Geburtshilfe Und Frauenheilkunde最新文献

{"title":"Correction: Induction of Labor at Term with Oral Misoprostol or as a Vaginal Insert and Dinoprostone Vaginal Insert - A Multicenter Prospective Cohort Study.","authors":"Jana Beyer, Yvonne Jäger, Derya Balci, Gelia Kolb, Friederike Weschenfelder, Sven Seeger, Dietmar Schlembach, Michael Abou-Dakn, Ekkehard Schleußner","doi":"10.1055/a-2704-9622","DOIUrl":"https://doi.org/10.1055/a-2704-9622","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1055/a-1860-0419.].</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 9","pages":"e3"},"PeriodicalIF":1.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polycystic Ovary Syndrome - Support and Prevention in Adolescence.","authors":"Katja Wechsung, Uta Neumann, Nicole Balint, Susanna Wiegand","doi":"10.1055/a-2622-6321","DOIUrl":"10.1055/a-2622-6321","url":null,"abstract":"<p><p>For up to eight years after menarche, adolescents are in a developmental stage where PCOS (polycystic ovary syndrome) symptoms are physiological. The diagnostic criteria for PCOS in adult women therefore only partially apply. A new German S2k guideline and the international PCOS guideline of 2023 provide standardized diagnostic criteria for hyperandrogenemia and menstrual disorders in adolescence. The provisional diagnosis of PCOS at risk has been introduced for adolescents who only partially meet the criteria and this diagnosis must be revisited three and eight years after menarche. Recommendations for therapy focus on providing information and lifestyle advice to adolescents and on the prevention and treatment of possible comorbidities such as obesity, insulin resistance and hypertension. This paper presents an overview of a structured diagnostic workup and therapeutic approaches to support adolescents with PCOS.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 9","pages":"927-933"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increase in Angiogenesis and Vascularization in Patient-Derived Endometriosis Tissue: Insights from a 3D In Vivo Model.","authors":"Patrick Scherer, Nina Kurz-Mammri, Eva Graf, Thomas Papathemelis, Silke Haerteis, Cynthia Kohl","doi":"10.1055/a-2649-6142","DOIUrl":"10.1055/a-2649-6142","url":null,"abstract":"<p><strong>Aim: </strong>Endometriosis is a gynecological disorder characterized by endometrial-like tissue outside the uterus. This study evaluates the vascularization and proliferation of human endometriosis and endometrium tissues engrafted onto the chorioallantoic membrane of chicken embryos using immunohistochemistry and laser speckle contrast analysis imaging. For the assessment of clinical relevance, a comparison between laboratory and clinical data was performed.</p><p><strong>Material and methods: </strong>Tissue samples from 10 patients categorized by #Enzian scores and undergoing endometriosis surgery were investigated in the chorioallantoic membrane model. Hematoxylin-eosin staining and immunohistochemical markers, including CD10, cytokeratin, Ki67, and Caspase-3, assessed cellular structures, proliferation, and apoptosis. Changes in blood perfusion, implemented as a surrogate marker for angiogenesis and vascularization, were analyzed over three days using laser speckle contrast analysis. The fertilized chicken eggs used for the chorioallantoic membrane model were stratified for their gender utilizing an in ovo sexing technique.</p><p><strong>Results: </strong>Immunohistochemistry confirmed stromal and glandular cells in transplanted tissues. Ki67 indicated variable proliferation, while Caspase-3 identified apoptosis. Perfusion increased significantly in 75% of endometriosis samples. Endometrium from a patient with endometriosis showed increased perfusion, contrasting with stable perfusion in healthy endometrium. Higher #Enzian scores partly correlated with increased vascularization.</p><p><strong>Summary: </strong>The chorioallantoic membrane model is a viable platform for studying endometriosis vascularization and angiogenesis. Endometriosis tissue showed enhanced vascularization influenced by lesion size and anatomical location, offering insights into disease progression and therapeutic strategies.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 9","pages":"951-963"},"PeriodicalIF":1.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction of Robot-assisted Surgery for Benign Total Hysterectomy with Salpingectomy: Learning Curve, Safety and Experience in a Tertiary Surgical Center.","authors":"Lisa Jung, Benedikt Kurz, Peter Jungmann, Maximilian Klar, Sarah Isabelle Huwer, Florin-Andrei Taran, Angeline Favre-Inhofer, Markus Medl, Markus Hübner, Ingolf Juhasz-Böss","doi":"10.1055/a-2606-9826","DOIUrl":"10.1055/a-2606-9826","url":null,"abstract":"<p><strong>Background: </strong>The dynamic advances in robot-assisted surgery have particularly affected gynecological surgery. An analysis of the surgical data of robot-assisted procedures, starting when the procedure is first introduced into a surgical center, provides valuable insights into the initial use and integration of the da Vinci system in routine clinical practice and the impact on patient care. This article aims to investigate the learning curve and show the increased proficiency with this approach. This analysis focuses on the most common procedure performed during the introductory phase: benign total hysterectomy with salpingectomy.