International Journal of Surgical Oncology最新文献

{"title":"Regional failures after selective neck dissection in previously untreated squamous cell carcinoma of oral cavity.","authors":"Hassan Iqbal,&nbsp;Abu Bakar Hafeez Bhatti,&nbsp;Raza Hussain,&nbsp;Arif Jamshed","doi":"10.1155/2014/205715","DOIUrl":"https://doi.org/10.1155/2014/205715","url":null,"abstract":"<p><strong>Aim: </strong>To share experience with regional failures after selective neck dissection in both node negative and positive previously untreated patients diagnosed with squamous cell carcinoma of the oral cavity.</p><p><strong>Patients and methods: </strong>Data of 219 patients who underwent SND at Shaukat Khanum Cancer Hospital from 2003 to 2010 were retrospectively reviewed. Patient characteristics, treatment modalities, and regional failures were assessed. Expected 5-year regional control was calculated and prognostic factors were determined.</p><p><strong>Results: </strong>Median follow-up was 29 (9-109) months. Common sites were anterior tongue in 159 and buccal mucosa in 22 patients. Pathological nodal stage was N0 in 114, N1 in 32, N2b in 67, and N2c in 5 patients. Fourteen (6%) patients failed in clinically node negative neck while 8 (4%) failed in clinically node positive patients. Out of 22 total regional failures, primary tumor origin was from tongue in 16 (73%) patients. Expected 5-year regional control was 95% and 81% for N0 and N+ disease, respectively (P < 0.0001). Only 13% patients with well differentiated, T1 tumors in cN0 neck were pathologically node positive.</p><p><strong>Conclusions: </strong>Selective neck dissection yields acceptable results for regional management of oral squamous cell carcinoma. Wait and see policy may be effective in a selected subgroup of patients.</p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2014 ","pages":"205715"},"PeriodicalIF":1.5,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/205715","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32266115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive esophagectomy for esophageal cancer: the first experience from Pakistan.","authors":"Farrukh Hassan Rizvi,&nbsp;Syed Shahrukh Hassan Rizvi,&nbsp;Aamir Ali Syed,&nbsp;Shahid Khattak,&nbsp;Ali Raza Khan","doi":"10.1155/2014/864705","DOIUrl":"https://doi.org/10.1155/2014/864705","url":null,"abstract":"<p><strong>Background: </strong>Two common procedures for esophageal resection are Ivor Lewis esophagectomy and transhiatal esophagectomy. Both procedures have high morbidity rates of 20-46%. Minimally invasive esophagectomy has been introduced to decrease morbidity. We report initial experience of MIE to determine the morbidity and mortality associated with this procedure during learning phase.</p><p><strong>Material and methods: </strong>Patients undergoing MIE at our institute from January 2011 to May 2013 were reviewed. Record was kept for any morbidity and mortality. Descriptive statistics were presented as frequencies and continuous variables were presented as median. Survival analysis was performed using Kaplan Meier curves.</p><p><strong>Results: </strong>We performed 51 minimally invasive esophagectomies. Perioperative morbidity was in 16 (31.37%) patients. There were 3 (5.88%) anastomotic leaks. We encountered 1 respiratory complication. Reexploration was required in 3 (5.88%) patients. Median operative time was 375 minutes. Median hospital stay was 10 days. The most frequent long-term morbidity was anastomotic narrowing observed in 5 (9.88%) patients. There were no perioperative mortalities. Our mean overall survival was 37.66 months (95% confidence interval 33.75 to 41.56 months). Mean disease-free survival was 24.43 months (95% CI 21.26 to 27.60 months).</p><p><strong>Conclusion: </strong>Minimally invasive esophagectomy, when performed in the learning phase, has acceptable morbidity and mortality.</p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2014 ","pages":"864705"},"PeriodicalIF":1.5,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/864705","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32602859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Close margins in oral cancers: implication of close margin status in recurrence and survival of pT1N0 and pT2N0 oral cancers.","authors":"Sandhya Gokavarapu,&nbsp;Ravi Chander,&nbsp;Nagendra Parvataneni,&nbsp;Sreenivasa Puthamakula","doi":"10.1155/2014/545372","DOIUrl":"https://doi.org/10.1155/2014/545372","url":null,"abstract":"<p><strong>Introduction: </strong>Among all prognostic factors, \"margin status\" is the only factor under clinician's control. Current guidelines describe histopathologic margin of >5 mm as \"clear margin\" and 1-5 mm as \"close margin.\" Ambiguous description of positive margin in the published data resulted in comparison of microscopically \"involved margin\" and \"close margin\" together with \"clear margin\" in many publications. Authors attempted to compare the outcome of close and clear margins of stage I and stage II squamous cell carcinoma of oral cavity to investigate the efficacy of description of margin status.