Hospital Pharmacy最新文献

{"title":"Distribution and Characteristics of Vaccine Adverse Events: Analysis of Over 2 Million Individual Case Safety Reports.","authors":"Eleonora Castellana, Maria Rachele Chiappetta","doi":"10.1177/00185787261470594","DOIUrl":"10.1177/00185787261470594","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the distribution and characteristics of adverse events following immunization (AEFI) using a large US pharmacovigilance database.</p><p><strong>Methods: </strong>A retrospective descriptive analysis of Individual Case Safety Reports (ICSRs) from the FDA AEMS database (January 2017-March 2026) was conducted. Reports were analyzed by vaccine type, adverse event terms, demographics, reporting year, and reporter category.</p><p><strong>Results: </strong>A total of 2 169 603 ICSRs were identified, with 44.0% classified as serious. COVID-19 vaccines accounted for 78.4% of reports, reflecting mass vaccination campaigns. The most frequently reported events were headache (12.8%), pyrexia (11.8%), and fatigue (11.1%), predominantly non-serious and consistent with known reactogenicity profiles. Reporting peaked in 2021 (48.8%). Females accounted for 60.6% of reports. Non-COVID vaccines contributed substantially fewer reports.</p><p><strong>Conclusions: </strong>Most vaccine-associated adverse events were mild and expected. Findings support a favorable benefit-risk profile and highlight the importance of continuous pharmacovigilance systems for vaccine safety monitoring.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261470594"},"PeriodicalIF":0.9,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence and Large Language Models as Decision-Support Tools in Hospital Compounding Pharmacy: A Proof-of-Concept Study.","authors":"Eleonora Castellana, Maria Rachele Chiappetta","doi":"10.1177/00185787261470578","DOIUrl":"10.1177/00185787261470578","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the efficiency and reliability of a large language model (LLM) as a decision-support tool in hospital compounding pharmacy for pediatric extemporaneous preparations requiring assessment of drug crushability, regulatory compliance, and formulation feasibility.</p><p><strong>Methods: </strong>A proof-of-concept study compared a structured LLM-assisted workflow with the traditional manual information retrieval process in a hospital pharmacy setting. The LLM (Claude Sonnet 4.6) was configured with a standardized prompt to extract and consolidate data from multiple authoritative sources: the Friuli Venezia Giulia \"Do Not Crush\" list, the Italian Medicines Agency (AIFA) database for Summary of Product Characteristics (SmPC), AIFA Law 648/96 off-label use lists, and the Stabilis database for oral liquid formulation stability. Two representative drugs, propranolol hydrochloride and imatinib mesylate, were analyzed. For each drug, the model generated a structured output including crushability, regulatory information, off-label status, and extemporaneous formulation data. The same queries were manually performed by an experienced hospital pharmacist. Primary outcome was information retrieval time; secondary outcomes included completeness and accuracy.</p><p><strong>Results: </strong>The LLM-assisted workflow reduced retrieval time to less than 2 minutes per drug (mean 1 minute 45 seconds), compared with a mean of 20 minutes (range 15-25 minutes) for the manual process, plus an additional 5 to 10 minutes for transcription. Output completeness was 100%, with all predefined fields correctly populated. The model accurately classified drug crushability and correctly identified Law 648/96 regulatory status. For propranolol, the system identified crushability, pediatric off-label authorization, and SyrSpend-based formulations with stability data of up to 146 days at room temperature. For imatinib, the model highlighted cytotoxic handling precautions, identified the absence of SyrSpend formulations, and retrieved alternative formulation stability data (30 days refrigerated).</p><p><strong>Conclusions: </strong>A properly configured LLM can function as an effective decision-support tool in hospital compounding pharmacy, improving efficiency while maintaining high standards of completeness, accuracy, and regulatory compliance. These preliminary results support further investigation into the integration of the LLM system into routine pediatric galenical preparation practice.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261470578"},"PeriodicalIF":0.9,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diclofenac-Associated Kounis Syndrome: A Systematic Review and Disproportionality Analysis of FAERS Database.","authors":"Betsy Abraham, Kannan Sridharan","doi":"10.1177/00185787261465849","DOIUrl":"10.1177/00185787261465849","url":null,"abstract":"<p><strong>Background: </strong>Kounis syndrome, or allergic acute coronary syndrome, is a potentially underdiagnosed condition triggered by hypersensitivity reactions. Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently implicated, with diclofenac repeatedly reported as a precipitating agent. However, no systematic synthesis has specifically evaluated the clinical characteristics, management, and outcomes of diclofenac-induced Kounis syndrome.</p><p><strong>Methods: </strong>We conducted a systematic review of case reports and case series describing diclofenac-associated Kounis syndrome, searching PubMed/MEDLINE, Scopus, and Google Scholar from inception through January 31, 2026. Eligible studies documented a temporal association between diclofenac exposure and acute coronary events with allergic manifestations. Data on demographics, clinical presentation, diagnostic findings, management, and outcomes were extracted. Methodological quality was assessed using a modified CARE checklist framework. Data were synthesized descriptively. Additionally, we carried out disproportionality analysis of reported events with Kounis syndrome and diclofenac from the United States Food and Drug Administration Adverse Event Reporting System (FAERS).</p><p><strong>Results: </strong>Twenty-seven patients were included. The majority were male (81.5%), and 44.4% had no cardiovascular comorbidities. Allergic manifestations included hypotension (70.4%), urticaria (66.7%), and chest pain (85.2%). Type I Kounis syndrome (vasospasm without underlying coronary disease) was most common (59.3%), followed by type II (25.9%) and type III (3.7%). ST-segment elevation was present in 66.7%, and coronary angiography was normal in 63.0%. Management consisted of antihistamines (85.2%), corticosteroids (77.8%), and epinephrine (37.0%). Percutaneous coronary intervention was performed in 11.1%. Causality was probable or definite in all cases. All patients survived discharge. Quality assessment revealed high-quality reporting in 70.4% of cases, though documentation of patient perspective and informed consent was universally absent. FAERS analysis revealed positive signals between diclofenac and Kounis syndrome from 137 reports.</p><p><strong>Conclusion: </strong>Diclofenac-induced Kounis syndrome most commonly presents as type I vasospastic myocardial ischemia with prominent allergic features, ST-segment elevation, and normal coronary angiography. Outcomes are favorable with prompt recognition and combined anti-allergic and anti-ischemic therapy. Clinicians should maintain a high index of suspicion following diclofenac exposure, even in patients without cardiovascular risk factors, and strict avoidance of re-exposure is essential.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261465849"},"PeriodicalIF":0.9,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13381680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Peripheral Rabbit Anti-Thymocyte Globulin Without Heparin and Hydrocortisone Additives on Local Infusion Reactions.","authors":"Leanna Borges, Meagan Conrath, David M O'Sullivan, Kristen Marti","doi":"10.1177/00185787261467261","DOIUrl":"10.1177/00185787261467261","url":null,"abstract":"<p><strong>Background: </strong>Rabbit anti-thymocyte globulin (rATG) is indicated for induction immunosuppression therapy in renal transplant recipients. Heparin and hydrocortisone are standardly added to peripheral rATG preparations to reduce the incidence of local infusion reactions. In March 2023, this institution removed heparin and hydrocortisone additives in peripheral rATG preparations to avoid medication waste in the setting of drug shortages.</p><p><strong>Objective: </strong>The purpose of this study was to compare the incidence of local infusion reactions in renal transplant recipients receiving peripheral rATG with and without additives.</p><p><strong>Methods: </strong>This was a single-center, retrospective, pre- and post-implementation cohort study of adult renal transplant recipients. Patients were included if they were ≥18 years of age, received rATG through a peripheral line, and received a renal transplant between November 1, 2022 and July 12, 2023, inclusive. The primary outcome was the incidence of local infusion reactions. Descriptive statistics were used to report baseline demographics and a Fisher's exact test was used to compare rates of local infusion reactions in the additives and no additives groups.</p><p><strong>Results: </strong>A total of 261 peripheral rATG doses were included in the analysis. The baseline characteristics were similar between the two groups. Of the 261 rATG infusions, 120 infusions included heparin and hydrocortisone in the preparation, while 141 of the infusions did not contain additives. The difference between groups in occurrence of local infusion reactions was not statistically significant. Local infusion reactions were reported during ten (8.3%) rATG infusions with additives compared to eight (5.7%) rATG infusions without additives (<i>P</i> = .398).