</p><p><strong>Material and method: </strong>A retrospective data analysis was carried out of the first 250 patients operated on between February 2020 and June 2022 by five different surgeons in Freiburg University Hospital using the da Vinci surgical system. The evaluation includes classic surgical parameters such as preparation times, incision-to-suture times, and console times as well as the learning curves of the surgeons and the surgical team (incl. CUSUM analysis). Perioperative patient characteristics (e.g., blood loss, hospitalization times, conversion rate) are also presented.</p><p><strong>Results: </strong>Most procedures (30%) were carried out for uterine fibroids. Operating times decreased significantly over time as more and more robot-assisted procedures were carried out: the surgical preparation time decreased over the first 30 procedures from 28.1 ± 8.6 min to 23.8 ± 7.2 min. The initial incision-to-suture time for benign total hysterectomies with salpingectomy was 94.0 ± 42.2 min and had decreased significantly by the end of the first 20 procedures. The average console time was 66.8 ± 36.1 min, and the decrease was particularly visible over the first 20 procedures. The individual learning curves of the surgeons showed significant decreases in time. For example, the average console time of surgeon A decreased over the first ten procedures from 70.5 ± 23.0 min to 46.9 ± 13.5 min. The conversion rate for the whole cohort was 0.8%.</p><p><strong>Discussion: </strong>The evaluation of the first 250 da Vinci surgeries demonstrates the easy learnability of robot-assisted surgery. The conversion rate was very low, coming in at just 0.8%. A positive effect on the learning curve of individual surgeons was found after about 20 procedures. Both the preparation times and the incision-to-suture times decreased rapidly, meaning that there were no problems integrating the new approach into routine clinical practice.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 9","pages":"964-975"},"PeriodicalIF":1.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunities and Limitations of Modern High Throughput Sequencing in Invasive Prenatal Diagnostics.","authors":"Heinz Gabriel, Markus Stumm","doi":"10.1055/a-2567-3396","DOIUrl":"10.1055/a-2567-3396","url":null,"abstract":"<p><p>Prenatal diagnostics are used to identify the causes of fetal anomalies detected on ultrasound. If ultrasound findings appear to indicate a genetic disorder, sequencing methods offer the opportunity to safely diagnose numerous genetic disorders prenatally with the help of diagnostic puncture and aspiration. Depending on the type of ultrasound abnormality, massive parallel sequencing (MPS) (the terms \"high throughput sequencing\" and \"next generation sequencing\" [NGS] are often used synonymously) can identify up to 50% of the causes of fetal malformations (skeletal abnormalities). Confirmation of a genetic disorder makes it possible to inform and advise pregnant women or parents who are looking for advice about the expected development of their unborn child and provides a science-based assessment of the risk of recurrence. This review article describes the benefits and special features of prenatal diagnostic tests using next generation sequencing and looks ahead at the developments in molecular genetic diagnostic procedures which may be used for the prenatal confirmation of genetic disorders in the future.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 9","pages":"934-940"},"PeriodicalIF":1.9,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update Gynecologic Malignancies 2025 - Expert Opinion on Systemic Therapy for Early and Advanced Gynecological Cancers.","authors":"Julius Emons, Julia Gocke, Carla Schulmeyer, Frederik Alexander Stübs, Annika Krückel, Niklas Amann, Matthias W Beckmann, Manuel Hörner, Patrik Pöschke","doi":"10.1055/a-2622-0684","DOIUrl":"10.1055/a-2622-0684","url":null,"abstract":"<p><p>There have been major changes in the understanding of gynecologic malignancies in recent years, leading to new therapy options and subsequently to greater responsibilities for every professional treating those patients. The most significant therapeutic advances were achieved with checkpoint inhibitors (CPI), especially for endometrial and cervical cancer. In ovarian cancer the dominant and most important new substances are poly (ADP-ribose) polymerase inhibitors (PARPi). This review aims to summarize