European urology focus最新文献

{"title":"Re: Guillermo Conde-Santos, Barbara Padilla-Fernández. Targeting the Autonomic Nervous System for Urinary Incontinence Treatment. Eur Urol Focus. In press. https://doi.org/10.1016/j.euf.2025.02.015.","authors":"Hao-Wei Chen, Wei-Chung Tsai, Yu-Hsiang Lin, Yu-Chen Chen","doi":"10.1016/j.euf.2025.04.012","DOIUrl":"https://doi.org/10.1016/j.euf.2025.04.012","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies for Treatment De-escalation in Metastatic Renal Cell Carcinoma.","authors":"Shuchi Gulati, Lorenzo Nardo, Primo N Lara","doi":"10.1016/j.euf.2025.05.014","DOIUrl":"https://doi.org/10.1016/j.euf.2025.05.014","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICIs) and targeted therapies have revolutionized the management of metastatic renal cell carcinoma (mRCC). Currently, the frontline standard of care for patients with mRCC involves the provision of systemic ICI-based combination therapy with no clear guidelines on holding or de-escalating treatment, even with a complete or partial radiological response. Treatments usually continue until disease progression or unacceptable toxicity, frequently leading to overtreatment, which can elevate the risk of toxicity without providing a corresponding increase in therapeutic efficacy. In addition, the ongoing use of expensive antineoplastic drugs increases the financial burden on the already overstretched health care systems and on patients and their families. De-escalation strategies could be designed by integrating contemporary technologies, such as circulating tumor DNA, and advanced imaging techniques, such as computed tomography (CT) scans, positron emission tomography CT, magnetic resonance imaging, and machine learning models. Treatment de-escalation, when appropriate, can minimize treatment-related toxicities, reduce health care costs, and optimize the patients' quality of life while maintaining effective cancer control. This paper discusses the advantages, challenges, and clinical implications of de-escalation strategies in the management of mRCC. PATIENT SUMMARY: In this report, we describe the burden of overtreatment in patients who are never able to stop treatments for metastatic kidney cancer. We discuss the application of the latest technology that can help in making de-escalation decisions.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjuvant Therapy for Renal Cell Carcinoma After Metastatectomy: A Focus on Therapy Intensification.","authors":"Michael Serzan","doi":"10.1016/j.euf.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.euf.2025.05.005","url":null,"abstract":"<p><p>Adjuvant therapy for patients with completely resected metastases in renal cell carcinoma remains a clinical conundrum. Owing to the high risk of disease recurrence, several clinical trials are investigating treatment intensification with combination regimens aimed at improving efficacy and limiting toxicity.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Adjuvant Therapy in Current Perioperative Immunotherapy-based Trials in Bladder Cancer: A Justified Standard.","authors":"Guru P Sonpavde","doi":"10.1016/j.euf.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.euf.2025.05.008","url":null,"abstract":"<p><p>None of the ongoing phase 3 trials are evaluating the impact of the adjuvant component of perioperative PD1/PDL1 inhibition combined with neoadjuvant chemotherapy for muscle-invasive bladder cancer. Biomarkers of benefit are not validated. Hence, omission of the adjuvant component cannot be supported. Prospective investigation is required to evaluate this question.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Jonathan S. Ellison, Gregory E. Tasian. Engaging Patients in Clinical Trials on Kidney Stones: Lessons Learned. Eur Urol Focus. In press. https://doi.org/10.1016/j.euf.2025.03.005.","authors":"Hao-Wei Chen, Yu-Chen Chen, Jung-Ting Lee","doi":"10.1016/j.euf.2025.04.034","DOIUrl":"https://doi.org/10.1016/j.euf.2025.04.034","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Androgen Receptor Pathway Inhibitor Monotherapy in Prostate Cancer: Safety, Oncologic Outcomes, and Quality of Life-A Systematic Review and Meta-analysis.","authors":"Tamás Fazekas, Marcin Miszczyk, Alexander Giesen, Tamás Kói, Fabio Zattoni, Lara Rodriguez-Sanchez, Takafumi Yanagisawa, Akihiro Matsukawa, Tibor Szarvas, Piotr Kryst, Juan Gómez Rivas, Axel S Merseburger, Maria De Santis, Steven Joniau, Alberto Briganti, Giancarlo Marra, Péter Nyirády, Giorgio Gandaglia, Shahrokh F Shariat, Pawel Rajwa","doi":"10.1016/j.euf.