</p><p><strong>Conclusion: </strong>Renal transplant recipients receiving rATG induction therapy without heparin and hydrocortisone additives via peripheral infusion had a similar incidence of local infusion reactions compared to those with additives. Additional studies are needed to substantiate these findings.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261467261"},"PeriodicalIF":0.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrapleural Tissue Plasminogen Activator With or Without Dornase Alfa: A Multicenter Retrospective Cohort Study.","authors":"Michelle P Dillon, Eric C Pyles, Emily H To","doi":"10.1177/00185787261462057","DOIUrl":"10.1177/00185787261462057","url":null,"abstract":"<p><strong>Background: </strong>Intrapleural tissue plasminogen activator (tPA) and DNase are used when drainage of loculated pleural effusions is inadequate, but the real-world performance of pragmatic once-daily protocols remains uncertain.</p><p><strong>Methods: </strong>We performed a retrospective cohort study across seven hospitals between January 1, 2019, and December 31, 2020. Adults who received intrapleural tPA 20 or 50 mg once daily with optional DNase 5 mg once daily for complicated pleural effusion, empyema, or hemothorax were included. The primary outcome was treatment success, defined as survival to hospital discharge without surgical intervention during the index admission. Secondary outcomes included chest tube drainage change, hospital length of stay, ICU length of stay, mortality, major bleeding, and peri-procedural pain requiring analgesics. A post hoc subgroup analysis compared monotherapy with combination therapy.</p><p><strong>Results: </strong>Among 120 included patients, treatment success occurred in 102 (85.0%; 95% CI, 77.3%-90.9%). The median paired increase in chest tube drainage was 487.5 mL (IQR, 72.5-979.0; <i>P</i> < .001). Major bleeding occurred in one patient (0.8%), whereas peri-procedural pain requiring additional analgesia occurred in 69 (57.5%). In the exploratory subgroup analysis, treatment success was 83.8% with tPA monotherapy and 87.0% with tPA/DNase combination therapy.</p><p><strong>Conclusions: </strong>In this multicenter real-world cohort, standardized intrapleural tPA with or without DNase was associated with high observed treatment success, substantial increases in drainage, and rare major bleeding. Comparative findings between combination therapy and monotherapy should be interpreted cautiously because treatment allocation was nonrandomized and exposure groups were imbalanced.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261462057"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stability of Diluted Intravenous Metronidazole in 0.9% Sodium Chloride.","authors":"Grzegorz Szynkaruk, Marta Puchalska, Kacper Osuch, Maria Miotk, Wiktoria Ziaja, Daria Sygnecka, Marta Karaźniewicz-Łada, Joanna Sobiak","doi":"10.1177/00185787261462798","DOIUrl":"10.1177/00185787261462798","url":null,"abstract":"<p><strong>Objectives: </strong>The stability of metronidazole has been demonstrated for high concentration and short-term storage. Little is known about the stability of its dilutions in 0.9% sodium chloride at concentrations relevant for neonatal clinical practice. This study aimed to evaluate the stability of metronidazole solutions at concentrations of 0.1 and 0.6 mg/mL, stored at room temperature and under refrigeration for 24 and 48 hours in 0.9% sodium chloride.</p><p><strong>Methods: </strong>Metronidazole concentrations were measured using a high-performance liquid chromatography method with ultraviolet detection. Calibration curves were linear over the concentration range of 0.025 to 1.25 mg/mL. Stability was defined as retention of 90% to 110% of the initial concentration. Results were expressed as percent deviation from the initial (0 hour) concentration, where 0% corresponds to the initial value (100%).</p><p><strong>Key findings: </strong>At room temperature, mean relative accuracy ranged from 0.7 ± 1.8% to 5.5 ± 1.1%. Under refrigeration, it ranged from -5.5 ± 4.0% to 3.5 ± 1.8%. All samples remained within the pharmacopeial acceptance range (90%-110%) of the initial concentration, corresponding to deviations within ±10%.</p><p><strong>Conclusions: </strong>Metronidazole concentrations of 0.1 and 0.6 mg/mL remained within the predefined acceptance limits for up to 48 hours in 0.9% w/v sodium chloride at 6°C and 22°C, supporting safe short-term storage in neonatal practice.