{"title":"Long-Term Outcome of Anterior-Apical Mesh (Surelift) Versus Anterior Colporrhaphy and Sacrospinous Ligament Fixation in Advanced Pelvic Organ Prolapse Surgery.","authors":"Tsia-Shu Lo, Louiza Erika Rellora, Eyal Rom, Huan-Ka Chiung, Chia-Hsuan Yang, Yi-Hao Lin","doi":"10.1007/s00192-025-06105-1","DOIUrl":"https://doi.org/10.1007/s00192-025-06105-1","url":null,"abstract":"<p><strong>Objective: </strong>This study first aims to compare the outcomes of Surelift (anterior-apical transvaginal mesh) and sacrospinous ligament fixation (SSF) with anterior repair using objective and subjective cure rates. Second, to compare the quality of life and its major and minor complications.</p><p><strong>Material and methods: </strong>A retrospective study was conducted between December 2011 and January 2020. Patients with symptomatic stage ≥ 3 anterior or apical prolapse were included. Those who had prior POP mesh and who were unfit for surgery were excluded. Preoperative evaluation included history and physical exam, urodynamic studies, and validated questionnaires (IIQ-7, UDI-6, POPDI-6) at baseline, 1, 3, and 5 years later.</p><p><strong>Results: </strong>One hundred eighty-one patients were included: 98 underwent anterior-apical transvaginal mesh and 83 had SSF with anterior colporrhaphy (SSF+A). Anterior-apical transvaginal mesh and SSF+A patients had mean follow-up periods of 83.5 ± 6.1 and 91.6 ± 39 months, respectively. At 1 year, no statistically significant difference was noted in objective and subjective cure rates between anterior-apical transvaginal mesh (96.8% and 94.7%) and SSF+A (89.9% and 88.6%). However, after 3 and 5 years, anterior-apical transvaginal mesh showed superior results with objective cure rates of 94.1% and 89.1%, respectively, compared to 80% and 64.4% for SSF+A (p = 0.008). At 3 and 5 years, anterior-apical transvaginal mesh had 92.9% and 85.9% subjective cure rates compared to SSF's 77.1% and 60%, respectively (p = 0.005).</p><p><strong>Conclusions: </strong>The long-term follow-up showed that native tissue repair was strongly associated with increased risk of recurrence compared to the anterior-apical mesh with minor complications in both groups.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eriq Burovski, Donna Sellers, Russ Chess-Williams, Iris Lim
{"title":"Inhibition of PDE-4 and PDE-5 Differentially Modulates Isolated Porcine Urethral Contractility.","authors":"Eriq Burovski, Donna Sellers, Russ Chess-Williams, Iris Lim","doi":"10.1007/s00192-025-06102-4","DOIUrl":"https://doi.org/10.1007/s00192-025-06102-4","url":null,"abstract":"<p><strong>Purpose/objective: </strong>This study explores the role of phosphodiesterase (PDE) inhibitors (specifically PDE-4, PDE-5 and PDE-1) in modulating the contractility of the porcine urethral smooth muscle and mucosal layers.</p><p><strong>Methods: </strong>Using an organ bath setup, the effects of PDE inhibitors rolipram, roflumilast, sildenafil, tadalafil and vinpocetine (0.1 nM to 10 μm) on isolated porcine urethral mucosa-intact smooth muscle, mucosa-denuded smooth muscle and mucosal layers were investigated.</p><p><strong>Results: </strong>Our results demonstrate that PDE-4 inhibitors (rolipram and roflumilast) significantly relaxed mucosa-intact urethral smooth muscle and reduced spontaneous contraction rates in the mucosal strips. Conversely, PDE-5 inhibitors (sildenafil and tadalafil) relaxed smooth muscle tissues denuded of mucosa but required exogenous source of nitric oxide (sodium nitroprusside) for effectiveness in relaxing the mucosa-intact tissues. PDE-1 inhibitor vinpocetine exhibited negligible effects.</p><p><strong>Conclusion: </strong>The results from the study suggest a potential role of the cAMP pathway in modulating spontaneous contractions within the urethral mucosa, while the NO/cGMP pathway appears to be important in modulating urethral smooth muscle tonic contractions. These findings suggest differential roles of PDE isoenzymes in urethral tissues.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sónia Cristóvão, Emelie Asplén, Josefin Borssén, Maria E H Larsson, Sabine Vesting
