Prostate Cancer and Prostatic Diseases最新文献

{"title":"Delayed definitive management of localized prostate cancer: what do we know?","authors":"Osama Mohamad, Yun Rose Li, Felix Feng, Julian C Hong, Anthony Wong, Zakaria El Kouzi, Mohamed Shelan, Thomas Zilli, Peter Carroll, Mack Roach","doi":"10.1038/s41391-024-00876-2","DOIUrl":"10.1038/s41391-024-00876-2","url":null,"abstract":"<p><p>Delays in the work-up and definitive management of patients with prostate cancer are common, with logistics of additional work-up after initial prostate biopsy, specialist referrals, and psychological reasons being the most common causes of delays. During the COVID-19 pandemic and the subsequent surges, timing of definitive care delivery with surgery or radiotherapy has become a topic of significant concern for patients with prostate cancer and their providers alike. In response, recommendations for the timing of definitive management of prostate cancer with radiotherapy and radical prostatectomy were published but without a detailed rationale for these recommendations. While the COVID-19 pandemic is behind us, patients are always asking the question: \"When should I start radiation or undergo surgery?\" In the absence of level I evidence specifically addressing this question, we will hereby present a narrative review to summarize the available data on the effect of treatment delays on oncologic outcomes for patients with localized prostate cancer from prospective and retrospective studies.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":"280-287"},"PeriodicalIF":5.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardizing targeted and perilesional biopsy: considerations and challenges.","authors":"Olivier Windisch, Massimo Valerio, Jean de la Rosette","doi":"10.1038/s41391-025-00955-y","DOIUrl":"10.1038/s41391-025-00955-y","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":"526-527"},"PeriodicalIF":5.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of transperitoneal anterior, retzius-sparing, extraperitoneal, transvesical and perineal approaches on urinary continence recovery after robot-assisted radical prostatectomy: a systematic review and meta-analysis of comparative studies.","authors":"Vincenzo Ficarra, Marta Rossanese, Romito Ilaria, Gianluca Giannarini, Alexandre Mottrie, Christian Thomas, Felix Chun, Antonio Galfano, Firas Abdollah, Ettore Di Trapani","doi":"10.1038/s41391-025-00943-2","DOIUrl":"10.1038/s41391-025-00943-2","url":null,"abstract":"<p><strong>Background: </strong>Urinary incontinence significantly impacts on health-related quality of life of patients undergoing radical prostatectomy. In the last decades, several approaches (extraperitoneal, Retzius-sparing (RS), perineal and, transvesical) for robot-assisted radical prostatectomy (RARP) have proposed with the aim to improve functional outcomes in comparison with transperitoneal, anterior ones.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of studies published in English language, in the last ten years, comparing the different approaches used to perform RARP. We included only studies reporting urinary continence rates at different follow-up time points. From each eligible study, we extracted the number of analyzed patients; the study design; the continence definition; and, when available, immediate, 1-, 3-, 6-, and 12-mo urinary continence rates. Statistical analyses were performed using RevMan version 5.4 (Cochrane Collaboration, Oxford, United Kingdom, UK). The Odds Ratio (OR) with 95% confidence intervals (CIs) was calculated using the generic inverse variance. A p value of <0.05 was set as significance level when comparing studies.</p><p><strong>Results: </strong>The meta-analyses of studies comparing anterior, transperitoneal RARP and RS-RARP in terms of immediate (OR = 3.73; 95% CI: 2.17-6.43; p < 0.0001), 1-mo (OR = 4.16; 95% CI: 2.68-6.48; p < 0.00001), 3-mo (OR 4.71; 95% CI: 3.70-6.00; p < 0.0001), 6-mo (OR 4.12; 95% CI: 2.95-5.75; p < 0.00001) and 12-mo (OR = 3.25; 95% CI: 1.76-5.99; p < 0.00001) urinary continence rates showed a statistically significant advantage in favor of RS approach. However, a sub-analysis of Randomized Controlled Trials showed overlapping urinary continence rates between the two approaches at 6-mo (OR = 1.99; 95% CI: 0.90-4.42; p = 0.09) and 12-mo (OR = 1.36; 95% CI: 0.43-4.31; p = 0.60) after surgery. The meta-analysis of studies comparing extraperitoneal and transperitoneal approaches showed that 6-mo urinary continence rates were overlapping between the two approaches (OR = 1.18; 95% CI: 0.85-1.65; p = 0.32). The meta-analysis of studies comparing single-port (SP) and multi-port (MP) RARP showed comparable 6-mo urinary continence rates (OR = 0.93; 95% CI 0.65-1.33; p = 0.69).