</p><p><strong>Patients and methods: </strong>Historical cohorts of patients treated between January 2010 and December 2011 at tertiary cancer hospital were investigated and filtered for stage I and stage II primary squamous cell carcinomas of oral cavity. Patients with margin status of tumor at margin or within 1mm from cut margin were excluded and analyzed in multivariate logistic regression model for locoregional recurrences and Cox regression for overall survival.</p><p><strong>Results: </strong>A total of 104 patients fulfilled the abovementioned criteria, of whom 36 were \"clear margin\" and 68 were \"close margin\" with median period of follow-up of 39 months. There was no significant difference in locoregional recurrence (P value: 0.0.810) and survival (P value: 0.0.851) among \"close margin\" and \"clear margin\" patients.</p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2014 ","pages":"545372"},"PeriodicalIF":1.5,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/545372","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32848777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a new modification of pancreaticogastrostomy after pancreaticoduodenectomy: anastomosis of the pancreatic duct to the gastric mucosa with invagination of the pancreatic remnant end into the posterior gastric wall for patients with cancer head of pancreas and periampullary carcinoma in terms of postoperative pancreatic fistula formation.","authors":"Mohamed Mazloum Osman,&nbsp;Walid Abd El Maksoud","doi":"10.1155/2014/490386","DOIUrl":"https://doi.org/10.1155/2014/490386","url":null,"abstract":"<p><strong>Background/objectives: </strong>Postoperative pancreatic fistula (POPF) remains the main problem after pancreaticoduodenectomy and determines to a large extent the final outcome. We describe a new modification of pancreaticogastrostomy which combines duct to mucosa anastomosis with suturing the pancreatic capsule to posterior gastric wall and then invaginating the pancreatic remnant into the posterior gastric wall. This study was designed to assess the results of this new modification of pancreaticogastrostomy.</p><p><strong>Methods: </strong>The newly modified pancreaticogastrostomy was applied to 37 consecutive patients after pancreaticoduodenectomy for periampullary cancer (64.86%) or cancer head of the pancreas (35.14%). Eighteen patients (48.65%) had a soft pancreatic remnant, 13 patients (35.14%) had firm pancreatic remnant, and 6 patients (16.22%) had intermediate texture of pancreatic remnant. Rate of mortality, early postoperative complications, and hospital stay were also reported.</p><p><strong>Results: </strong>Operative mortality was zero and morbidity was 29.73%. Only three patients (8.11%) developed pancreatic leaks; they were treated conservatively. Eight patients (16.1%) had delayed gastric emptying, one patient (2.70%) had minor hemorrhage, one patient (2.70%) had biliary leak, and four patients (10.81%) had superficial wound infection.</p><p><strong>Conclusions: </strong>The new modified pancreatogastrostomy seems safe and reliable with low rate of POPF. However, further prospective controlled trials are essential to support these results.</p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2014 ","pages":"490386"},"PeriodicalIF":1.5,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/490386","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32735188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies to evaluate synchronous carcinomas of the colon and rectum in patients that present for emergent surgery.","authors":"Jennifer L Agnew,&nbsp;Benjamin Abbadessa,&nbsp;I Michael Leitman","doi":"10.1155/2013/309439","DOIUrl":"https://doi.org/10.1155/2013/309439","url":null,"abstract":"<p><p>It is not always possible to evaluate patients that present acutely with carcinoma of the colon and rectum for synchronous lesions. Patients that require emergent surgery necessitate urgent and efficient operation. Patients with lower gastrointestinal bleeding, perforation, or obstruction represent a challenging subset of patients with colorectal cancer. An organized approach to these patients in the effort not to overlook a synchronous carcinoma is important. The present paper provides an evidenced-based approach to this special situation.</p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2013 ","pages":"309439"},"PeriodicalIF":1.5,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/309439","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31295425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor regression grades: can they influence rectal cancer therapy decision tree?","authors":"Marisa D Santos,&nbsp;Cristina Silva,&nbsp;Anabela Rocha,&nbsp;Eduarda Matos,&nbsp;Carlos Nogueira,&nbsp;Carlos Lopes","doi":"10.1155/2013/572149","DOIUrl":"https://doi.org/10.1155/2013/572149","url":null,"abstract":"<p><strong>Background: </strong>Evaluating impact of tumor regression grade in prognosis of patients with locally advanced rectal cancer (LARC).