{"title":"Pelvic Floor Muscle Strength and Bothersome Urinary Incontinence After Pregnancy: A Cohort Study.","authors":"Sónia Cristóvão, Emelie Asplén, Josefin Borssén, Maria E H Larsson, Sabine Vesting","doi":"10.1007/s00192-025-06085-2","DOIUrl":"https://doi.org/10.1007/s00192-025-06085-2","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Postpartum urinary incontinence (UI) is prevalent, and women with bothersome UI tend to seek more help. This study was aimed at evaluating the association between pelvic floor muscle (PFM) strength and bothersome UI in the 1st year postpartum.</p><p><strong>Methods: </strong>A prospective cohort study was conducted with 504 participants. UI was evaluated by the International Consultation on Incontinence Questionnaire Short Form (online) and PFM strength was assessed via vaginal palpation (Modified Oxford Scale, MOS), at 3, 6, 9, and 12 months postpartum. Logistic regression analysis was used to analyze the data.</p><p><strong>Results: </strong>At 3 months postpartum, 52% of women had a PFM strength of ≥ 3 MOS, increasing to 84% at 12 months. 42% of women reported UI at 3 months, which remained unchanged by 12 months. PFM strength ≥ 3 MOS was moderately associated with less UI at 3 months (OR = 0.63, 95% CI 0.42-0.94) and at timepoints 6, 9, and 12 months. Antepartum UI was strongly associated with postpartum UI at all time points: 3 months (OR = 10.23, 95% CI 4.90-21.37), 6 months (OR = 7.75, 95% CI 3.95-15.21), 9 months (OR = 9.95, 95% CI 4.61-21.47), and 12 months (OR = 4.55, 95% CI 2.29-9.04). Grade 2 perineal tears were moderately associated with UI at 9 months postpartum (OR = 1.82, 95% CI 1.11-3.0).</p><p><strong>Conclusions: </strong>A stronger pelvic floor was associated with less bothersome UI in the 1st year postpartum. UI during pregnancy was most strongly associated with bothersome UI after childbirth. Antenatal screening for UI and promoting PFM training may be warranted to support postpartum recovery and minimize UI.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ann-Sophie Page, Eline Borowski, Emma Bauters, Susanne Housmans, Frank Van der Aa, Jan Deprest
{"title":"Vaginal Erbium Laser Versus Pelvic Floor Muscle Training for Stress Urinary Incontinence: A Randomised Controlled Trial.","authors":"Ann-Sophie Page, Eline Borowski, Emma Bauters, Susanne Housmans, Frank Van der Aa, Jan Deprest","doi":"10.1007/s00192-025-06091-4","DOIUrl":"https://doi.org/10.1007/s00192-025-06091-4","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Current studies on vaginal laser therapy for the management of stress urinary incontinence (SUI) are inconclusive, and many lack comparison with another conservative treatment. Therefore, we compared the efficacy of Er:YAG laser for SUI with that of pelvic floor muscle training (PFMT).</p><p><strong>Methods: </strong>Single-centre, randomised controlled trial comparing laser treatment (3-6 applications) with PFMT (9-18 sessions) in women with mild to moderate SUI. Main outcome measures included subjective change in urinary incontinence symptoms by change from baseline to 4 months after randomisation by Urogenital Distress Inventory-6 (UDI-6; primary), adverse events, and other subjective and objective outcomes up to 24 months. A priori sample size calculation for a non-inferiority study resulted in 28 patients per arm. Because of a higher than expected dropout early in the study, we increased our sample size from 56 to 60, without unblinding of the data.</p><p><strong>Results: </strong>Sixty women were enrolled. Two participants discontinued their allocated treatment (one in each group). At 4 months, mean difference in change in UDI-6 scores was -6.99 (95% CI = -22.34; 8.37), demonstrating non-inferiority of laser to PFMT (p = 0.023). Within groups, most patients improved, yet subjective cure was reached in only a minority (laser: 11% [3 out of 28]; PFMT: 8% [2 out of 26]). The mean number of treatment visits was 4.25 (SD 1.17) in the laser group and 10.04 (SD 6.36) in the PFMT group. There were no subjective or objective inter-group differences. At 24 months, the majority of patients requested additional, yet alternative treatment. There were no serious adverse events at any time point.</p><p><strong>Conclusions: </strong>Treatment effect of vaginal laser and PFMT in patients with mild and moderate SUI were comparable, limited and short lasting. No adverse events were reported.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment on \"Gestational Diabetes Mellitus Affects the Risk of Obstetric Anal Sphincter Injury: A Systematic Review and Meta-Analysis of Cohort Studies\".","authors":"Lakshmi T","doi":"10.1007/s00192-025-06064-7","DOIUrl":"10.1007/s00192-025-06064-7","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mehr Jain, Jocelyn Stairs, Alana Sorgini, Aisling Clancy