</p><p><strong>Conclusions: </strong>Within the limitations of mainly low to moderate quality of evidence, the RS  approach offers significant advantages compared to an anterior, transperitoneal, approach in terms of urinary continence recovery at different follow-up time points in patients who underwent MP-RARP. MP perineal and transvesical approaches need to be further tested and might be of interest in the setting of SP-RARP. Our meta-analysis showed comparable results between SP- and MP-RARP in terms of urinary continence rates.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":"328-341"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of patient and disease characteristics with the overtreatment of low-risk prostate cancer from 2010 to 2016.","authors":"Cooper Desmond, Sumedh Kaul, Aaron Fleishman, Ruslan Korets, Peter Chang, Andrew Wagner, Simon P Kim, Nima Aghdam, Aria F Olumi, Boris Gershman","doi":"10.1038/s41391-024-00822-2","DOIUrl":"10.1038/s41391-024-00822-2","url":null,"abstract":"<p><strong>Background: </strong>Although active surveillance is the preferred management for low-risk prostate cancer (PCa), some men remain at risk of overtreatment with definitive local therapy. We hypothesized that baseline characteristics may be associated with overtreatment and represent a potential source of health disparities. We therefore examined the associations of patient and disease characteristics with the surgical overtreatment of low-risk PCa.</p><p><strong>Methods: </strong>We identified men aged 45-75 years with cT1 cN0 cM0 prostate adenocarcinoma with biopsy Gleason score 6 and PSA < 10 ng/ml from 2010-2016 in the National Cancer Database (NCDB) and who underwent radical prostatectomy (RP). We evaluated the associations of baseline characteristics with clinically insignificant PCa (iPCa) at RP (i.e., \"overtreatment\"), defined as organ-confined (i.e., pT2) Gleason 3 + 3 disease, using multivariable logistic regression.</p><p><strong>Results: </strong>We identified 36,088 men with low-risk PCa who underwent RP. The unadjusted rate of iPCa decreased during the study period, from 54.7% in 2010 to 40.0% in 2016. In multivariable analyses adjusting for baseline characteristics, older age (OR 0.98, 95% CI 0.97-0.98), later year of diagnosis (OR 0.62, 95% CI 0.57-0.67 for 2016 vs. 2010), Black race (OR 0.85, 95% CI 0.79-0.91), treatment at an academic/research program (OR 0.82, 95% CI 0.73-0.91), higher PSA (OR 0.91, 95% CI 0.90-0.92), and higher number of positive biopsy cores (OR 0.87, 95% CI 0.86-0.88) were independently associated with a lower risk of overtreatment (iPCa) at RP. Conversely, a greater number of biopsy cores sampled (OR 1.01, 95% CI 1.01-1.02) was independently associated with an increased risk of overtreatment (iPCa) at RP.</p><p><strong>Conclusions: </strong>We observed an ~27% reduction in rates of overtreatment of men with low-risk PCa over the study period. Several patient, disease, and structural characteristics are associated with detection of iPCa at RP and can inform the management of men with low-risk PCa to reduce potential overtreatment.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":"385-393"},"PeriodicalIF":5.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140330097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeted and perilesional biopsy: triumphs and cautions.","authors":"Xingkang Jiang, Baojie Ma, Yong Xu","doi":"10.1038/s41391-025-00945-0","DOIUrl":"10.1038/s41391-025-00945-0","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":"524-525"},"PeriodicalIF":5.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ChatGPT can help guide and empower patients after prostate cancer diagnosis.","authors":"Harry Collin, Kandice Keogh, Marnique Basto, Stacy Loeb, Matthew J Roberts","doi":"10.1038/s41391-024-00864-6","DOIUrl":"10.1038/s41391-024-00864-6","url":null,"abstract":"<p><strong>Background/objectives: </strong>Patients often face uncertainty about what they should know after prostate cancer diagnosis. Web-based information is common but is at risk of being of poor quality or readability.</p><p><strong>Subjects/methods: </strong>We used ChatGPT, a freely available Artificial intelligence (AI) platform, to generate enquiries about prostate cancer that a newly diagnosed patient might ask and compared to Google search trends. Then, we evaluated ChatGPT responses to these questions for clinical appropriateness and quality using standardised tools.