Lupus最新文献

{"title":"Systemic lupus erythematosus with hypothermia and Wallenberg's syndrome as signs of brainstem encephalitis: A grand rounds case.","authors":"Reo Shiratani, Takayuki Shibahara, Mikio Shiba, Haruka Murao, Jeong Hoon Park, Tomomi Tada, Nachi Ishikawa, Jun Fujimoto, Junki Jinno, Makoto Tatsumi, Tomoki Yamada, Yoshiharu Higuchi, Shinji Higa","doi":"10.1177/09612033251324496","DOIUrl":"https://doi.org/10.1177/09612033251324496","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is an autoimmune disease that causes inflammation and organ damage. However, brain-stem encephalitis is rare in patients with SLE. We report a rare case of a patient with incipient SLE who simultaneously presented with brainstem encephalitis and cardiomyopathy. An 18-year-old woman was admitted to our hospital with fever, polyarthralgia, and malar rash. Laboratory tests revealed leukopenia, thrombocytopenia, proteinuria, an elevated anti-double-stranded deoxyribonucleic acid antibody titer, and hypocomplementemia. She was diagnosed with SLE and treated with an intermediate dose of prednisolone. Her fever disappeared 2 days later, but high-grade fever reappeared, and a high dose of prednisolone was administered from the eighth day of hospitalization. On the tenth day of hospitalization, she developed a headache, hypothermia, dysphagia, respiratory failure, and myocarditis. Brain magnetic resonance imaging indicated brainstem encephalitis. Under ventilator management, the patient received intravenous methylprednisolone pulse therapy, cyclophosphamide, and plasma exchange. Her general condition improved, however, dysphagia and hoarseness persisted, and Wallenberg's syndrome was diagnosed. Our findings suggest that patients with SLE can present with Wallenberg's syndrome as a sign of brainstem encephalitis and that early aggressive immunotherapy can be effective in patients with brainstem encephalitis and cardiomyopathy associated with SLE.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251324496"},"PeriodicalIF":1.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinctive cerebral small vessel disease patterns are associated with ischemic stroke in systemic lupus erythematosus.","authors":"Guilherme D Silva, Germana T Vieira, Carolina de M Rimkus, Emily F Neves Yuki, Raymundo S Azevedo, Gisela Tinone, Rosa Mr Pereira, Adriana B Conforto","doi":"10.1177/09612033251322930","DOIUrl":"https://doi.org/10.1177/09612033251322930","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus (SLE) increases the risk of ischemic stroke (IS) and cerebral small vessel disease (CSVD) through a unique interplay of cardiovascular and immune-mediated mechanisms. There is an unmet need of predictors of IS risk and of characterization of the distinctive features of CSVD in patients with SLE.</p><p><strong>Objectives: </strong>To assess if CSVD is more extensive in patients with SLE and ischemic stroke (IS+) than in those without (IS-); to identify distinctive neuroimaging features of CSVD in patients with SLE.</p><p><strong>Methods: </strong>This observational study, conducted at an academic referral center in São Paulo, Brazil, included SLE patients who underwent brain MRI between 2010 and 2021. Two neuroradiologists, blinded to clinical data, reached a consensus on the summary CSVD score, that consists of microbleeds, lacunes of presumed vascular origin, enlarged perivascular spaces, and white matter hyperintensities of presumed vascular origin. Logistic regression was performed with IS as the dependent variable.</p><p><strong>Results: </strong>We included 106 patients, 53 IS+ and 53 IS- (median age: 41; interquartile range, 34;51 years; 92% women). The summary CSVD score was independently associated with the IS + group (OR 3.83, 95% CI 1.73 - 9.87, <i>p</i> = 0.002), even after adjusting for age, hypertension, secondary antiphospholipid syndrome, and use of antimalarial drugs. Microbleeds predominated in cortical regions (23/24, 92%), lacunes in the basal ganglia (10/16, 63%) and white matter hyperintensities in the deep white matter (47/59, 80%).</p><p><strong>Conclusion: </strong>CSVD was more frequent in IS+ than in IS-, highlighting the need for prospective studies in SLE to test CSVD as a biomarker of IS risk. Microbleeds predominated in the cortical region, different from reports of age-related and hypertension-associated CSVD.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251322930"},"PeriodicalIF":1.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of low-grade proteinuria with changes of lupus nephritis in kidney biopsy in SLE patients.","authors":"Homa Timlin, Abbal Koirala, Matthew Gross, Duvuru Geetha, Ihab Kamel, Mohamed G Atta","doi":"10.1177/09612033251321655","DOIUrl":"10.1177/09612033251321655","url":null,"abstract":"<p><strong>Background: </strong>A kidney biopsy is essential for definitive histopathological diagnosis in lupus nephritis, informing therapeutic strategies. Current guidelines (ACR and EULAR/ERA-EDTA) do not include a kidney biopsy for patients with isolated proteinuria of less than 500 mg/g. We explored the histopathologic findings in patients with SLE with proteinuria ≤500 mg/g.