronic abdominal pain related to the appendix.</p><p><strong>Methods: </strong>We evaluated 60 patients with chronic abdominal pain related to the appendix between January 2023 and January 2024, all of whom underwent cholangioscope-assisted endoscopic retrograde appendicitis therapy. The success rate (technical and clinical), procedure time, visual analog scale (VAS) score, length of hospital stay, and complication rate were recorded and analyzed.</p><p><strong>Results: </strong>The technical success rate of cholangioscopy was 100%, and the clinical success rate was 90%. The mean procedure time was 5.4 ± 1.9 min (standard deviation [SD]). The abdominal pain score at the mean follow-up time of 6.6 ± 1.4 months after the procedure was 0 (VAS method) in 90% of the patients. The average length of hospital stay was 2.1 ± 0.7 days. No adverse events occurred.</p><p><strong>Conclusion: </strong>Cholangioscope-assisted endoscopic retrograde appendicitis therapy appears to be an effective novel therapy for chronic abdominal pain related to the appendix.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064462","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":"Re-intervention Utility After Endoscopic Ultrasound-Guided Hepaticogastrostomy Using a Partially Covered Stent with Anchoring Flange.","authors":"Il Sang Shin, Jong Ho Moon, Yun Nah Lee, Jae Woo Park, Tae Hoon Lee, Jae Kook Yang, Young Deok Cho, Sang-Heum Park","doi":"10.1007/s10620-025-08852-z","DOIUrl":"https://doi.org/10.1007/s10620-025-08852-z","url":null,"abstract":"<p><strong>Background and aim: </strong>Although long self-expandable metal stent (SEMS) with a sufficient intragastric portion is typically preferred for endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS), this design can complicate endoscopic re-intervention for recurrent biliary obstruction (RBO). We evaluated the efficacy and safety of endoscopic re-intervention for RBO through the stent after EUS-HGS using a novel partially covered SEMS with an anchoring flange.</p><p><strong>Methods: </strong>The partially covered SEMS was designed with a intrahepatic uncovered portion measuring 1.5 cm in length and a resilient fold-back wide distal anchoring flange with a 2.0 cm diameter. Re-interventions were performed through the stent lumen while the stent was in situ. The primary outcomes were technical and clinical success, and secondary outcomes were procedure time, adverse events, and the median time to RBO after re-intervention.</p><p><strong>Results: </strong>In total, 35 re-interventions were performed in 19 patients. Re-intervention was successfully conducted in 97.1% (34/35) of cases via the intragastric end of the stent in a retroflexed position. Technical and clinical success were 94.3% (33/35) and 88.6% (31/35). Re-intervention methods included stent cleaning (18.2%), additional HGS stent placement (33.3%), and antegrade stent placement (48.5%). Mild cholangitis occurred in 5.7% (2/35) of patients and was managed conservatively. The median time to RBO after re-intervention was 148 days.</p><p><strong>Conclusion: </strong>Endoscopic re-interventions can be effectively and safely performed through the lumen of the novel partially covered SEMS with an anchoring flange.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045975","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":"Emerging Frontiers in Colorectal Cancer Therapy: From Targeted Molecules to Immunomodulatory Breakthroughs and Cell-Based Approaches.","authors":"Nayeralsadat Fatemi, Seyedeh Nasim Mirbahari, Sascha Tierling, Fatemeh Sanjabi, Shabnam Shahrivari, Mandana AmeliMojarad, Melika Amelimojarad, Meygol Mirzaei Rezaei, Parsa Nobaveh, Mehdi Totonchi, Ehsan Nazemalhosseini Mojarad","doi":"10.1007/s10620-024-08774-2","DOIUrl":"https://doi.org/10.1007/s10620-024-08774-2","url":null,"abstract":"<p><p>Colorectal cancer (CRC) is ranked as the second leading cause of cancer-related deaths globally, necessitating urgent advancements in therapeutic approaches. The emergence of groundbreaking therapies, including chimeric antigen receptor-T (CAR-T) cell therapies, oncolytic viruses, and immune checkpoint inhibitors, marks a transformative era in oncology. These innovative modalities, tailored to individual genetic and molecular profiles, hold the promise of significantly enhancing patient outcomes. This comprehensive review explores the latest clinical trials and advancements, encompassing targeted molecular therapies, immunomodulatory agents, and cell-based therapies. By evaluating the strengths, limitations, and potential synergies of these approaches, this research aims to reshape the treatment landscape and improve clinical outcomes for CRC patients, offering new found hope for those who have exhausted conventional options. The culmination of this work is anticipated to pave the way for transformative clinical trials, ushering in a new era of personalized and effective CRC therapy.