{"title":"Readability of Online Patient-Directed Content About Cystoscopy and Urodynamic Testing.","authors":"Mehr Jain, Jocelyn Stairs, Alana Sorgini, Aisling Clancy","doi":"10.1007/s00192-025-06100-6","DOIUrl":"https://doi.org/10.1007/s00192-025-06100-6","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The objective was to assess the readability of commonly accessed patient-focused websites about cystoscopy or urodynamic studies (UDS).</p><p><strong>Methods: </strong>Keywords related to cystoscopy and UDS were searched in three commonly accessed search engines in 2024 and compared with a search from 2022. The top 25 search results from each search engine were assessed against the study inclusion/exclusion criteria. Readability scores (Flesch Reading Ease score [FRES], Flesch-Kincaid Grade Level [FKGL], Gunning Frequency of Gobbledygook [FOG], Simple Measure of Gobbledygook [SMOG]) were calculated for the websites included. Mean readability scores of websites were compared by procedure type and publisher using the Mann-Whitney test.</p><p><strong>Results: </strong>In 2024, a total of 75 patient-oriented websites were identified, 33 (44.0%) of which were about cystoscopy and 42 (56.0%) websites were about UDS. Cystoscopy websites were difficult to read (FRES median 56 [55-69]), requiring grade 8-11 reading level (Gunning FOG median 11.3 [10.3-12.3]; FKGL median 8 [7.11-8.84]) and 8 years of education to read (SMOG median 8.06 [7.41-8.71]). UDS websites were difficult to read (FRES median 56 [41-66]), requiring grade 9-11 reading level (Gunning FOG median 11.45 [9.5-13.7]; FKGL median 8.85 [6.93-10.88]) and 8 years of education to read (SMOG median 8.49 [7.11-9.98]). Websites in 2024 were significantly easier to read than websites in 2022 based on Gunning FOG (p value 0.0079), FKGL (p value 0.0001), and SMOG scores (p value 0.0001), but still did not meet the recommendation of grade 6 reading level.</p><p><strong>Conclusions: </strong>Patient-focused online information about cystoscopy and UDS was harder to read than the American Medical Association-recommended grade 6 reading level of patient information. Readability of cystoscopy and UDS online information has improved over 2 years.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Liam Christopher Martin, Alireza Hadizadeh, Henry H Chill, Durwash Badr, Steven D Abramowitch, Ghazaleh Rostaminia
{"title":"Differences in Pelvic Muscular Shape and Thickness in Women With and Without Significant Bladder Descent.","authors":"Liam Christopher Martin, Alireza Hadizadeh, Henry H Chill, Durwash Badr, Steven D Abramowitch, Ghazaleh Rostaminia","doi":"10.1007/s00192-025-06101-5","DOIUrl":"https://doi.org/10.1007/s00192-025-06101-5","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Pelvic organ prolapse (POP) is the descent of pelvic organs, causing patient discomfort. Despite its increasing prevalence, agreement in the field as to the cause is elusive. Weakness in pelvic floor muscles is implicated, but specific structural changes remain unclear. This study aimed to identify such differences in the levator ani, hypothesizing differences in pelvic muscle shape between greater and lesser bladder descent.</p><p><strong>Methods: </strong>We reviewed our patient database for cystocele diagnoses via MR defecography, including patients with static axial MRIs and dynamic midsagittal defecography. Patients were divided into two groups based on bladder descent relative to the genital hiatus (a measure our group had previously used). We used a statistical shape model of levator shapes to compare the groups. Additionally, we conducted MRI-based measurements (thickness of the obturator internus and anterior pelvic area) which have previously shown differences in similar groups.</p><p><strong>Results: </strong>Among 67 cystocele patients, 28 had greater bladder descent. The shape model identified significant variation in pelvic floor shape, specifically near the arcus tendineus levator ani (ATLA). The MRI-based measurements showed an increase in anterior pelvic area (53.8 ± 6.0 vs. 58.0 ± 5.3 cm<sup>2</sup>, p < 0.001) with increased prolapse severity and thinning of obturator's along the ATLA (16.2 ± 2.7 vs. 13.9 ± 2.2 mm, p < 0.001), specifically in the region around the insertion of the levators and obturators.</p><p><strong>Conclusions: </strong>Patients with greater bladder descent exhibited a larger anterior pelvic area, thinner obturators, and greater pelvic floor muscle descent, potentially due to muscle detachment at DeLancey's level II support.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment on: Letter to the Editor: The Association between Depression and Overactive Bladder: A Cross-Sectional Study of NHANES 2011-2018.","authors":"Tianyue Li, Kunjie Wang","doi":"10.1007/s00192-025-06097-y","DOIUrl":"https://doi.org/10.1007/s00192-025-06097-y","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Martin Havir, Khaled M Ismail, Martin Smazinka, Vladimir Kalis, Zdenek Rusavy
