European Journal of Gastroenterology & Hepatology最新文献

{"title":"Dieulafoy lesion of the gastrointestinal tract: what's new? A narrative review.","authors":"Giuseppe Losurdo, Nicolas Favia, Daniele Angelillo, Antonella Contaldo, Marcantonio Gesualdo, Andrea Iannone, Ilaria Ditonno, Fabio Castellano, Martino Mezzapesa, Enzo Ierardi, Mariabeatrice Principi","doi":"10.1097/MEG.0000000000003144","DOIUrl":"10.1097/MEG.0000000000003144","url":null,"abstract":"<p><p>Dieulafoy's lesion is a rare but potentially life-threatening cause of gastrointestinal bleeding because of an abnormally dilated submucosal artery that erodes the overlying epithelium without a primary ulceration. Typically located in the proximal stomach near the esophagogastric junction, Dieulafoy's lesions can also occur throughout the whole gastrointestinal tract, including the oesophagus, small bowel, and colon. Rare cases have been reported in the respiratory tract. Dieulafoy's lesion accounts for approximately 3.5% of gastrointestinal bleeding cases, with mortality rates ranging from 23 to 79%, mainly because of the risk of rebleeding and surgical complications. The aetiology of Dieulafoy's lesion remains unclear, despite congenital vessel dilation and stress-induced factors have been invoked. Common symptoms include haematemesis, melena, and signs of acute arterial bleeding; nevertheless, the diagnosis is often challenging because of intermittent haemorrhage. Endoscopic examination typically reveals a pigmented protuberance without ulceration; however, excessive bleeding or small lesion size may hinder detection. Early endoscopy (within 12 h) significantly improves diagnostic accuracy. Therapeutic approaches may differ in relation to the presentation and lesion location. Endoscopic haemostasis is the preferred technique, achieving success in nearly 90% of cases. Haemostatic procedures include injective, thermal, and mechanical methods. Angiographic embolisation or surgery are limited in cases of endoscopic treatment failure. Advances in endoscopic therapy have reduced Dieulafoy's lesion-related mortality from 80 to 8.6%, despite rebleeding remains a concern. A multidisciplinary approach, combining endoscopy, radiology, and surgery when necessary, is crucial for optimal management, thus improving patient outcomes.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 9","pages":"995-1000"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673142","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":"Association of alcohol intake with pre-sarcopenia risk in steatotic liver disease: a dose-dependent relationship.","authors":"Qiyang Chen, Ruifang Xu, Linxue Qian, Yujiang Liu, Xiangdong Hu","doi":"10.1097/MEG.0000000000003212","DOIUrl":"10.1097/MEG.0000000000003212","url":null,"abstract":"<p><strong>Objectives: </strong>An increased gradient of alcohol intake distinguished distinct clinical outcome risks across steatotic liver disease (SLD) subcategories, including metabolic dysfunction-associated steatotic liver disease (MASLD), MASLD with increased alcohol intake (MetALD), and alcohol liver disease (ALD). However, association between alcohol intake and pre-sarcopenia risk was not studied.</p><p><strong>Methods: </strong>All adult participants with complete data of alcohol intake, controlled transient elastography and dual-energy X-ray absorptiometry were collected from the National Health and Nutrition Examination Survey 2017-2018. The pre-sarcopenia burden was compared between SLD and non-SLD, also across SLD subcategories. Association between alcohol intake and pre-sarcopenia risk was evaluated by logistic regression and restricted cubic spline analysis.</p><p><strong>Results: </strong>Among 1506 evaluable participants, there were 836 non-SLD participants, 354 MASLD, 185 MetALD, 115 ALD and 16 cryptogenic SLD participants. The prevalence of pre-sarcopenia in SLD was higher than that in non-SLD (14.93% vs. 5.02%). Regardless of sex, three SLD subcategories had the lower appendicular lean mass index than non-SLD group. The pre-sarcopenia prevalence was only higher among males in SLD subcategories than non-SLD group. An L-shaped negative nonlinear relationship between alcohol intake and pre-sarcopenia was observed in females (0-28 g/day), but not in males. Logistic regression showed physical inactivity, lower creatinine, higher weight-adjusted waist index and sex male were associated with increased pre-sarcopenia risk.</p><p><strong>Conclusion: </strong>Regardless of sex, MASLD, MetALD or ALD had a higher pre-sarcopenia burden than non-SLD. A nonlinear relationship between low-moderate alcohol intake and pre-sarcopenia risk was revealed in females.