</p><p><strong>Methods: </strong>We conducted a retrospective review of 27 biopsies of lupus patients with proteinuria ≤500 mg/g who underwent a kidney biopsy at Johns Hopkins. Clinical and laboratory data were obtained from a review of the medical records. The study was approved by the Office of Human Subjects Research and Institutional Review Board.</p><p><strong>Results: </strong>Most individuals were females (93%) and African American (56%), with a mean age of 42.1 (12.4) years at the time of biopsy. Twelve individuals had no prior history of lupus nephritis. The average creatinine at the biopsy was 1.05 mg/dl, and UPCR was 0.27 grams/gram. Most patients (100%) were on hydroxychloroquine, 41% were on prednisone, and 33% were on mycophenolate mofetil. Kidney biopsies were most commonly performed based on extra-renal disease activity, new-onset or worsening proteinuria (88.9%) and worsening dsdNA levels (55.6%). At the time of biopsy, 55.6% of patients presented with extrarenal lupus, most commonly arthritis or arthralgias and mucosal ulcers. Of the 27 patients, 23 patients had evidence of lupus nephritis (85.1%), including class III (33%), V (30%), III/V (7%), class II (4%) and class I (11%). Nine patients had a UPCR of 200 mg/g or lower. Among these patients, 22% did not show signs of lupus nephritis in the kidney biopsy, 44% had class V LN, and 11% had class I and III LN. Kidney biopsy was well tolerated, with the majority (93%) not developing post-biopsy complications.</p><p><strong>Conclusions: </strong>We identified patients with proteinuria ≤500 mg/g who had lupus nephritis, with the majority ranging from Class III to V with only one class II. This study supports that normal or low UPCR <500 mg/g lacks the sensitivity to detect early lupus nephritis. Better biomarkers for the cutoff of biopsy are needed to improve kidney outcomes and trial design.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251321655"},"PeriodicalIF":1.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for bleeding in patients with thrombotic antiphospholipid syndrome during antithrombotic therapy.","authors":"Pedro Gaspar, Prabal Mittal, Hannah Cohen, David A Isenberg","doi":"10.1177/09612033251322927","DOIUrl":"https://doi.org/10.1177/09612033251322927","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to explore the prevalence and risk factors for bleeding in patients with thrombotic antiphospholipid syndrome (tAPS) on antithrombotic therapy.</p><p><strong>Methods: </strong>Single-centre retrospective analysis of patients with tAPS (Sydney criteria). Bleeding events were classified according to the International Society on Thrombosis and Haemostasis as (a) major bleeding and (b) any bleeding. Risk factors for any bleeding and for major bleeding were explored using logistic regression.</p><p><strong>Results: </strong>We identified 197 patients (female, 71.1%; primary APS, 65.9%; presenting with arterial thrombosis, 44.2%; median disease duration, 10 years), all of whom had been exposed to antithrombotic therapy: anticoagulation, 98.5% (90.2% warfarin), and combined antithrombotic therapy, 24.9%. Eighty patients (40.6%) experienced 167 bleedings (22.8% major bleedings). Recurrent thrombosis during treatment occurred in 26.9% of patients (58.5% arterial thrombosis), and 41.9% of patients received high-intensity anticoagulation schemes (all warfarin target INR >3). Thrombocytopenia (<150 × 10⁹ platelets/L) affected 12.7% of patients. Secondary APS was associated with major bleeding, whereas recurrent thrombosis and high-intensity anticoagulation were associated with any bleeding. Combined antithrombotic therapy and thrombocytopenia increased the risk for any bleeding and major bleeding, with thrombocytopenia associated with both outcomes (OR = 5.58, 95% CI, 1.93-16.13; OR = 2.82, 95% CI, 1.06-7.51, respectively) after multivariate analysis.</p><p><strong>Conclusion: </strong>Patients with secondary APS, those experiencing recurrent thrombosis and exposed to combined antithrombotic treatment, are particularly at risk for bleeding. Patients with thrombocytopenia warrant the most attention as it is both an independent and the strongest risk factor for bleeding that we identified.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251322927"},"PeriodicalIF":1.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-hospital outcomes of patients with antiphospholipid syndrome undergoing transcatheter and surgical aortic valve replacement: A population-based analysis of national inpatient sample from 2015-2021.","authors":"Renxi Li, Stephen J Huddleston","doi":"10.1177/09612033251322012","DOIUrl":"https://doi.org/10.1177/09612033251322012","url":null,"abstract":"<p><strong>Background: </strong>Valvular abnormalities are common in antiphospholipid syndrome (APS). For patients who undergo aortic valve replacement (AVR), previous single institutional studies or case reports reported higher risks of mortality and thromboembolic complications among APS patients. This study aimed to investigate in-hospital outcomes of APS patients undergoing transcatheter (TAVR) and surgical aortic valve replacement (SAVR) using the largest all-payer database in the United States.