Journal of Clinical Densitometry最新文献

{"title":"Corrigendum to ‘Executive Summary of the 2023 Adult Position Development Conference of the International Society for Clinical Densitometry: DXA Reporting, Follow-up BMD Testing and Trabecular Bone Score Application and Reporting’ Journal of Clinical Densitometry Volume 27, Issue 1, January–March 2024, 101435","authors":"Christopher Shuhart , Angela Cheung , Ranjodh Gill , Linsey Gani , Heenam Goel , Auryan Szalat","doi":"10.1016/j.jocd.2024.101548","DOIUrl":"10.1016/j.jocd.2024.101548","url":null,"abstract":"","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 1","pages":"Article 101548"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872616","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":"Bone Health ECHO Case Report: Significant Elevation in Bone Turnover Markers and Progression of Vertebral Fractures After Denosumab Discontinuation Followed by a PTH-Analog","authors":"Yevgeniya Kushchayeva ,&nbsp;Sergiy Kushchayev ,&nbsp;Kimberly Dunn ,&nbsp;Iryna Pestun ,&nbsp;Micol S. Rothman ,&nbsp;E. Michael Lewiecki","doi":"10.1016/j.jocd.2024.101551","DOIUrl":"10.1016/j.jocd.2024.101551","url":null,"abstract":"<div><div>Bone Health ECHO (Extension for Community Healthcare Outcomes) is a virtual community of practice, where healthcare professionals have met via videoconferencing weekly since 2015. This model of learning is focused on short didactics and the presentation of real but de-identified patient cases followed by highly interactive discussions. These are often clinical situations with diagnostic and therapeutic dilemmas that are not readily addressed by randomized placebo-controlled clinical trials and clinical practice guidelines. Here we present the case of a woman with postmenopausal osteoporosis with adverse consequences following discontinuation of denosumab and uncertainties on next steps for management. This case highlights the relevance of selection of the initial bone-targeted medication and the sequence of therapy in osteoporosis management.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 1","pages":"Article 101551"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899962","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":"Bone Health ECHO Case Report: High Bone Mass in a Patient with Chronic Kidney Disease","authors":"Zhanna Belaya ,&nbsp;Elena Przhiyalkovskaya ,&nbsp;Elizaveta Mamedova ,&nbsp;Sofia Gronskaia ,&nbsp;Natalia Tarbaeva ,&nbsp;Margarita Sharova ,&nbsp;Sergey Popov ,&nbsp;Michael Lewiecki","doi":"10.1016/j.jocd.2024.101554","DOIUrl":"10.1016/j.jocd.2024.101554","url":null,"abstract":"<div><div>Bone Health ECHO (Extension of Community Healthcare Outcomes) is a growing family of online educational programs. Its mission is to enhance delivery of best practice skeletal healthcare worldwide. Each program typically consists of a didactic lecture and discussion of clinical cases with diagnostic and treatment dilemmas. Here we present a Bone Health ECHO case of a 39-year-old man who has received hemodialysis for 12 years. This case is characterized by the development of chronic kidney disease - mineral and bone disorder (CKD-MBD) which was managed using conservative treatment to maintain phosphate and calcium levels within the reference range in spite of severe secondary hyperparathyroidism, after the patient declined parathyroidectomy. Although this patient had multiple vertebral fractures with height loss, his bone mineral density was higher than expected for his age and gradually increased over the period of observation. Whole-exome sequencing showed a heterozygous, likely pathogenic variant in <em>LEMD3</em> gene (13 exon HG38, chr12:65246271dup, с.2682dup in a heterozygous state), which may explain the high bone mass phenotype. As a result of the ECHO presentation, we decided that successful treatment of CKD-MBD would be the most effective approach to managing his bone fragility. His high bone mass phenotype was most likely associated with <em>LEMD3</em> gene variant. This patient does not require any specific anti-osteoporotic treatment at this time; however, he is likely to benefit from parathyroid surgery.