{"title":"Rectocervical Fistula Repair After Laparoscopic Supracervical Hysterectomy and Laparoscopic Sacrocervicopexy.","authors":"Martin Havir, Khaled M Ismail, Martin Smazinka, Vladimir Kalis, Zdenek Rusavy","doi":"10.1007/s00192-025-06108-y","DOIUrl":"10.1007/s00192-025-06108-y","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Rectocervical fistula after a urogynecological surgery has never been described. In this video article, we present occurrence of this complication after laparoscopic supracervical hysterectomy and laparoscopic sacrocervicopexy (LSCH + LSC) and how it was treated.</p><p><strong>Methods: </strong>This was a case of a 47-year-old patient who had a laparoscopic supracervical hysterectomy and laparoscopic sacrocervicopexy (LSCH + LSC) for stage two pelvic organ prolapse. Within 3 months after the surgery, the patient complained of an odorous brownish vaginal discharge. On examination, this discharge was identified to be from the cervical canal. A provisional diagnosis of a rectocervical fistula was postulated and later confirmed by ultrasonography and colonoscopy. Consequently, a laparoscopic fistula repair with concomitant partial explantation of the mesh followed by removal of the cervix and transposition of an omental flap between the vaginal and rectal suture lines. The patient made an uneventful recovery. The resulting rectocele was repaired by a colpoperineorrhaphy 2 years after the surgery.</p><p><strong>Conclusion: </strong>Rectocervical fistula is a rare complication after laparoscopic sacrocervicopexy with concomitant supracervical hysterectomy. We demonstrated the feasibility of repairing this fistula laparoscopically. We opted for mesh explantation and removal of the cervix at the time of the fistula repair to mitigate the risk of recurrence.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marina Mesquita, Luís Cavalheiro, Pedro Ferreira, Rui Soles Gonçalves, Sónia Vicente
{"title":"Cross-Cultural Adaptation and Validation of the Portuguese Version of the \"Australian Pelvic Floor Questionnaire\".","authors":"Marina Mesquita, Luís Cavalheiro, Pedro Ferreira, Rui Soles Gonçalves, Sónia Vicente","doi":"10.1007/s00192-025-06087-0","DOIUrl":"10.1007/s00192-025-06087-0","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Pelvic floor dysfunction (PFD) is a common problem that occurs among women and increases with age and weight. This study was aimed at cross-culturally adapting and validating the original version of the Australian Pelvic Floor Questionnaire (APFQ) into Portuguese.</p><p><strong>Methods: </strong>The process of cultural and linguistic adaptation and validation followed the guidelines. The obtained Portuguese version was assessed by an expert panel of physiotherapists specialized in women's health. Women with pelvic floor dysfunction also participated in a cognitive pre-test (n = 9). A sample of 50 women with PFD completed the questionnaire to evaluate internal consistency, construct validity, reproducibility, floor/ceiling effects assessment, and standard error of measurement. Test-retest was assessed with a 2-week interval. The study was approved by the Ethics Commission and all participants signed an informed consent form.</p><p><strong>Results: </strong>Fifty women with a mean age of 53.90 (± 18.57) years, BMI of 27.5 (± 4.2), 55.6% with a bachelor's degree, and all with at least one child, participated in the study. The psychometric properties of the APFQ showed a high Cronbach's alpha for the four domains: bladder (0.837), bowel and sexual function (0.756), pelvic organ prolapse (0.840), and total score (0.714). In terms of reproducibility, intraclass coefficient domain values ranged from 0.934 to 0.976, with a total score of 0.948.</p><p><strong>Conclusions: </strong>The APFQ was cultural and linguistically adapted and validated for Portuguese. The Portuguese version of the APFQ (APFQ_P) showed acceptable values of validity and good reliability. It can be used in both clinical evaluation and in research on pelvic floor dysfunction.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}