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.euf.2025.05.006","url":null,"abstract":"<p><strong>Background and objective: </strong>Androgen receptor pathway inhibitors (ARPIs) as monotherapy are studied increasingly across prostate cancer disease states. We aimed to evaluate the safety, oncologic efficacy, and quality of life (QoL) of ARPI monotherapy as compared with ARPI + androgen deprivation therapy (ADT) and ADT alone.</p><p><strong>Methods: </strong>PubMed/Medline, Embase, and Cochrane/Central were queried through June 2024 for clinical trials. The primary outcomes were the rates of adverse events (AEs) presented as risk ratios (RRs); the secondary outcomes included efficacy and QoL.</p><p><strong>Key findings and limitations: </strong>We synthesized data from 2015 men, retrieved from 17 studies. The incidence of any AEs was similar between patients on ARPIs, ARPI + ADT (RR: 1.01, 95% confidence interval [CI]: 1-1.02, p = 0.08), and ADT (RR: 1.01, 95% CI: 0.98-1.04, p = 0.3). The incidence of grade ≥3 AEs was higher in patients on ARPI monotherapy than in those on ADT (RR: 1.18, 95% CI: 1.11-1.24, p < 0.01), driven mainly by fatigue and cardiovascular toxicity. There was no statistically significant difference in grade ≥3 AEs between patients treated with ARPIs and ARPI + ADT (RR: 1.07, 95% CI: 0.87-1.3, p = 0.4). ARPI monotherapy led to a lower incidence of hot flushes (RR: 0.4, 95% CI: 0.18-0.89, p = 0.03) but higher incidences of breast pain (RR: 6.03, 95% CI: 3.34-10.88, p < 0.01) and gynecomastia (RR: 5.73, 95% CI: 3.79-8.66, p < 0.01) than treatment with ARPI + ADT. ARPIs demonstrated promising oncologic efficacy for patients with biochemical recurrence, while maintaining favorable overall and sexual QoL.</p><p><strong>Conclusions and clinical implications: </strong>ARPI monotherapy results in overall similar toxicities for ARPI + ADT and ADT alone. The specific AE pattern of each combination can serve as a basis to tailor therapy to each patient's needs and wishes.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Oncological Outcomes for Patients with Non-muscle-invasive Bladder Cancer Treated with Bacillus Calmette-Guérin (BCG): A Comparative Analysis of Adequate Versus Inadequate BCG Treatment.","authors":"Pietro Scilipoti, Mattia Longoni, Mario de Angelis, Paolo Zaurito, Aleksander Ślusarczyk, Francesco Soria, Benjamin Pradere, Wojciech Krajewski, David D'Andrea, Andrea Mari, Francesco Del Giudice, Renate Pichler, José Daniel Subiela, Gautier Marcq, Andrea Gallioli, Luca Afferi, Riccardo Mastroianni, Giuseppe Simone, Simone Albisinni, Laura S Mertens, Ekaterina Laukhtina, Katharina Oberneder, José Luis Rodríguez Elena, Javier Aranda, Alfonso Lafuente Puentedura, Jorge Caño Velasco, Roberto Contieri, Rodolfo Hurle, Keiichiro Mori, Piotr Radziszewski, Shahrokh F Shariat, Paolo Gontero, Andrea Necchi, Morgan Rouprêt, Francesco Montorsi, Andrea Salonia, Alberto Briganti, Marco Moschini","doi":"10.1016/j.euf.2025.04.033","DOIUrl":"https://doi.org/10.1016/j.euf.2025.04.033","url":null,"abstract":"<p><strong>Background and objective: </strong>Intravesical bacillus Calmette-Guérin (BCG) instillation is recommended for intermediate-risk (IR) and high-risk (HiR) non-muscle-invasive bladder cancer (NMIBC). There are limited comparisons of long-term outcomes between adequate and inadequate BCG.</p><p><strong>Methods: </strong>We analyzed data from a multicenter European database (2010-2024) for 1558 patients diagnosed with IR- or HiR-NMIBC who underwent BCG treatment and received at least five BCG instillations. Adequate BCG was defined as at least five of six induction instillations and two of three maintenance doses, or two of six doses of a reinduction course. A 3-mo landmark analysis was conducted. Recurrence-free survival (RFS), high-grade RFS (HG-RFS), progression-free survival (PFS), and overall survival (OS) were estimated using inverse probability of treatment weighting (IPTW)-adjusted Kaplan-Meier curves and IPTW-adjusted multivariable Cox regression models. Cancer-specific mortality (CSM) was assessed via cumulative incidence curves and Fine-Gray competing-risks regression analysis.