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 1","pages":"Article 101554"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958100","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":"Calcaneal Bone Mineral Assessment in Elite Female Trail Runners","authors":"Javier Espasa-Labrador ,&nbsp;John O. Osborne ,&nbsp;Álex Cebrián-Ponce ,&nbsp;Silvia Puigarnau ,&nbsp;Toni Planas ,&nbsp;Quim Rosales ,&nbsp;Amigó, Alfredo Irurtia ,&nbsp;Marta Carrasco-Marginet","doi":"10.1016/j.jocd.2024.101555","DOIUrl":"10.1016/j.jocd.2024.101555","url":null,"abstract":"<div><div>This study aimed to assess the calcaneal bone mineral density (BMD) of elite female trail runners and evaluate its reliability using a novel DXA method. It also examined the relationship between calcaneal BMD and other regions of interest to better understand bone health in this specific population. A cross-sectional study was conducted with 35 elite female trail runners from the Spanish national team. BMD was measured at six anatomical regions using DXA, with particular focus on the calcaneus. Intra- and inter-rater reliability were evaluated using intraclass correlation coefficients (ICC). Descriptive statistics and correlations between calcaneal BMD and other anatomical sites, such as the lumbar spine and femoral neck, were analyzed. Calcaneal BMD showed excellent reliability (ICC = 0.95–0.98), confirming the robustness of the proposed measurement method. The mean calcaneal BMD (0.660 ± 0.105 g·cm²) was higher than that of non-athletes but lower than athletes from other endurance sports, such as road running. Significant correlations were found between calcaneal BMD and other regions, including the femoral neck (r = 0.58) and lumbar spine (r = 0.50), indicating that calcaneal BMD may provide complementary information for assessing bone health. The study confirms the reliability of calcaneal BMD measurement in elite female trail runners and highlights its potential as a useful complementary tool for monitoring bone health. Further longitudinal studies are needed to determine whether calcaneal BMD can serve as an indicator for stress fractures and other bone-related injuries in endurance athletes.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 1","pages":"Article 101555"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916105","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":"An Approach to Identify Forearm “Slot Error”","authors":"G. Gottinger,&nbsp;N. Binkley,&nbsp;D. Krueger","doi":"10.1016/j.jocd.2024.101557","DOIUrl":"10.1016/j.jocd.2024.101557","url":null,"abstract":"","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 1","pages":"Article 101557"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014268","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 Impact of Traditional Chinese Medicine Kidney-Tonifying Methods on Osteoporosis or Bone Loss in HR+ Breast Cancer Patients Following Endocrine Therapy","authors":"Jie Luo ,&nbsp;Peng Jiang ,&nbsp;Liming Xu","doi":"10.1016/j.jocd.2024.101558","DOIUrl":"10.1016/j.jocd.2024.101558","url":null,"abstract":"<div><div><em>Objective:</em> This study aims to systematically assess the therapeutic effects of Traditional Chinese Medicine (TCM) kidney-tonifying methods on osteoporosis in HR+ breast cancer patients after endocrine therapy, and to explore their clinical application value.</div><div><em>Methods:</em> This systematic review and meta-analysis adhered to the PRISMA guidelines and aimed to evaluate the impact of TCM kidney-tonifying methods on osteoporosis in HR+ breast cancer patients after endocrine therapy. Literature searches were conducted through October 2024 in databases including CBM, CNKI, Wanfang Data, PubMed, Web of Science, Cochrane Central, VIP, and renowned TCM databases such as TCM Online. Randomized controlled trials reporting lumbar spine bone density, femoral neck bone density, osteocalcin levels, pain VAS scores, and drug safety were included. The Cochrane tool was used for quality assessment, and meta-analysis was performed using RevMan 5.3 and Stata software.</div><div><em>Results:</em> This meta-analysis included 25 studies, covering 1795 patients. The combined results showed significant improvements in lumbar spine bone density (SMD = 0.98, 95 % CI: 0.52–1.44, <em>P</em> &lt; 0.0001), femoral neck bone density (SMD = 0.73, 95 % CI: 0.35–1.10, <em>P</em> = 0.0001), and osteocalcin levels (SMD = 1.23, 95 % CI: 0.52–1.93, <em>P</em> = 0.0007) in patients treated with TCM kidney-tonifying methods compared to those in the control group. There was also a significant reduction in pain VAS scores (SMD = −1.14, 95 % CI:1.55 to −0.72, <em>P</em> &lt; 0.00001). The safety data indicated no significant adverse reactions associated with the treatment.