the latest studies and developments in the therapeutic landscape of endometrial, ovarian, and cervical cancer. The treatment of advanced endometrial cancer has changed significantly with the introduction of CPI such as dostarlimab (RUBY trial), durvalumab (DUO-E trial) and pembrolizumab (Keynote-868 trial). For ovarian cancer PARPi have shown substantial PFS benefits in key approval trials, including PRIMA for niraparib, PAOLA for olaparib, and ATHENA-MONO for rucaparib. These findings have established PARPi as the standard of care in maintenance therapy. Overall survival (OS) data for PRIMA and PAOLA are now available and are analyzed and placed into context in this article. Furthermore, mirvetuximab soravtansine is the first antibody-drug conjugate (ADC) approved in Germany for platinum-resistant ovarian cancer for patients with folate receptor alpha expression. The Keynote-A18 and BEATcc trials have opened new options for the utilization of immuno-oncology in cervical cancer treatment. Along with new therapeutic options, new biomarkers have also become part of daily clinical practice as predictive and prognostic factors as well as forming the basis for targeted personalized medicine. The use of CPI is revolutionizing the treatment of all gynecologic cancers and offers significant benefits for progression-free survival (PFS) and OS in most therapy regimens. With the increased use of ADCs, this is not the end of these developments. Therapy algorithms from a certified German oncology center are developed and presented in this article.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 7","pages":"736-745"},"PeriodicalIF":2.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Patients with Early Breast Cancer: 19th St. Gallen International Breast Cancer Consensus Discussed against the Background of German Treatment Recommendations.","authors":"Michael Untch, Maggie Banys-Paluchowski, Sara Y Brucker, Carsten Denkert, Peter A Fasching, Renate Haidinger, Nadia Harbeck, Wolfgang Janni, David Krug, Sibylle Loibl, Diana Lüftner, Laura Michel, Eva Schumacher-Wulf, Christine Solbach, Rachel Würstlein, Jens Huober, Nina Ditsch","doi":"10.1055/a-2612-3790","DOIUrl":"10.1055/a-2612-3790","url":null,"abstract":"<p><p>This year's 19th St. Gallen (SG) consensus conference on the treatment of patients with early breast cancer (SGBCC: St. Gallen Breast Cancer Conference) is based on numerous patient examples, each with different variables, to reflect the increasingly personalized treatment decision for early breast cancer. More than ever, not only breast cancer subtype, performance status, age and life expectancy are considered as individual factors, but various molecular and genetic variables are also part of the treatment decision. In this manuscript, the SGBCC voting results are discussed by a German group of breast cancer specialists in the context of the recently (2025) updated treatment recommendations of the Commission of the Gynecological Oncology Working Group (AGO Mamma). The German treatment recommendations are based on current evidence. As the international panel of the SGBCC consists of experts from different countries and disciplines, the votes represent an international cross-section of opinions. Therefore, it is useful to discuss the voting results with respect to current German treatment guidelines.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 7","pages":"677-693"},"PeriodicalIF":2.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Idea to Implementation: Development of the Smart-e-Moms App to Reduce Postpartum Depressive Symptoms.","authors":"Daria Daehn, Caroline Meyer, Maria Böttche, Viola Loew, Silke Pawils, Sophie Rudolf, Jessica Wabiszczewicz, Anna Will, Babette Renneberg","doi":"10.1055/a-2553-7247","DOIUrl":"10.1055/a-2553-7247","url":null,"abstract":"<p><strong>Introduction: </strong>Postpartum depression is the most common mental health disorder associated with the birth of a child. However, postpartum depression often remains untreated because there are not enough prevention and treatment options. Barriers such as lack of knowledge and fear of stigmatization also make it more difficult for affected women to start treatment. Digital interventions could be an option which might circumvent many of these barriers. This study describes the development process of the smartphone-based intervention Smart-e-Moms which aims to reduce postpartum depressive symptoms.</p><p><strong>Material and methods: </strong>The app was developed using a participatory and iterative approach. The three steps used for the formative evaluation were: (1) an analysis of needs and preferences (focus groups with 9 formerly affected women and 11 midwives), (2) an analysis of the barriers and facilitating factors to use the app (online survey of 37 mothers), and (3) testing of the app (online interviews with 10 acutely affected women). Qualitative data was analyzed with MAXQDA for content analysis.