</p><p><strong>Methods: </strong>Patients who underwent TAVR and SAVR were selected from National Inpatient Sample from Q4 2015-2021. Exclusion criteria were age under 18 years and concomitant procedures. Preoperative characteristics were matched between APS and non-APA patients using a 1:5 propensity-score matching in TAVR and SAVR, separately. In-hospital outcomes were examined.</p><p><strong>Results: </strong>After propensity-score matching, 504 non-APS patients were matched to 100 APS patients in TAVR, while 581 non-APS patients were matched to 119 APS patients in SAVR. All outcomes between APS and non-APS patients were comparable after TAVR. In contrast, APS patients undergoing SAVR had higher risks of pulmonary embolism (PE; 5.13% vs 0.86%, <i>p</i> < .01) and acute kidney injury (AKI; 35.04% vs 22.55%, <i>p</i> = .01).</p><p><strong>Conclusion: </strong>This study represents one of the first large-scale, population-based analyses of AVR outcomes for APS patients using a national registry. APS patients had all comparable outcomes after TAVR, while they had higher risks of PE and AKI after SAVR. This highlights the necessity for close perioperative antithrombotic management and careful monitoring of renal function in APS patients. TAVR may offer a safer alternative to SAVR for appropriately selected patients, including those with APS.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251322012"},"PeriodicalIF":1.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare costs of systemic lupus erythematosus in New Zealand.","authors":"Chunhuan Lao, Philippa van Dantzig, Nicola Tugnet, Ross Lawrenson, Douglas White","doi":"10.1177/09612033241308109","DOIUrl":"10.1177/09612033241308109","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to estimate the annual medical costs of systemic lupus erythematosus (SLE) in New Zealand (NZ).</p><p><strong>Methods: </strong>SLE patients were linked to the Australia and New Zealand Dialysis and Transplant Registry, Pharmaceutical Collection, National Minimum Dataset, National Non-Admitted Patients Collection and Mortality Collection. National direct medical costs of SLE in 2006-2021 and annual costs per patient were estimated. Generalized linear model was used to examine the impact of various factors on medical costs, including ethnicity, gender, age, socioeconomic status and presence of end-stage kidney disease (ESKD).</p><p><strong>Results: </strong>The annual national costs of SLE were stable over time, around NZ$12 million. The average costs were NZ$8,324 (US$5,277, €5,011) per patient per year, with the costs for patients with ESKD being nine times higher than patients without ESKD (NZ$47,143 vs NZ$5,091). The costs per patient for Māori and Pacific were both around twice the costs for European/Others (NZ$13,124 and NZ$11,842 vs NZ$6,153), but the difference attenuated after adjustment for ESKD and other factors. Among patients without ESKD, Asian, males and patients living in the most deprived areas were associated with higher costs. For patients with ESKD, Māori and patients living in the most deprived areas had higher costs.</p><p><strong>Conclusions: </strong>The annual national costs of SLE were stable over time. The increase in pharmaceutical costs were offset by decrease in hospitalisation costs. Costs for patients with ESKD were nine times higher than costs for patients without ESKD. Interventions for slowing the disease progression and preventing ESKD can reduce medical costs.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"204-216"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilisation patterns of immunomodulators and pregnancy outcomes in systemic lupus erythematosus: Insights from Korean national data.","authors":"Yu-Seon Jung, Yeo-Jin Song, Hyeon Ji Lee, Eunji Kim, Soo-Kyung Cho, Yoon-Kyoung Sung, Sun-Young Jung","doi":"10.1177/09612033241310087","DOIUrl":"10.1177/09612033241310087","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the trends in immunomodulator use and pregnancy outcomes among pregnant women with systemic lupus erythematosus (SLE), a condition requiring medication to maintain disease activity.</p><p><strong>Methods: </strong>This descriptive study used data from the National Health Information Database in Korea from 2002 to 2018. We included 5,044 pregnancies initiated between 2005 and 2017 in 3,120 SLE patients. Annual trends in SLE therapy, drug utilisation patterns during the preconception and pregnancy periods, and pregnancy outcomes were analysed.