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1074-1082"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148053423","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":"Diagnostic and prognostic performance of the fibrotic nonalcoholic steatohepatitis index in patients with metabolic dysfunction-associated steatotic liver disease.","authors":"Weiyi Zhang, Mingkai Li, Yujun Luo, Zhanpeng Wen, Jiliang Huang","doi":"10.1097/MEG.0000000000003174","DOIUrl":"10.1097/MEG.0000000000003174","url":null,"abstract":"<p><strong>Background and aims: </strong>Identifying patients with fibrotic metabolic dysfunction-associated steatohepatitis (MASH) is crucial in order to refer them to specialist care as fibrotic MASH represents one of the major inclusion criteria for clinical trials. This study evaluated the diagnostic and prognostic value of the fibrotic nonalcoholic steatohepatitis index (FNI) in the representative US population.</p><p><strong>Methods: </strong>The FNI was assessed in National Health and Nutrition Examination Survey (NHANES) 2017-2020 (cross-sectional; n  = 6520) for fibrotic MASH detection, using FibroScan-AST score-defined cases. Prognostic value was examined in NHANES III (1988-1994; n  = 6166) with mortality follow-up through 2019. Receiver operating characteristic analysis evaluated diagnostic accuracy. Cox models assessed associations between FNI and all-cause, cardiovascular, and diabetes-related mortality. Correlations with the triglyceride-glucose (TyG) index and cardiometabolic risk burden were analyzed.</p><p><strong>Results: </strong>FNI showed excellent diagnostic accuracy for fibrotic MASH (area under the curve [AUC] = 0.937), outperforming FIB-4 (AUC = 0.697). In NHANES III, elevated FNI (≥0.33) was independently associated with higher risk of all-cause [hazard ratio = 3.19; 95% confidence interval (CI): 2.56-3.97], cardiovascular (hazard ratio = 6.43; 95% CI: 3.32-12.47), and diabetes-related mortality (hazard ratio = 25.15; 95% CI: 10.56-59.89). FNI correlated positively with TyG ( R  = 0.458, P  < 0.001) and increased progressively with the number of cardiometabolic risk factors.</p><p><strong>Conclusion: </strong>FNI is a robust, noninvasive marker that identifies individuals with fibrotic MASH and stratifies mortality risk. Its integration into clinical and public health practice may improve early detection and risk-guided management of metabolic liver disease.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1052-1062"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503549","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":"Answer letter to 'Methodological Limitations in Morphometric Assessment of Steatosis and Fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease', from Mahala Ali.","authors":"Luis Fernando Ferreira, Muriel Mânica, Juliana Maria Macedo, Cristiane Valle Tovo","doi":"10.1097/MEG.0000000000003237","DOIUrl":"10.1097/MEG.0000000000003237","url":null,"abstract":"","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 9","pages":"1114"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673120","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 presentation, anti-tTG IgA levels, and histological severity in adult celiac disease.","authors":"Gonca Karakan, Banu Böyük, Hande Erman, Rahmi Irmak, Didem Canoğlu","doi":"10.1097/MEG.0000000000003178","DOIUrl":"10.1097/MEG.0000000000003178","url":null,"abstract":"<p><strong>Background: </strong>Adult celiac disease may present with atypical or nonspecific symptoms. Although the diagnostic value of anti-tissue transglutaminase IgA (anti-tTG IgA) in relation to histological severity has been well-established in pediatric cases, data in adults remain limited.</p><p><strong>Objective: </strong>To evaluate the association between anti-tTG IgA levels and histological severity according to the Marsh-Oberhuber classification in adult celiac patients, and to assess the diagnostic performance of anti-tTG IgA in predicting advanced mucosal damage.</p><p><strong>Methods: </strong>A total of 228 adult patients with celiac disease who underwent duodenal biopsy between 2017 and 2022 were included retrospectively. Clinical features, laboratory parameters, serological markers, histopathological findings were recorded. Patients were classified according to anti-tTG IgA titers as high-titer (≥10 times the upper limit of normal) or low-titer positive.</p><p><strong>Results: </strong>Anti-tTG IgA levels showed a significant stepwise increase with higher Marsh grades. Anti-tTG IgA levels and disease duration were independent predictors of Marsh score. Higher anti-tTG IgA levels were associated with an increased likelihood of advanced histological damage, whereas longer disease duration was associated with lower Marsh scores. Receiver operating characteristic curve analysis demonstrated diagnostic performance of anti-tTG IgA for predicting Marsh score greater than or equal to 2 (area under the curve = 0.836, 95% confidence interval: 0.781-0.883; P < 0.0001). A cutoff value of less than 93.2 RU/ml yielded a sensitivity of 76.73% and a specificity of 83.33%.