</p><p><strong>Results: </strong>ChatGPT generates broad and representative questions, and provides understandable, clinically sound advice.</p><p><strong>Conclusions: </strong>AI can guide and empower patients after prostate cancer diagnosis through education. However, the limitations of the ChatGPT language-model must not be ignored and require further evaluation and optimisation in the healthcare field.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":"513-515"},"PeriodicalIF":5.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141458935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biopsy strategies in the era of mpMRI: a comprehensive review.","authors":"Olivier Windisch, Massimo Valerio, Chi-Hang Yee, Paolo Gontero, Baris Bakir, Christof Kastner, Hashim U Ahmed, Cosimo De Nunzio, Jean de la Rosette","doi":"10.1038/s41391-024-00884-2","DOIUrl":"10.1038/s41391-024-00884-2","url":null,"abstract":"<p><strong>Background: </strong>Since its initial description the prostate biopsy technique for detection of prostate cancer (PCA) has constantly evolved. Multiparametric magnetic resonance imaging (mpMRI) has been proven to have a sensitivity exceeding 90% to detect the index lesion. This narrative review discusses the evidence around several biopsy strategies, especially in the context of patients that might be eligible for focal therapy.</p><p><strong>Method: </strong>A non-systematic literature research was performed on February 15th 2024 using the Medical Literature Analysis and Retrieval System Online (Medline), Web of Science and Google Scholar.</p><p><strong>Results: </strong>The transrectal (TR) route is associated with an increased postoperative sepsis rate, even with adequate antibiotic prophylaxis. The transperineal (TP) route is now recommended by international guidelines, firstly for its decreased rate of urosepsis. Recent evidence shows a non-inferiority of TP compared to TR route, and even a higher detection rate of clinically significant PCA (csPCA) in the anterior and apical region, that are usually difficult to target using the TR route. Several targeting techniques (cognitive, software-fusion or in-bore) enhance our ability to provide an accurate risk assessment of prostate cancer aggressiveness and burden, while reducing the number of cores and reducing the number of clinically insignificant prostate cancer (ciPCA). While MRI-TB have proven their role, the role of systematic biopsies (SB) is still important because it detects 5-16% of csPCA that would have been missed by MRI-TB alone. The strategies of SB depend mainly on the route used (TR vs. TP) and the number of cores to be collected (10-12 cores vs. saturation biopsies vs. trans-perineal template mapping-biopsies or Ginsburg Protocol vs. regional biopsies).</p><p><strong>Conclusion: </strong>Several biopsy strategies have been described and should be known when assessing patients for focal therapy. Because MRI systematically under evaluates the lesion size, systematic biopsies, and especially perilesional biopsies, can help to increase sensitivity at the cost of an increased number of cores.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":"288-297"},"PeriodicalIF":5.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Follow-up on patients with initial negative mpMRI target and systematic biopsy for PI-RADS ≥ 3 lesions-an EAU-YAU study enhancing prostate cancer detection.","authors":"Khan Amir, M Minhaj Siddiqui","doi":"10.1038/s41391-024-00912-1","DOIUrl":"10.1038/s41391-024-00912-1","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":"249"},"PeriodicalIF":5.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nerve-sparing radical prostatectomy using the neurovascular structure-adjacent frozen-section examination (NeuroSAFE): results after 20 years of experience.","authors":"Francesca Ambrosini, Felix Preisser, Derya Tilki, Hans Heinzer, Georg Salomon, Uwe Michl, Thomas Steuber, Tobias Maurer, Felix K H Chun, Lars Budäus, Randi M Pose, Carlo Terrone, Thorsten Schlomm, Pierre Tennstedt, Hartwig Huland, Markus Graefen, Alexander Haese","doi":"10.1038/s41391-024-00851-x","DOIUrl":"10.1038/s41391-024-00851-x","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the long-term oncological outcomes and functional results of the neurovascular structure-adjacent frozen-section examination (NeuroSAFE) during nerve-sparing (NS) radical prostatectomy (RP).