Revista Espanola De Enfermedades Digestivas最新文献

{"title":"Trends in Incidence and Prevalence of Inflammatory Bowel Disease in Spain: A Nationwide Population-Based Study (2011-2024).","authors":"Eduard Brunet, Stephanie Coward, Julia Gorospe, Lindsay Hracs, Brooke Maracle, Shinji Okabayashi, Abel Botelho Quaresma, Jeongkuk Seo, Joseph W Windsor, María Algara, Emili Vela, Santiago García-López, Daniel Ginard, Beatriz Sicilia, Alfredo J Lucendo, Marisa Iborra, Vicent Hernandez, Manuel Barreiro de Acosta, María Chaparro, Iago Rodríguez-Lago, Víctor Rodríguez-Gómez, Antonio M Caballero-Mateos, Montserrat Rivero Tirado, Marta Carrillo Palau, Ruth de Francisco, Yamile Zabana, Gilaad G Kaplan, Xavier Calvet","doi":"10.17235/reed.2026.12201/2026","DOIUrl":"https://doi.org/10.17235/reed.2026.12201/2026","url":null,"abstract":"<p><strong>Background: </strong>Long-term epidemiologic data on inflammatory bowel disease (IBD) in Spain are limited. We aimed to describe population-based temporal trends and forecast their future.</p><p><strong>Methods: </strong>Population-based study using the Spanish Primary Care Clinical Database (BDCAP) from 2011-2024. Cases were identified using International Classification of Primary Care, second edition (ICPC-2) coding. Annual incidence and prevalence rates per 100,000 persons were obtained. Average annual percentage changes (AAPC) with associated 95% confidence intervals (CI), were calculated using log-linear regression . Forecasting was performed using autoregressive integrated moving average. Incidence was forecasted to 2029 and prevalence to 2034 with 95% prediction intervals (PIs).</p><p><strong>Results: </strong>Between 2011-2024, incidence remained stable, averaging around 40 per 100,000 persons annually, with no significant variations (AAPC: -0.9%; 95%CI: -2.9, 1.1). Prevalence increased from 244 to 587 cases per 100,000 persons (AAPC: 6.7%; 95%CI: 6.0, 7.5). Prevalence increased across all age groups, peaking at approximately 900 per 100,000 inhabitants among those aged 60-74 years in 2024. Substantial geographic variability was observed across regions (p<0.001). Forecasting analyses predicted stable incidence rates (AAPC: 0.0% 95%PI: 0.0%, 0.0%), while prevalence is predicted to rise continuously, reaching approximately 850 cases per 100,000 persons by 2034 (95%PI: 777.9, 923.8), with an estimated AAPC of 3.7% (95%PI: 3.57, 3.81).</p><p><strong>Conclusion: </strong>IBD in Spain is characterized by stable incidence and rapidly increasing prevalence, consistent with epidemiologic stage 3 (compounding prevalence). The growing and aging IBD population indicates an increasing healthcare burden, emphasizing the need for long-term healthcare planning and resource allocation.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149272793","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":"Endoscopic ultrasound in the diagnosis of chronic pancreatitis: a structured state-of-the-art review.","authors":"Julio Iglesias-García, Yessica Domínguez Novoa, José Lariño Noia, Enrique Domínguez-Muñoz","doi":"10.17235/reed.2026.12242/2026","DOIUrl":"https://doi.org/10.17235/reed.2026.12242/2026","url":null,"abstract":"<p><p>Chronic pancreatitis (CP) is diagnosed by integrating clinical probability, structural imaging and, when required, pancreatic function. Endoscopic ultrasound (EUS) is proposed as a first-line investigation in selected patients evaluated in expert centers when the principal question is early or minimal-change CP in a high-probability clinical setting, or when a known focal pancreatic lesion requires detailed characterization or tissue acquisition. This proposed sequence is an individualized alternative to guidance recommending CT or MRI as initial imaging in the general population with suspected CP; cross-sectional imaging remains complementary for alternative diagnoses, complications and lesion staging. EUS also has an established role after inconclusive CT or MRI/MRCP. This structured state-of-the-art review addresses predefined clinical questions and separates established practice from adjunctive and investigational EUS technologies. Conventional B-mode EUS with standardized morphologic reporting is the established endoscopic technique, although interobserver variability and imperfect specificity limit its use as an isolated reference standard. Strain elastography, contrast-enhanced EUS and secretin-stimulated EUS pancreatic function testing can add stiffness, perfusion or functional information in selected patients. Shear wave elastography and detective flow imaging remain emerging technologies requiring multicenter validation and standardized thresholds. Tissue acquisition is not recommended solely to prove CP and should be reserved mainly for suspected malignancy or autoimmune pancreatitis. A stepwise pathway distinguishes selected first-line EUS assessment from the guideline-based CT/MRI-first sequence and integrates complementary imaging and selective functional testing.