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045974","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":"Anti-tumor Necrosis Factor Drug Concentration Is Not Associated with Disease Outcomes in Pouchitis: A Retrospective, International Study.","authors":"Sailish Honap, Bénédicte Caron, Jacob E Ollech, Maya Fischman, Konstantinos Papamichael, Djuna De Jong, Krisztina B Gecse, Andrea Centritto, Mark A Samaan, Peter M Irving, Miles P Sparrow, Konstantinos Karmiris, Thomas Chateau, Iris Dotan, Laurent Peyrin-Biroulet","doi":"10.1007/s10620-024-08821-y","DOIUrl":"https://doi.org/10.1007/s10620-024-08821-y","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic drug monitoring is important for optimizing anti-tumor necrosis factor-α (TNF-α) therapy in inflammatory bowel disease. However, the exposure-response relationship has never been assessed in pouchitis.</p><p><strong>Aims: </strong>To explore associations between anti-TNF-α drug concentration and pouchitis disease activity in patients with a background of ulcerative colitis.</p><p><strong>Methods: </strong>A retrospective, multicenter, cross-sectional study was conducted in adult patients with pouchitis requiring anti-TNF-α treatment. Rates of clinical and endoscopic remission were calculated, and drug concentrations during maintenance therapy were compared between remission and non-remission cohorts.</p><p><strong>Results: </strong>Sixty-three patients were included: median age, 48 years (IQR 36-59) and median time since pouchitis diagnosis, 7 years (IQR 2-13). Patients received infliximab, n = 27 (43%), adalimumab, n = 29 (46%), or both n = 7 (11%). Thirty-two (51%) patients received concomitant immunomodulation. Median infliximab trough concentrations (mg/ml) were similar between patients in clinical remission (n = 21) vs non-remission (n = 11), 5.3 vs. 4.4, p = 0.73. For adalimumab, median drug concentrations did not significantly differ between remission/non-remission groups based on clinical (n = 18/18), 11.4 vs 7.6, p = 0.32, or endoscopic assessment, (n = 7/29), 9.0 vs. 7.8, p = 0.78. Four patients had positive anti-drug antibodies with undetectable drug concentration.</p><p><strong>Conclusion: </strong>In a cohort of patients with pouchitis, higher anti-TNF-α drug concentrations were not associated with more clinical or endoscopic remission.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045973","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":"Usefulness of Novel Image-Enhanced Endoscopy for Predicting Maintenance of Clinical Remission in Ulcerative Colitis.","authors":"Yukiyo Mamiya, Takashi Taida, Jun Kato, Keisuke Matsusaka, Yoshiki Matsubara, Tomomi Ozaki, Takuya Ohashi, Toshiyuki Ito, Syohei Mukai, Nobuaki Syu, Yushi Koshibu, Yusuke Ozeki, Makoto Furuya, Yuhei Oyama, Hayato Nakazawa, Ryosuke Horio, Chihiro Goto, Satsuki Takahashi, Yoshihito Ozawa, Yuki Shiko, Akane Kurosugi, Michiko Sonoda, Tatsuya Kaneko, Tsubasa Ishikawa, Yuki Ohta, Kenichiro Okimoto, Keiko Saito, Tomoaki Matsumura, Jun-Ichiro Ikeda, Naoya Kato","doi":"10.1007/s10620-025-08849-8","DOIUrl":"https://doi.org/10.1007/s10620-025-08849-8","url":null,"abstract":"<p><strong>Purpose: </strong>The performance of endoscopic evaluation of ulcerative colitis (UC) using conventional scoring, including Mayo endoscopic subscore (MES) and ulcerative colitis endoscopic index of severity (UCEIS), is not satisfactory. Recently, the usefulness of novel image-enhanced endoscopy (IEE) such as texture and color enhancement imaging (TXI) and red dichromatic imaging (RDI) has been reported in the endoscopic evaluation of UC. We evaluated the performance of IEEs in UC, particularly focusing on the correlation with MES and UCEIS, and prediction of relapse.