</p><p><strong>Results: </strong>Pregnancy compatible immunosuppressant (PC-IS) and hydroxychloroquine use during the first trimester were 10.7% and 41.4%, respectively. Most SLE medications exhibited a decline in usage from the preconception period to the first trimester. A prescription rate of 0.9% for pregnancy incompatible immunosuppressants (PIC-IS) was observed during the first trimester, and the incidence of live births, stillbirths, and abortions remained consistent from 2005 to 2017.</p><p><strong>Conclusions: </strong>Insufficient usage of hydroxychloroquine and PC-IS, along with a reduction in PIC-IS usage primarily during early pregnancy rather than before conception, highlights the unmet need for preconceptional family planning with appropriate medication management strategies in SLE pregnancies.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"140-148"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thanks to Reviewers.","authors":"","doi":"10.1177/09612033251314644","DOIUrl":"https://doi.org/10.1177/09612033251314644","url":null,"abstract":"","PeriodicalId":18044,"journal":{"name":"Lupus","volume":"34 2","pages":"220-222"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2019 EULAR/ACR classification criteria for SLE score predicts future lupus hospital admission and costs.","authors":"Saurav Suman, Hammad Ali, Connor R Buechler, Heidi C Rogers, W Neal Roberts","doi":"10.1177/09612033241310071","DOIUrl":"10.1177/09612033241310071","url":null,"abstract":"<p><strong>Objective: </strong>To test the ability of the 2019 EULAR/ACR Classification Criteria for SLE score to predict lupus related hospitalization and overall cost of hospitalization.</p><p><strong>Methods: </strong>217 University of Kentucky patient records that met our preliminary inclusion criteria, 44 patients were selected by a random number generator algorithm for a thorough chart review to collect data needed for calculation of the 2019 EULAR/ACR Classification Criteria for SLE score. Total hospitalization cost was calculated by using hospital adjusted expenses per inpatient day data, which estimates the expense incurred by the hospital to provide services and thus removes the variability of charges and reimbursements introduced by insurance type.</p><p><strong>Results: </strong>Patients with a score of 19 or more had increased risk of hospitalization in at least the 6 months after initial outpatient visit as compared to their counterparts with scores less than 19 [<i>p</i>= .069]. The odds of being hospitalized for lupus among those with initial score ≥19 was 5.71 times higher than for those with score <19. Patients who scored 19 or less at initial visit had a mean hospitalization cost of $14,499, whereas those scored >19 had mean hospitalization cost of $28,725.</p><p><strong>Conclusion: </strong>This study adds to the growing evidence that 2019 EULAR/ACR Classification Criteria score for SLE can be used as a surrogate marker to assess disease severity. The weighted 2019 EULAR/ACR Classification Criteria for SLE score offers a promising tool beyond its primary objective to find true lupus cases for research and clinical trials.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"178-180"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864793","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":"Lupus and SARS-CoV-2: What have we learned after the pandemic?","authors":"Rachele Francese, Massimo Rittà, David Lembo, Manuela Donalisio","doi":"10.1177/09612033241309845","DOIUrl":"10.1177/09612033241309845","url":null,"abstract":"<p><p>After the end of the COVID-19 public health emergency, we analysed the relationship between Systemic Lupus Erythematosous (SLE) and COVID-19 from the virologist's perspective based on recent findings. SLE and COVID-19 co-morbidity present unique challenges, as individuals with SLE may be at increased risk for severe COVID-19 illness due to immune system abnormalities and ongoing therapies. Effective management of both diseases requires careful monitoring, adherence to vaccination programs, preventive measures and approved and patient-tailored therapies. This review covers various aspects, including the clinical outcome of SLE patients infected by SARS-CoV-2, the impact of this infection on SLE onset or flare-ups and the benefits of vaccination for this population. Furthermore, this review presents the most recent recommendations on clinical management of COVID-19 in rheumatic patients, including those with SLE, discussing the currently available therapeutic options. Finally, we explore the most effective tools for SARS-CoV-2 diagnosis in autoimmune conditions and examine prognostic biomarkers in COVID-19 rheumatic patients with potential implications on their clinical oversight. By adopting a comprehensive approach, we address these complexities from the virologist's perspective, aiming to improve health care for this vulnerable population.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"117-132"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}