</p><p><strong>Materials and methods: </strong>We identified from our colorectal cancer database 168 patients with LARC who received neoadjuvant therapy followed by complete mesorectum excision surgery between 2003 and 2011: 157 received 5-FU-based chemoradiation (CRT) and 11 short course RT. We excluded 29 patients, the remaining 139 were reassessed for disease recurrence and survival; the slides of surgical specimens were reviewed and classified according to Mandard tumor regression grades (TRG). We compared patients with good response (Mandard TRG1 or TRG2) versus patients with bad response (Mandard TRG3, TRG4, or TRG5). Outcomes evaluated were 5-year overall survival (OS), disease-free survival (DFS), local, distant and mixed recurrence.</p><p><strong>Results: </strong>Mean age was 64.2 years, and median followup was 56 months. No statistically significant survival difference was found when comparing patients with Mandard TRG1 versus Mandard TRG2 (p = .77). Mandard good responders (TRG1 + 2) have significantly better OS and DFS than Mandard bad responders (TRG3 + 4 + 5) (OS p = .013; DFS p = .007).</p><p><strong>Conclusions: </strong>Mandard good responders had a favorable prognosis. Tumor response (TRG) to neoadjuvant chemoradiation should be taken into account when defining the optimal adjuvant chemotherapy regimen for patients with LARC.</p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2013 ","pages":"572149"},"PeriodicalIF":1.5,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/572149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31830431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Clinicopathological Characteristics in the Patients with Cardiac Cancer with or without Esophagogastric Junctional Invasion: A Single-Center Retrospective Cohort Study.","authors":"Hiroaki Ito,&nbsp;Haruhiro Inoue,&nbsp;Noriko Odaka,&nbsp;Hitoshi Satodate,&nbsp;Michitaka Suzuki,&nbsp;Shumpei Mukai,&nbsp;Yusuke Takehara,&nbsp;Tomokatsu Omoto,&nbsp;Shin-Ei Kudo","doi":"10.1155/2013/189459","DOIUrl":"https://doi.org/10.1155/2013/189459","url":null,"abstract":"<p><p>Background. This study addresses clinicopathological differences between patients with gastric cardia and subcardial cancer with and without esophagogastric junctional invasion. Methods. We performed a single-center, retrospective cohort study. We studied patients who underwent curative surgery for gastric cardia and subcardial cancers. Tumors centered in the proximal 5 cm of the stomach were classed into two types, according to whether they did (Ge) or did not (G) invade the esophagogastric junction. Results. A total of 80 patients were studied; 19 (73.1%) of 26 Ge tumors and 16 (29.6%) of 54 G tumors had lymph nodes metastases. Incidence of nodal metastasis in pT1 tumors was significantly higher in the Ge tumor group. No nodal metastasis in cervical lymph nodes was recognized. Only two patients with Ge tumors had mediastinal lymph node metastases. Incidence of perigastric lymph node metastasis was significantly higher in those with Ge tumors. Ge tumors tended to be staged as progressive disease using the esophageal cancer staging manual rather than the gastric cancer staging manual. Conclusion. Because there are some differences in clinicopathological characteristics, it is thought to be adequate to distinguish type Ge from type G tumor.</p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2013 ","pages":"189459"},"PeriodicalIF":1.5,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/189459","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31200231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical margins in breast conservation.","authors":"Sheldon Marc Feldman","doi":"10.1155/2013/136387","DOIUrl":"https://doi.org/10.1155/2013/136387","url":null,"abstract":"Significant progress has been made in the diagnosis and treatment of breast cancer during the past 30 years. The increased availability of screening mammography has resulted in a higher percentage of woman being diagnosed with early stage disease allowing the option of breast conservation therapy to be more widely available. Long-term follow-up studies clearly demonstrate equivalent survival with breast conservation surgery (lumpectomy) and radiotherapy versus total mastectomy [1–3]. The importance of obtaining clear lumpectomy surgical margins has been well established in minimizing the risk of local recurrence [4]. Unfortunately there is a lack of uniform guidelines in terms of what constitutes an adequately clear lumpectomy margin. Substantial debate about bigger margins being better continues [5]. This has led to wide variations in lumpectomy margin reexcision rates from 15 to 47% [6]. These additional surgical procedures cause significant patient distress, utilize health care resources, and can adversely affect cosmesis. From the patient perspective, they may wonder why we did not get it right the first time. They want their cancer gone while maintaining a normal appearance. \u0000 \u0000This special issue highlights the areas of controversy and demonstrates current best practices and emerging novel approaches towards optimal breast conservation approach. The goal is to improve our ability to provide breast-conserving approaches for breast cancer while avoiding multiple surgical procedures, minimizing recurrence risk while obtaining excellent cosmesis. We have chosen 6 of 16 submissions to be published in this special issue. Each paper was evaluated by at least two expert reviewers and revised according to review comments. \u0000 \u0000P. Ananthakrishnan et al. provide an excellent comprehensive review article on all aspects involved in optimizing breast conservation. They include discussion of preoperative breast imaging, lesion localization, impact of tumor biology and systemic therapy, intraoperative lesion identification and margin assessment techniques, the role of margin ablation and oncoplastic techniques. They also discuss the promise of ductal anatomy mapping toward the goal of validating the “Sick lobe hypothesis” [7, 8] which may allow for more accurate identification of breast tissue to be targeted for excision. \u0000 \u0000R. Emmadi and E. L. Wiley provide an excellent review from the pathology perspective of the different approaches to margin assessment. They explore issues of specimen processing, fixation, cutting techniques, and reporting. They well explain the reasons for the reporting variations between institutions and the need for standardization. \u0000 \u0000J. L. Baker et al. present a scholarly review of our current understanding of the issue of atypical ductal hyperplasia (ADH) as it relates to surgical margins. They highlight the large interobserver variability among pathologists in differentiating ADH from low-grade ductal carcinoma in situ (DCIS). The ","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2013 ","pages":"136387"},"PeriodicalIF":1.5,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/136387","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31231457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are the American Society for Radiation Oncology guidelines accurate predictors of recurrence in early stage breast cancer patients treated with balloon-based brachytherapy?","authors":"Moira K Christoudias,&nbsp;Abigail E Collett,&nbsp;Tari S Stull,&nbsp;Edward J Gracely,&nbsp;Thomas G Frazier,&nbsp;Andrea V Barrio","doi":"10.1155/2013/829050","DOIUrl":"https://doi.org/10.1155/2013/829050","url":null,"abstract":"<p><p>The American Society for Radiation Oncology (ASTRO) consensus statement (CS) provides guidelines for patient selection for accelerated partial breast irradiation (APBI) following breast conserving surgery. The purpose of this study was to evaluate recurrence rates based on ASTRO CS groupings. A single institution review of 238 early stage breast cancer patients treated with balloon-based APBI via balloon based brachytherapy demonstrated a 4-year actuarial ipsilateral breast tumor recurrence (IBTR) rate of 5.1%. There were no significant differences in the 4-year actuarial IBTR rates between the \"suitable,\" \"cautionary,\" and \"unsuitable\" ASTRO categories (0%, 7.2%, and 4.3%, resp., P = 0.28). ER negative tumors had higher rates of IBTR than ER positive tumors. The ASTRO groupings are poor predictors of patient outcomes. Further studies evaluating individual clinicopathologic features are needed to determine the safety of APBI in higher risk patients. </p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2013 ","pages":"829050"},"PeriodicalIF":1.5,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/829050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31993362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life study following cytoreductive surgery and intraperitoneal chemotherapy for pseudomyxoma peritonei including redo procedures.","authors":"Rachel Kirby,&nbsp;Winston Liauw,&nbsp;Jing Zhao,&nbsp;David Morris","doi":"10.1155/2013/461041","DOIUrl":"https://doi.org/10.1155/2013/461041","url":null,"abstract":"<p><strong>Background: </strong>Our aim was to evaluate the quality of life following cytoreductive surgery and intraperitoneal chemotherapy for pseudomyxoma peritonei. We also conducted an analysis of all patients who underwent CRS and HIPEC for pseudomyxoma peritonei from 1997 to 2012.</p><p><strong>Methods: </strong>We contacted 87 patients using the FACT C (version 4) quality of life questionnaire, and FACIT-TS-G (version 1) was also used.</p><p><strong>Results: </strong>A total of 63 patients (response rate 72%) were available for quality of life interview and analysis. The median time from surgery to questionnaire evaluation was 31 months (range 6-161 months). 62% were females with an average age of 54 years. 22% of the patients had over one cytoreductive surgical procedure. We analysed our patients postoperatively based on physical, functional, social, and emotional well being who reported favourable outcomes in all sections. Patients who had a single procedure had a significantly higher score (P = 0.016) in the additional concerns section of the questionnaire. The patients who had a single procedure had better gastrointestinal digestion in terms of bowel control, appetite, and food digestion and also body appearance scoring.</p><p><strong>Conclusions: </strong>79% of the patients stated that they would undergo further cytoreductive surgery and that redo procedures do not result in a significantly worse quality of life.</p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2013 ","pages":"461041"},"PeriodicalIF":1.5,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/461041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31689855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}