</p><p><strong>Conclusion: </strong>Anti-tTG IgA is associated with histological severity in adult celiac disease and demonstrate diagnostic accuracy for predicting clinically significant mucosal damage. We suggest that anti-tTG IgA may serve as a useful adjunctive marker for estimating histological involvement in adults.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1022-1029"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503622","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":"Investigating aspirin and post-colonoscopy colorectal cancer and cancer-specific mortality risk: a Swedish Register Study 2007-2016.","authors":"Anna Forsberg, Linnea Widman, Anna Andreasson","doi":"10.1097/MEG.0000000000003177","DOIUrl":"10.1097/MEG.0000000000003177","url":null,"abstract":"<p><strong>Objective: </strong>Acetylsalicylic acid (ASA) has been linked to reduced incidence and mortality in colorectal cancer (CRC), although its sex-specific effects remain unclear. Post-colonoscopy colorectal cancer (PCCRC), is a CRC diagnosed after a colonoscopy negative for cancer. The aim of this study was to explore the sex-specific effects of ASA on cancer-specific mortality risk in in CRC in general and in PCCRC specifically.</p><p><strong>Methods: </strong>This retrospective register-based study analyzed the conditional CRC-specific survival in 22 270 Swedish patients who underwent colonoscopy, including 1647 PCCRCs. The analyses were stratified on sex.</p><p><strong>Results: </strong>ASA use was associated with lower CRC mortality in men but not in women, hazard ratio (HR) = 0.85, 95% confidence interval (CI): 0.72-0.99, P  = 0.043 for men and HR = 1.13, 95% CI: 0.93-1.37, P  = 0.230 for women. Notably, ASA use in women, but not in men, with PCCRC was linked to increased mortality risk; HR for interaction PCCRC × ASA in women = 1.60, 95% CI: 1.02-2.51, P  = 0.040 and HR for interaction PCCRC × ASA in men = 0.81, 95% CI: 0.50-1.32, P  = 0.41.</p><p><strong>Conclusion: </strong>These exploratory analyses suggest sex-specific differences in the effect of ASA on CRC outcomes, particularly in PCCRC. Further research is needed to elucidate underlying the mechanisms and optimize chemopreventive strategies.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1017-1021"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503575","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":"Lower drug clearance of adalimumab is associated with proactive therapeutic drug monitoring and mucosal healing in patients with inflammatory bowel disease.","authors":"Tina Deyhim, Alessandra Saraga, Ajay Gade, Grace Geeganage, Mostafa A Soliman, Samantha Zullow, Loren G Rabinowitz, Laurie B Grossberg, Adam S Cheifetz, Thierry Dervieux, Konstantinos Papamichael","doi":"10.1097/MEG.0000000000003183","DOIUrl":"10.1097/MEG.0000000000003183","url":null,"abstract":"<p><strong>Objectives: </strong>There are limited data regarding adalimumab (ADM) clearance in inflammatory bowel disease (IBD). The aim of this study was to identify factors associated with ADM clearance and to assess its association with mucosal healing.</p><p><strong>Methods: </strong>This single-center, retrospective study included consecutive patients with IBD who received maintenance ADM therapy and underwent therapeutic drug monitoring (TDM) between January 2018 and May 2023. Drug clearance was determined using a nonlinear mixed-effect model with Bayesian priors. Mucosal healing was defined as an endoscopic Mayo score 1 or less; for ulcerative colitis, no ulcerations for patients with Crohn's disease, or a Rutgeerts score of i1 or less for patients with an ileocolonic resection for Crohn's disease and was evaluated within 3 months from TDM.</p><p><strong>Results: </strong>The study population consisted of 263 patients with IBD (74% Crohn's disease) who underwent a total of 515 TDM tests (388 proactive). Multivariable linear regression analysis identified that proactive TDM was associated with lower ADM clearance [beta coefficients (β): -0.173, 95% confidence interval (CI): -0.180 to -0.088, P  < 0.001], while BMI (β: 0.125, 95% CI: 0.005-0.013, P  < 0.001), prior biologic exposure (β: 0.087, 95% CI: 0.022-0.112, P  = 0.004), and antibodies to ADM (β: 0.676, 95% CI: 0.628-0.750, P  < 0.001) were associated with higher ADM clearance. Receiver operating characteristic analysis identified an ADM clearance threshold of 0.301 L/day (area under the receiver operating characteristic curve: 0.731; 95% CI: 0.654-0.808; P  < 0.001; sensitivity: 61%; specificity: 78%) distinguishing patients with or without mucosal healing.</p><p><strong>Conclusion: </strong>This study demonstrated that lower ADM clearance is associated with proactive TDM and mucosal healing in patients with IBD.