</p><p><strong>Key findings and limitations: </strong>The cohort included 606 IR-NMIBC (39%), 840 HiR-NMIBC (54%), and 112 very HiR (VHR)-NMIBC (7.1%) cases. Adequate BCG was administered to 1226 patients (78%). Among 1239 patients (80%) with documented treatment termination reasons, 503 (41%) completed guideline-recommended treatment and 150 (12%) discontinued because of BCG intolerance. Over median follow-up of 37 mo, adequate BCG was associated with higher IPTW-adjusted 5-yr RFS (72% vs 52%; hazard ratio [HR] 0.40, 95% confidence interval [CI] 0.31-0.85; p < 0.001), HG-RFS (83% vs 68%; HR 0.43, 95% CI 0.32-0.58; p < 0.001), PFS (92% vs 85%; HR 0.47, 95% CI 0.30-0.74; p = 0.001), and OS (88% vs 71%; HR 0.52, 95% CI 0.37-0.74; p = 0.001). CSM rates were comparable between the groups (3% vs 4.9%; p = 0.3).</p><p><strong>Conclusions and clinical implications: </strong>Adequate BCG, as defined by the International Bladder Cancer Group (IBCG), was associated with significantly better RFS, PFS, and OS. These findings support use of the IBCG definition as a standardized benchmark for BCG exposure. However, further prospective validation to confirm causality is needed.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostate-specific Antigen Response as a Prognostic Factor for Overall Survival in Patients with Prostate Cancer Treated with Androgen Receptor Pathway Inhibitors: A Systematic Review and Meta-analysis.","authors":"Marcin Miszczyk, Tamás Fazekas, Paweł Rajwa, Akihiro Matsukawa, Ichiro Tsuboi, Michael S Leapman, Gero Kramer, Maha Hussain, Axel Merseburger, Alberto Briganti, Anthony V D'Amico, Silke Gillessen, Fred Saad, Shahrokh F Shariat","doi":"10.1016/j.euf.2025.03.019","DOIUrl":"https://doi.org/10.1016/j.euf.2025.03.019","url":null,"abstract":"<p><strong>Background and objective: </strong>For patients with advanced prostate cancer (PC) treated with androgen deprivation therapy (ADT) plus an androgen receptor pathway inhibitor (ARPI), the decline in prostate-specific antigen (PSA) is a potential biomarker for treatment response. We synthesised data regarding the association of the PSA response with overall survival (OS).</p><p><strong>Methods: </strong>The MEDLINE, Embase, Web of Science, and Google Scholar databases were searched up to November 2024 to identify studies evaluating the association between the PSA response and OS among patients treated with ADT + ARPI. Hazard ratios (HRs) were pooled in random-effects meta-analyses.</p><p><strong>Key findings and limitations: </strong>We identified 14 studies comprising a total of 8883 patients. Among four studies in metastatic hormone-sensitive PC (n = 2197), achievement of an undetectable PSA level was associated with better OS (HR 0.33, 95% confidence interval [CI] 0.23-0.49). In two studies in nonmetastatic castration-resistant PC (n = 1507), a PSA decline to <0.2 ng/ml (HR 0.28, 95% CI 0.21-0.36), a PSA reduction of ≥90% (HR 0.39, 95% CI 0.28-0.52), and a PSA reduction of ≥50% (HR 0.34, 95% CI 0.16-0.69) were associated with better OS. Among four studies in metastatic castration-resistant PC (n = 3728), PSA reductions of ≥90% (HR 0.22, 95% CI 0.14-0.34) and ≥50% (HR 0.29, 95% CI 0.20-0.41) were associated with better OS. The main limitations include heterogeneity in study designs and use of ADT before baseline PSA measurement in mHSPC studies.</p><p><strong>Conclusions and clinical implications: </strong>The PSA response following ADT + ARPI therapy is significantly associated with OS across all metastatic and castration-resistant PC states and could serve as a clinically useful early signal of efficacy. It remains to be proven whether the PSA response is a surrogate for OS or should guide changes in clinical care.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gleason Grade Group 3 Represents a Spectrum of Disease: Results from a Large Institutional Cohort.","authors":"Kevin Shee, Janet E Cowan, Chien-Kuang Cornelia Ding, Lufan Wang, William Pace, Nancy Greenland, Jeffry P Simko, Samuel L Washington, Katsuto Shinohara, Hao G Nguyen, Matthew R Cooperberg, Peter R Carroll","doi":"10.1016/j.euf.2025.04.027","DOIUrl":"https://doi.org/10.1016/j.euf.2025.04.027","url":null,"abstract":"<p><strong>Background and objective: </strong>A biopsy diagnosis of Gleason grade group (GG) 3 prostate cancer (PC) automatically classifies patients as having at least unfavorable intermediate-risk disease warranting definitive treatment. We hypothesized that GG3 PCs are not equally unfavorable.