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149272824","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":"Biosimilars in inflammatory bowel disease: from initial uncertainty to clinical normalization.","authors":"Federico Argüelles-Arias, Yamile Zabana","doi":"10.17235/reed.2026.12282/2026","DOIUrl":"https://doi.org/10.17235/reed.2026.12282/2026","url":null,"abstract":"<p><p>Biosimilars have become an integral part of the treatment of inflammatory bowel disease (IBD), evolving from initial uncertainty regarding indication extrapolation and non-medical switching to widespread clinical acceptance. Early concerns focused mainly on the absence of disease-specific evidence and the potential impact of switching on effectiveness, safety, and immunogenicity. Over the past decade, however, extensive real-world evidence and randomized data have consistently supported the use of infliximab and adalimumab biosimilars in both biologic-naïve patients and patients switched from originator products. Recent systematic reviews and meta-analyses further reinforce these findings, showing preserved clinical remission, treatment persistence, inflammatory biomarkers, and immunogenicity after switching. The biosimilar landscape is now expanding to newer therapeutic targets, including ustekinumab, while biosimilar-to-biosimilar and multiple switching is becoming increasingly relevant in routine practice. Nevertheless, scientific interchangeability should not be equated to automatic substitution. Switching decisions should remain clinically supervised and involve gastroenterologists within a multidisciplinary framework, taking into account disease activity, previous response, safety, immunogenicity, and patient preferences. Appropriate communication is also essential to minimize a potential nocebo effect and to avoid unnecessary discontinuation. Biosimilars should therefore be considered fully established biological therapies rather than lower-tier alternatives to originator drugs. Future research should focus less on re-confirming single-switch equivalence and more on unresolved questions, including long-term outcomes after multiple switching, biosimilars of newer therapeutic targets, patient-reported outcomes, treatment persistence, and comparative pharmacoeconomic impact across healthcare systems.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":"118 ","pages":"667-669"},"PeriodicalIF":4.8,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149272840","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":"Partial regression of a refractory gastric ulcer following abdominal radiotherapy during a sofalcone-containing combination regimen.","authors":"Zhong-Wei Guo, Jin-Xuan Zhang, Han-Chuan Li, Xin-Yao Chang, Hao-Rui Zheng, Qi-Wen Wang, Zhuan Liao","doi":"10.17235/reed.2026.12263/2026","DOIUrl":"https://doi.org/10.17235/reed.2026.12263/2026","url":null,"abstract":"<p><p>Radiation-induced gastric ulcer is uncommon but can be persistent and difficult to heal, particularly in patients receiving ongoing multimodality cancer treatment. We report a 68-year-old man with pancreatic ductal adenocarcinoma who developed a refractory antral ulceration after upper abdominal radiotherapy during intermittent chemotherapy. High-dose pantoprazole, rebamipide, Kangfuxin liquid, and subsequent vonoprazan achieved bleeding control but failed to induce healing. After sofalcone was added, postprandial pain improved substantially, and serial endoscopy showed regression of the ulcer from 2.0×1.8 cm to 0.6×0.8 cm. This case highlights the therapeutic challenge of post-radiation gastric ulceration and supports further study of repair-directed therapy.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149272829","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":"The Madrid Declaration on metabolic dysfunction-associated steatotic liver disease (MASLD). Innovation, equity, and transformation of the health-system response to the metabolic disease challenge of the 21st century.","authors":"Javier Crespo, Rafael Bañares, José Luis Calleja, Juana Carretero Gómez, Tomás Castillo, Tomás Cobo Castro, Javier Escalada, Conrado M Fernández Rodríguez, Noelia Fontanillas, Paula Iruzubieta, Jeffrey Lazarus, María Luz Martínez-Chantar, Manuel Romero Gómez, Francisco Tinahones, Tomás de Vega","doi":"10.17235/reed.2026.12198/2026","DOIUrl":"https://doi.org/10.17235/reed.2026.12198/2026","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease worldwide and one of the most clinically important manifestations of systemic metabolic dysfunction. Rather than a condition confined to the liver, MASLD represents an early marker of risk within the cardio-hepato-renal-metabolic continuum and an opportunity to intervene before irreversible organ damage becomes established. The Madrid Declaration on MASLD emerged from the meeting 'Innovation and Equity in the Management of MASLD', held on 4 March 2026 at the headquarters of the Spanish General Medical Council, with the endorsement of the Council and several scientific societies. In line with resolution WHA79.4, adopted by the Seventy-ninth World Health Assembly in May 2026, the Declaration sets out a ten-point framework for a health-system and policy response commensurate