</p><p><strong>Results: </strong>Step 1 identified numerous challenges after giving birth such as stress, negative thoughts and feelings, and lack of support, all of which flowed into the contents of the app. Ensuring that the units were short and the topics \"self-care\" and \"relationship to the child\" were also considered important. In step 2, barriers and facilitating factors were identified and incorporated into the design of the app. Step 3 consisted of a positive assessment of the first version of the app in terms of content and formal design as well as usability. The final app consisted of 10 behavioral units with written psychological guidance, constantly accessible exercises on self-care and the relationship to the child and permanently available information on common challenges after giving birth.</p><p><strong>Conclusion: </strong>We present a new and innovative approach which aims to reach out more easily to women with postpartum depressive symptoms. The most important insights from the development process, the final design, and the elements of the program are described here.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 8","pages":"870-883"},"PeriodicalIF":1.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduction of Neonatal Macrosomia Rate of Infants Born to Overweight and Obese Women through Nutrition Counseling in Pregnancy - A One-arm Interventional Study.","authors":"Sabine Körber, Marina Polei, Toralf Reimer, Henrik Rudolf, Johannes Stubert","doi":"10.1055/a-2558-2169","DOIUrl":"10.1055/a-2558-2169","url":null,"abstract":"<p><strong>Introduction: </strong>Because of fetal programming, neonatal macrosomia is associated with a higher long-term risk of metabolic disease. In 2020, the overall macrosomia rate of term-born singletons born to overweight or obese mothers in our center was approximately 30%. The aim of our study was to reduce the macrosomia rate with pregnancy-related nutrition counseling.</p><p><strong>Methods: </strong>This is a single center, one-arm, interventional pilot study of 99 singleton pregnancies. The intervention took the form of three individual and group education sessions on pregnancy-relevant nutritional topics and exercise in the 10th to 14th, 20th to 24th and 30th to 34th weeks of gestation. The primary endpoint was the overall macrosomia rate born to overweight/obese mothers and birth ≥ 37 weeks of gestation. Macrosomia was defined as the presence of at least one of the following criteria: birth weight ≥ 4000 g, birth weight > 90th percentile, length-related birth weight > 90th percentile, birth weight > 90th percentile after adjustment for initial maternal weight and height. The results were compared with those of a non-interventional cohort from the same center.</p><p><strong>Results: </strong>Ninety-one percent of pregnant women with a pre-pregnancy BMI ≥ 25 kg/m ² had a delivery at term (n = 77/85). The overall macrosomia rate of these children was 19.5% (95% CI: 11.3% to 30.1%, n = 15/77) and therefore lower than the expected BMI-corrected macrosomia rate of the comparison group of 31.3% (p = 0.026). In the total cohort, which included normal-weight women, a trend toward normalization of birth weights was observed (p = 0.083).</p><p><strong>Conclusion: </strong>Professional nutrition counseling during pregnancy can reduce the neonatal macrosomia rate of infants born to women with a BMI ≥ 25 kg/m ² . Relevant provision of counseling services in the context of antenatal care would be useful for affected women.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 8","pages":"851-861"},"PeriodicalIF":1.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting Genomic Instability, Tumor Microenvironment and Immune Response in High-Grade Serous Ovarian Cancer.","authors":"Leonie Ratz, Sunhwa Baek, Stephanie Panier","doi":"10.1055/a-2613-0489","DOIUrl":"10.1055/a-2613-0489","url":null,"abstract":"<p><p>High-grade serous tubo-ovarian cancer is the most common and aggressive type of ovarian cancer characterized by extensive genomic instability and marked inter- and intra-patient tumor heterogeneity. Tumor-site specific signaling crosstalk between cancer cells and the tumor microenvironment influences different tumor ecosystems that drive therapy response and disease progression. Cancer cell-intrinsic genomic aberrations further contribute to the diversity of the tumor immune landscape. Homologous recombination deficiency is considered a key oncogenic driver in 50% of the cases underlying distinctive mechanisms of tumor evolution. The heterogenous character of the tumor microenvironment represents a major challenge to identify predictive biomarkers of therapy response and to stratify subgroups amenable to immunotherapies.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 7","pages":"694-709"},"PeriodicalIF":2.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}