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261462798"},"PeriodicalIF":0.9,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13303257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Comment on \"Early Versus Later Anticoagulation After Ischemic Stroke in Atrial Fibrillation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials\".","authors":"Chia Siang Kow, Dinesh Sangarran Ramachandram, Kaeshaelya Thiruchelvam, Syed Shahzad Hasan, Abdullah Faiz Zaihan","doi":"10.1177/00185787261462793","DOIUrl":"https://doi.org/10.1177/00185787261462793","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261462793"},"PeriodicalIF":0.9,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significant Published Articles in 2025 for Pharmacy Nutrition Support Practice.","authors":"Angela L Bingham, Roland N Dickerson, Titilola M Afolabi, Todd W Canada, Lingtak-Neander Chan, Sarah V Cogle, Diana Mulherin, Anne M Tucker","doi":"10.1177/00185787261454527","DOIUrl":"https://doi.org/10.1177/00185787261454527","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this article is to assist the pharmacist engaged in nutrition support therapy in staying current with pertinent literature.</p><p><strong>Methods: </strong>A group of board-certified nutrition support pharmacists compiled a list of articles relevant to pharmacy nutrition support that were published in 2025. Citations were organized into a spreadsheet, and each author independently assessed whether the article was important to nutrition support pharmacy practice. Articles receiving affirmative votes from at least 5 of the 8 participating authors were included in the final list of key publications. Guidelines, consensus statements, and recommendation papers considered important to practice were included, but not formally ranked.</p><p><strong>Results: </strong>A total of 124 articles were identified; 5 from the primary literature were voted by the group as being of high importance. Nine guidelines, position, recommendation, or consensus papers were also identified. The top-ranked articles from the primary literature were summarized and a narrative regarding its implications to pharmacy nutrition support practice were provided.</p><p><strong>Conclusion: </strong>Pharmacists engaged in nutrition support therapy should be familiar with these publications, as they may have important implications for clinical practice.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261454527"},"PeriodicalIF":0.7,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Early Versus Later Anticoagulation After Ischemic Stroke in Atrial Fibrillation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials\".","authors":"A Aashish, P B Surendar, D Chamundeeswari, A Anish Kumar","doi":"10.1177/00185787261455666","DOIUrl":"https://doi.org/10.1177/00185787261455666","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261455666"},"PeriodicalIF":0.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13233595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Cystatin C-Based and Serum Creatinine-Based Renal Function Estimates Against Timed Urine Collection in Critically Ill Patients.","authors":"Sung Jin Jeong, Andrew J Webb, Kristy M Phillips, Kalynn A Northam","doi":"10.1177/00185787261452063","DOIUrl":"https://doi.org/10.1177/00185787261452063","url":null,"abstract":"<p><strong>Background: </strong>Creatinine-based estimation equations for renal function, especially the Cockcroft-Gault creatinine clearance (CG-CrCL) equation, may be inaccurate in critically ill patients. We sought to determine if a cystatin C (CysC)-based (CKD-EPI CysC-serum creatinine (SCr) estimated glomerular filtration rate [eGFRcr-cys]) calculation better estimated renal clearance compared to CG-CrCL against measured creatinine clearance (mCrCL) from timed urine creatinine collection in adult critically ill patients.</p><p><strong>Materials and methods: </strong>This was a single-center retrospective cohort study of adult patients admitted to an intensive care unit (ICU) between July 1, 2022, and July 31, 2023, who had concurrent creatinine and cystatin C measured within 24 hours of a timed urine creatinine collection. The primary outcome was the mean difference in bias between eGFRcr-cys and C-G CrCL compared to timed urine creatinine collection. eGFR was adjusted for body surface area (BSA) and reported as mL/min.</p><p><strong>Results: </strong>Forty-five patients were included in this study. The mean bias between C-G CrCL and mCrCL was 23.8 mL/min (95% CI -40.3 to 87.8 mL/min) and 3.3 mL/min (95% CI -43.3 to 49.9 mL/min) between eGFRcr-cys and mCrCL. The mean difference between the biases was 20.5 mL/min (<i>P</i> = .001).</p><p><strong>Conclusions: </strong>In critically ill patients, eGFRcr-cys was subject to less bias compared to C-G CrCL. Future research is needed to better understand the clinical implications of using eGFRcr-cys over C-G CrCL, particularly for medication-related decision making in critically ill patients.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261452063"},"PeriodicalIF":0.7,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148137864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}