with the scale of the challenge. It calls for MASLD to be recognised as a public health priority and explicitly integrated into national strategies for noncommunicable diseases. Key proposals include early detection and risk stratification using non-invasive tools in primary care, supported by stepwise referral pathways that ensure an effective clinical response after detection. The Declaration further advocates value-based care and risk-proportionate interventions, reserving specialist care for people at greatest risk of progression and currently authorised disease-specific pharmacotherapies for appropriately selected patients with non-cirrhotic MASH and F2-F3 fibrosis. Equity is positioned as a structural principle of care, alongside stigma-free communication, integrated multidisciplinary models of care, and transparent evaluation against verifiable targets. The Declaration calls on policymakers, institutions, scientific societies, health professionals, and civil society to act in a coordinated and evidence-based manner.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149272869","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":"Rising mortality from small intestinal cancer in Spain, 1999-2023: joinpoint and age-period-cohort analysis.","authors":"Lucía Cayuela, Julián Librero, Álvaro Giráldez-Gallego, Francisco H Machancoses, Aurelio Cayuela Domínguez","doi":"10.17235/reed.2026.11997/2026","DOIUrl":"https://doi.org/10.17235/reed.2026.11997/2026","url":null,"abstract":"<p><strong>Introduction: </strong>Small intestinal cancer is a rare neoplasm whose mortality has been increasing in several high‑income countries, yet long‑term patterns in Spain remain poorly described.</p><p><strong>Objectives: </strong>This study aims to analyse temporal trends and decompose the effects of age, period, and birth cohort on small intestinal cancer mortality in Spain between 1999 and 2023.</p><p><strong>Material and methods: </strong>A population-based time-series study was conducted using national mortality data from the National Statistics Institute. Age-standardized mortality rates (ASMR) were calculated using the 2013 European Standard Population. Joinpoint regression was used to identify significant trend changes, and age-period-cohort modelling was applied to quantify the contributions of biological aging, calendar period, and generational effects.</p><p><strong>Results: </strong>Between 1999 and 2023, the ASMR rose significantly in men (0.43 to 0.81 per 100,000; average annual percentage change: 2.1%) and more modestly in women (0.30 to 0.38 per 100,000; AAPC: 1.1%). The increase was driven almost entirely by individuals aged 50 years and older, while rates in those under 50 remained low and stable. Age-period-cohort analysis revealed a significant net drift (1.07% per year) and strong birth cohort effects in men, with mortality risk increasing for successive generations born through the mid-20th century. In women, the rise was primarily attributed to the age effect.</p><p><strong>Conclusions: </strong>Small intestinal cancer mortality in Spain is increasing, particularly among men and older age groups. The significant cohort effect in men suggests that shifting environmental or lifestyle exposures are contributing to the growing burden of this malignancy.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149272848","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":"Transient suction marking for re-identification of a small gastric subepithelial lesion during miniprobe endoscopic ultrasonography.","authors":"Koichi Soga","doi":"10.17235/reed.2026.12284/2026","DOIUrl":"https://doi.org/10.17235/reed.2026.12284/2026","url":null,"abstract":"<p><p>A 76-year-old woman underwent esophagogastroduodenoscopy, which revealed a 5-mm smooth subepithelial elevation on the anterior wall near the lesser curvature of the upper gastric body with intact overlying mucosa. This elevation became more conspicuous with insufflation. Before deflation, we created a suction mark 3 cm proximal to the lesion. Endoscopic suction was applied for 15 seconds and augmented through the working channel using a 20-mL syringe with the plunger withdrawn by 10 mL. This produced a discrete erythematous mark. Then, the stomach was deflated and filled with 250 mL of water. A 20-MHz miniprobe was advanced using the mark as a mucosal landmark without repeated endoscopic searching for the elevation. Probe insertion began 50 seconds after water instillation, and the first evaluable EUS image was obtained 14 seconds later (total time, 64 seconds). EUS demonstrated an 8-mm lesion arising from the fourth sonographic layer with an internal hyperechoic focus accompanied by acoustic shadowing. The lesion had a smooth outer margin without a cystic component. These findings suggested a small mesenchymal tumor originating from the muscularis propria. A leiomyoma and gastrointestinal stromal tumor were considered in the differential diagnosis. Surveillance endoscopy was planned at 12 months. We applied this principle to re-identify a diminutive gastric SEL after deflation and water filling for miniprobe EUS. Although a single case cannot establish superiority over conventional localization, transient suction marking may provide a simple landmark that does not require a dedicated marking device and may help preserve spatial orientation during EUS assessments.