</p><p><strong>Materials and methods: </strong>A 10-yr survival analysis on 11069 RPs performed with or without the NeuroSAFE, between January 2002 to June 2011 was carried out. In the NeuroSAFE cohort, the neurovascular structure-adjacent prostatic margins are removed and stained for cryo-sectioning during RP. In case of a PSM, partial or full removal of the neurovascular bundle was performed. The impact of NeuroSAFE on biochemical recurrence-free survival (BFS), salvage radiation therapy-free survival, metastasis-free survival, and prostate cancer-specific survival at 10 years was analyzed. 1-year (1-yr) erectile function (EF), 1-yr, and 2-yr continence rates were assessed in propensity score-based matched cohorts.</p><p><strong>Results: </strong>Median follow-up was 121 (IQR: 73, 156) months. No differences in BFS between NeuroSAFE and non-NeuroSAFE were recorded (10-yr BFS: NeuroSAFE vs non-Neurosafe, pT2: 81% vs 84%, p = 0.06; pT3a: 58% vs. 63%, p = 0.6; ≥pT3b: 22% vs. 27%, p = 0.99). No differences were found between the two groups in terms of sRFS (pT2: p = 0.1; pT3a: p = 0.4; ≥pT3b: p = 0.4) (Fig. 1B, Table 2), and MTS (pT2: p = 0.3; pT3a: p = 0.6; ≥pT3b: p = 0.9). The NeuroSAFE-navigated patients reported a better 1-yr EF than non-NeuroSAFE (68% vs. 58%, p = 0.02) and no differences in 1-yr and 2-yr continence rates (92.4% vs. 91.8%, and 93.4% vs. 93%, respectively). The main limitation is the retrospective study design.</p><p><strong>Conclusions: </strong>While the NeuroSAFE approach did not show significant improvements in long-term oncologic or continence outcomes, it did provide an opportunity for a higher proportion of patients to improve postoperative functional results, possibly through increased nerve-sparing procedures.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":"483-489"},"PeriodicalIF":5.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radical prostatectomy without prostate biopsy based on a noninvasive diagnostic strategy: a prospective single-center study.","authors":"Changming Wang, Qiang Xie, Lei Yuan, Ming Ni, Dong Zhuo, Yukui Gao, Ying Liu, Xuehan Liu, Yifan Ma, Jun Xiao, Tao Tao","doi":"10.1038/s41391-024-00931-y","DOIUrl":"10.1038/s41391-024-00931-y","url":null,"abstract":"<p><strong>Background: </strong>Prostate biopsy is the most common approach for diagnosing prostate cancer (PCa); however, it has inherent limitations, such as the invasive procedure, postoperative complications, and false negative results. We aimed to provide a noninvasive diagnostic strategy for patients with highly suspected PCa and to evaluate the feasibility of performing biopsy-spared radical prostatectomy.</p><p><strong>Methods: </strong>This prospective study included a total of 57 patients between November 10, 2022, and December 1, 2023. All 57 patients underwent radical prostatectomy without prior prostate biopsy based on a noninvasive diagnostic strategy consisting of a diagnostic prediction model [comprised of the prostate imaging-reporting and data system (PI-RADS) score and prostate-specific antigen density (PSAD)] and the ¹⁸F-prostate-specific membrane antigen (PSMA)-1007 positron emission tomography (PET)/computed tomography (CT) examination. The primary endpoint was the positive predictive value (PPV) of clinically significant PCa [the International Society of Urological Pathology (ISUP) grade ≥2, Gleason score ≥3 + 4]. The secondary endpoints were a PPV of any-grade PCa (ISUP grade ≥ 1, Gleason score ≥3 + 3) and high-grade PCa (ISUP grade ≥3, Gleason score ≥4 + 3), and the false positive rate of the diagnostic strategy.</p><p><strong>Results: </strong>Of the 371 screened patients with clinically suspected PCa, 57 patients fulfilled the criteria and consented to participate in this study. The median PSAD level was 0.56 (0.42-0.82) ng/mL²; 13 (22.8%) patients were identified as having a PI-RADS score of 4, and 44 (77.2%) patients with a PI-RADS score of 5. The median SUVmax of ¹⁸F-PSMA-1007 PET/CT was 21.6 (15.8-33.0). For the 57 enrolled patients who received radical prostatectomy directly, the PPV of clinically significant PCa was 98.2% [56/57, 95% confidence interval (CI): 90.6-100%]. Only 1.8% (1/57, 95% CI: 0.0-9.4%) of patients were diagnosed with clinically insignificant PCa (ISUP grade = 1, Gleason score = 3 + 3). The PPV of any-grade PCa and high-grade PCa were 100% and 73.7% (42/57, 95% CI: 60.3-84.5%), respectively. No one had a false positive result.</p><p><strong>Conclusions: </strong>We proposed a noninvasive diagnostic strategy consisting sequentially of a diagnostic prediction model and the ¹⁸F-PSMA-1007 PET/CT examination for diagnosing PCa. Despite some limitations, our initial findings suggest the potential feasibility of radical prostatectomy without prior prostate biopsy.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":"496-502"},"PeriodicalIF":5.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}