</p><p><strong>Methods: </strong>The Urologic Outcomes Database at University of California-San Francisco was queried for men with localized, nonmetastatic PC diagnosed after 2000 who underwent radical prostatectomy (RP). The primary outcome was recurrence, defined as either biochemical failure (two prostate-specific antigen results ≥0.2 ng/ml) or salvage treatment. Multivariable Cox proportional-hazards regression models were used to calculate associations with the risk of recurrence, adjusted for clinicodemographic and postoperative factors.</p><p><strong>Key findings and limitations: </strong>We included 4934 men who underwent RP in the analysis, of whom 862 (17%) were diagnosed with GG3 PC on biopsy. Cancer of the Prostate Risk Assessment postsurgery (CAPRA-S) scores overall increased over time, but remained broadly distributed. Multivariable analysis controlled for postoperative factors with CAPRA-S revealed that favorable biopsy Gleason histology (not expansile cribriform or intraductal carcinoma) was the strongest factor associated with lower risk of recurrence after RP (hazard ratio [HR] 0.61, 95% confidence interval [CI] 0.41-0.91), independent of the percentage of pattern 4. A higher percentage of positive cores (PPC) was also significantly associated with the risk of recurrence (HR per 10% increment: 1.06, 95% CI 1.01-1.11). Limitations include the retrospective nature of the single-institution study and the homogeneous study population.</p><p><strong>Conclusions and clinical implications: </strong>Patients with GG3 PC on diagnostic biopsy have heterogeneous risk. Unfavorable biopsy histology and higher PPC were significantly associated with the risk of recurrence after RP after controlling for CAPRA-S scores. Not all GG3 cancers are equally unfavorable, and differential management may be warranted.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound for the Diagnosis of Testicular Torsion: A Systematic Review and Meta-analysis of Diagnostic Accuracy.","authors":"Cameron E Alexander, Hannah Warren, Alexander Light, Ridhi Agarwal, Aqua Asif, Bing Jie Chow, Keiran Clement, Vinson Chan, Eleanor Zimmermann, Sinan Khadhouri, Pieter Jan Eyskens, Taimur T Shah, Arjun Nathan, Kevin Byrnes, Nikita Bhatt, Nick Mani, Cathy Yuhong Yuan, Paul S Sidhu, Yemisi Takwoingi, Veeru Kasivisvanathan","doi":"10.1016/j.euf.2025.04.026","DOIUrl":"https://doi.org/10.1016/j.euf.2025.04.026","url":null,"abstract":"<p><strong>Background and objective: </strong>Uncertainty regarding the diagnostic accuracy of ultrasound for testicular torsion (TT) and a lack of high-level evidence to inform international guidelines have led to significant global variation in its use. The objective of this study was to assess the diagnostic accuracy of ultrasound for TT.</p><p><strong>Methods: </strong>This systematic review was undertaken in accordance with the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. A comprehensive electronic search strategy was applied up to January 4, 2024. Colour Doppler sonography (CDS) was the primary index test, with surgical scrotal exploration or clinical follow-up as the reference standard. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the risk of bias and applicability. Meta-analyses were performed using bivariate models.</p><p><strong>Key findings and limitations: </strong>Sixty-three studies met the inclusion criteria; 54 (85.7%) assessed CDS, and the others assessed spectral doppler sonography (n = 6), contrast enhanced ultrasound (n = 1), or an alternative combination of ultrasound technologies (n = 2). The summary sensitivity (95% confidence interval [CI]) and specificity (95% CI) of CDS for the diagnosis of TT were 95.3% (91.4-97.5) and 98.3% (96.2-99.3), respectively (42 studies, 4422 participants). Patient selection (related to the risk of bias and applicability concern) was identified as the domain of the greatest methodological concern on QUADAS-2 assessment.</p><p><strong>Conclusions and clinical implications: </strong>CDS has high diagnostic accuracy for TT. The ideal patient pathway for suspected TT should integrate timely access to ultrasound alongside clinical assessment, with careful patient counselling.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}