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1030-1035"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503581","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 machine learning-based noninvasive diagnostic model for liver fibrosis in metabolic-associated steatotic liver disease.","authors":"Yixin Hui, Yuping Zeng, Mei Zhang","doi":"10.1097/MEG.0000000000003206","DOIUrl":"10.1097/MEG.0000000000003206","url":null,"abstract":"<p><strong>Background: </strong>To address the lack of simple tools for assessing fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD), this study develops a machine learning-based diagnostic model to identify patients at high risk of significant fibrosis and advanced fibrosis.</p><p><strong>Methods: </strong>Data from biopsy-proven MASLD patients were randomly divided into training and validation sets. Variables were then selected, and models using Logistic, Support Vector Machine, and eXtreme Gradient Boosting (XGBoost) were compared with identify the optimal model. Finally, Shapley Additive Explanations-based interpretability analysis was applied to explain the best-performing model. The DeLong test was applied to compare the new model with the aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 index (FIB-4) models.</p><p><strong>Results: </strong>The XGBoost models demonstrated robust accuracy. For the significant fibrosis outcome, the model incorporating age, total cholesterol, glycosylated hemoglobin (HbA1c), and albumin/globulin ratio achieved an area under the receiver operating characteristic curve (AUC) of 0.74 in the training set and 0.72 in the testing set. Regarding the advanced fibrosis outcome, the model including age, total cholesterol, HbA1c, platelets, white cell count, and albumin/globulin ratio yielded an AUC of 0.78 in the training set and 0.74 in the testing set. Decision curve analysis curves confirmed clinical utility, and performance surpassed APRI and FIB-4 ( P < 0.05).</p><p><strong>Conclusion: </strong>This study developed a novel noninvasive diagnostic model for MASLD using simple and easily accessible variables, which demonstrates superior performance compared with traditional serological models.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1063-1073"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469551","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":"Methodological limitations in morphometric assessment of steatosis and fibrosis in metabolic dysfunction-associated steatotic liver disease.","authors":"Malaha Ali","doi":"10.1097/MEG.0000000000003239","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003239","url":null,"abstract":"","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 9","pages":"1112-1113"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673089","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":"Gastric atrophy and gastric cancer: a meta-analytical assessment of risk and the influence of topographical distribution.","authors":"Eoghan Burke, Patricia Harkins, Mayilone Arumugasamy","doi":"10.1097/MEG.0000000000003191","DOIUrl":"10.1097/MEG.0000000000003191","url":null,"abstract":"<p><p>Gastric atrophy is a precursor in the Correa cascade leading to gastric cancer, yet the precise magnitude of risk remains uncertain, particularly in low-incidence Western populations. We performed a systematic review and meta-analysis of observational studies published between 2010 and 2024 to evaluate gastric cancer risk in gastric atrophy, with stratification by anatomical distribution. Ten studies comprising 21 006 patients were included. Pooled analysis demonstrated a markedly increased risk of gastric cancer in gastric atrophy, with a standardised incidence ratio of 20.7 (95% confidence interval: 14.0-30.2). Subgroup analysis confirmed significantly higher risk with extensive gastric atrophy compared with antral-predominant disease (pooled odds ratio: 0.27), supporting current guideline stratification. We also reviewed studies excluded from pooled analysis, including several large European cohorts that initially appeared eligible but failed on methodological grounds. Common limitations included inadequate distinction between gastric atrophy and intestinal metaplasia, lack of stratification between autoimmune and Helicobacter pylori -associated atrophy, and use of Operative Link staging systems without atrophy-specific outcomes. These exclusions highlight the fragility of the Western evidence base and its limited ability to inform surveillance recommendations. Our findings extend prior meta-analyses by incorporating topography-specific risk estimates and explicitly identifying evidence gaps in Western populations. Gastric atrophy confers a markedly increased risk of gastric cancer, particularly when extensive. Standardised biopsy mapping and atrophy-specific reporting are needed to refine surveillance strategies and tailor guidelines to regional risk profiles. Current surveillance recommendations for distal gastric atrophy in low-risk Western populations should be applied cautiously, given the evidence and absence of robust prospective data.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1041-1051"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812689","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}