</p><p><strong>Methods: </strong>This is a prospective, observational study. UC patients in clinical remission who underwent colonoscopy with evaluation of IEEs and follow-up for > 3 months were analyzed. TXI and RDI were evaluated using the previously reported scoring system (TXI 0-2 and RDI 1-4). The IEE scores were compared with the conventional scoring, fecal calprotectin levels, and histological findings using Geboes score, and patient's clinical relapse rate stratified by each IEE score was examined.</p><p><strong>Results: </strong>Both TXI and RDI scores were well-correlated with MES and UCEIS (both p < 0.001), fecal calprotectin levels (p = 0.015 and p = 0.006), and histology evaluated with Geboes score. In the Geboes subscore, the subscore 2B (neutrophil infiltration in lamina propria) was the most correlated with each endoscopic scoring. RDI 3-4 was significantly correlated with subsequent relapse (hazard ratio 3.56, 95% confidence interval 1.13-11.24), but TXI scoring did not predict relapse significantly.</p><p><strong>Conclusion: </strong>The assessment using RDI could be a convenient and useful endoscopic evaluation method for predicting the prognosis of UC.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051979","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":"Abbreviated Duration of Vasoactive Agents Has Similar Outcomes as Standard Duration of Therapy in Patients with Liver Cirrhosis and Variceal Bleeding: An Individual Patient Data Meta-Analysis.","authors":"Sagnik Biswas, Gin-Ho Lo, Shubham Mehta, Anshuman Elhence, Yu Jun Wong, Manas Vaishnav, Umang Arora, Vignesh Dwarakanathan, Shekhar Swaroop, Arnav Aggarwal, Ayush Agarwal, Pranjal Singh, Amitkumar Chavan, Shashank Tripathi, Deba Prasad Dhibar, Sheik Manwar Ali, Vishal Sharma, Ashish Kumar, Samagra Agarwal, Shalimar","doi":"10.1007/s10620-025-08851-0","DOIUrl":"https://doi.org/10.1007/s10620-025-08851-0","url":null,"abstract":"<p><strong>Background: </strong>This two-stage individual patient data meta-analysis (IPD-MA) compared the efficacy of a shorter duration (≤ 2 days) of vasoactive (VA) drug therapy to standard duration (3-5 days) after acute variceal bleeding (AVB) in patients with liver cirrhosis.</p><p><strong>Patients and methods: </strong>Randomized clinical trials on patients with cirrhosis and AVB undergoing endoscopic band ligation which compared a short duration versus the standard duration of VA therapy were included. The primary outcome was 5-day rebleeding rate. Secondary outcomes included 5-day and 42-day mortality, 42-day rebleeding rate, and length of hospital stay in patients receiving short duration of therapy as compared to those receiving standard duration. Aggregate data meta-analysis and IPD-MA of trials were performed for these outcomes and comparisons in patients with different severities of liver disease.</p><p><strong>Results: </strong>Out of 11 eligible trials, 542 IPD data sets were available from 6 trials. Two hundred and seventy-nine patients received short duration and 263 received standard duration VA therapy. Two-stage IPD-MA revealed no significant differences in the 5-day rebleeding rate (HR = 0.59, 95%CI: 0.19-1.81, p = 0.66), 5-day mortality (HR = 1.12, 95%CI: 0.18-6.63, p = 0.44), 42-day rebleeding rate (HR = 0.95, 95%CI: 0.47-1.90, p = 0.90) and 42-day mortality (HR = 1.05, 95% CI: 0.43-2.56, p = 0.34) between the two groups. One-stage IPD-MA revealed no significant differences in the outcomes across Child-Pugh classes, with shorter hospital stay in short duration group.</p><p><strong>Conclusions: </strong>Short duration VA therapy has similar outcomes to standard duration in patients with liver cirrhosis presenting with AVB, irrespective of severity of liver disease.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045972","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":"Calling in Your Markers: Can Biomarkers Predict the Response to Anti-TNF Therapy in Pediatric Patients with Crohn's Disease?","authors":"Kevin L Watson","doi":"10.1007/s10620-025-08856-9","DOIUrl":"https://doi.org/10.1007/s10620-025-08856-9","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037601","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}