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149272854","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":"Ergonomics in gastrointestinal endoscopy ‒ A position statement of the Spanish Society of Gastrointestinal Endoscopy.","authors":"Hugo Uchima, Javier Tejedor-Tejada, María Muñoz García-Borruel, Liseth Rivero-Sánchez, Juan Ignacio Tellechea, Mónica Ayude Galego, Claudio Rodríguez Ramos, Vanesa Vega, Antonio Rodríguez de Jesús","doi":"10.17235/reed.2026.12252/2026","DOIUrl":"https://doi.org/10.17235/reed.2026.12252/2026","url":null,"abstract":"<p><p>Endoscopy involves prolonged standing, static postures, repetitive hand and wrist movements, sustained force on the controls, manual torque of the insertion tube and, during fluoroscopic procedures, the additional load imposed by radiation protection equipment. In a survey conducted by the Spanish Society of Gastrointestinal Endoscopy (SEED), 69.1% of responding physicians reported discomfort or injury associated with endoscopic practice that had led to medication use, medical consultation or sick leave. The most frequently affected regions were the back/neck (50.8%), wrists/hands (35.0%) and shoulders (8.5%). The SEED Ergonomics Committee was established and developed eight statements, all of which reached Delphi consensus (agreement ranging from 80.9% to 100%): 1. SEED recommends incorporating structured education in ergonomics (before, during and after procedures) into endoscopy training programmes and continuing professional development. 2. SEED recommends taking microbreaks during procedures and scheduled breaks during endoscopy sessions. 3. Alternate endoscopic activity with other tasks and avoid concentrating prolonged or physically demanding procedures within a single working day, where organisational arrangements and staffing permit. 4. Position the monitor directly in front of the operator and approximately 15-30° below eye level to promote a neutral neck posture and avoid sustained flexion or hyperextension. 5. Adjust the height of the procedure bed or table to promote a neutral posture during endoscopy, with the working area approximately at or slightly below elbow level and the elbows flexed at approximately 90°. 6. Introduce an ergonomic check or checklist before each procedure to assess posture, bed and monitor height, pedal positioning and equipment accessibility. 7. Consider technological adaptations of the endoscope and ergonomic support devices for endoscopists with musculoskeletal symptoms or difficulty adapting to standard equipment, as part of an individualised approach to prevention or rehabilitation. 8. Apply comprehensive ergonomic principles during fluoroscopic procedures, including optimisation of posture and distance from the radiation emitter, appropriate use of radiation protection measures and balanced distribution of the load imposed by protective equipment.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149272811","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":"Acute liver failure as the presenting manifestation of infiltrative hepatocellular carcinoma: a diagnostic challenge.","authors":"Lucía Ferreira-González, Susana Rivera-García, María Pilar Egea-Arias, María Trigás-Ferrín","doi":"10.17235/reed.2026.12290/2026","DOIUrl":"https://doi.org/10.17235/reed.2026.12290/2026","url":null,"abstract":"<p><p>We present the case of a patient with no prior diagnosis of liver disease who presents with acute liver failure in the context of hepatocellular carcinoma.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149272817","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":"Spontaneous complete regression of hepatocellular carcinoma with histopathological confirmation.","authors":"Laura Jiménez González, Elena Velasco Martínez, María Jordán de la Fuente, Jorge Lillo Díez, Pedro Enrile Sánchez, Natalia Marcos Carrasco, Carolina Almohalla Álvarez, Gloria Sánchez Antolín","doi":"10.17235/reed.2026.12240/2026","DOIUrl":"https://doi.org/10.17235/reed.2026.12240/2026","url":null,"abstract":"<p><p>Spontaneous regression (SR) of hepatocellular carcinoma (HCC) is an exceptional phenomenon, with an estimated incidence of 0.4% (1,2). Although various mechanisms have been proposed, including tumor ischemia and immune activation, its pathogenesis remains uncertain. Most published cases lack histological confirmation of tumor disappearance and have insufficiently documented follow-up. We present a case of SR with histopathological confirmation of complete tumor necrosis following exploratory laparoscopy, suggesting a possible ischemic mechanism and highlighting the challenges in therapeutic decision-making and in assessing the indication for liver transplantation.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149272827","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}