</div><div><em>Conclusion:</em> TCM kidney-tonifying methods can significantly improve osteoporosis symptoms post-endocrine therapy in HR+ breast cancer patients, enhance bone density, and effectively reduce pain, demonstrating good safety and potential clinical value. Future research should further validate these findings through large-scale, multi-center randomized controlled trials to optimize treatment strategies.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 1","pages":"Article 101558"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015006","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":"Moving towards an equitable future: Rethinking the use of race in pediatric densitometry","authors":"Amira Ramadan,&nbsp;Nessa Tantivit,&nbsp;Alicia Pendleton,&nbsp;Catherine M. Gordon,&nbsp;Robert H. Rosen,&nbsp;Nora E. Renthal","doi":"10.1016/j.jocd.2024.101536","DOIUrl":"10.1016/j.jocd.2024.101536","url":null,"abstract":"<div><div>Current guidelines from the International Society for Clinical Densitometry (ISCD) recommend considering race, sex, and age in calculating pediatric bone density z-scores by Dual-Energy X-ray Absorptiometry (DXA). However, as patient populations become increasingly diverse, the application of these guidelines presents significant challenges, potentially leading to racial bias and systemic inequities in care. In response to growing calls for a reevaluation of race's role in clinical decision-making, we aimed to assess the readiness of front-line providers of DXA services to address these challenges. We conducted a professional, anonymized clinical practice survey targeting DXA technologists from various centers as part of a workshop for Reevaluation of the Role of Race, Ethnicity, and Ancestry in Clinical Decision-Making at the 2024 Annual Meeting of the Pediatric Academic Society. The survey focused on their experiences with the recording and use of race demographics. Our findings revealed inconsistencies in race data collection practices, varying levels of perceived patient comfort, and concerns about the potential perpetuation of racial bias. These results highlight the need for standardized guidelines to facilitate the sensitive and unbiased collection of race-related data during DXA exams, ultimately promoting equitable care for all patients.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 1","pages":"Article 101536"},"PeriodicalIF":1.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593321","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":"Predicting bone mineral content from smartphone digital anthropometrics: evaluation of an existing application and the development of new prediction models","authors":"Austin J. Graybeal ,&nbsp;Sydney H. Swafford ,&nbsp;Abby T. Compton ,&nbsp;Megan E. Renna ,&nbsp;Tanner Thorsen ,&nbsp;Jon Stavres","doi":"10.1016/j.jocd.2024.101537","DOIUrl":"10.1016/j.jocd.2024.101537","url":null,"abstract":"<div><div><em>Introduction/Background:</em> Bone mineral content (BMC) is most commonly evaluated using dual-energy X-ray absorptiometry (DXA), but there are several challenges that limit use of DXA during routine care. Breakthroughs in digital imaging now allow smartphone applications to automate important anthropometrics that can predict several body composition components. However, it is unknown whether the anthropometrics automated using smartphone applications can predict DXA-derived BMC.</div><div><em>Methodology:</em> A total of 214 participants (129 F, 85 M) had BMC measurements collected from an existing proprietary prediction equation, embedded within a smartphone application (MeThreeSixty), and evaluated against DXA. LASSO regression was then used to develop a new BMC prediction equation using the anthropometric estimates produced by the smartphone application in a portion of the participants (n = 174), which was subsequently evaluated against DXA in the remaining sample (n = 40). BMC z-scores were calculated and used to identify the prevalence of <em>low BMC</em> for the existing and newly developed smartphone prediction equations and evaluated against DXA-derived z-scores.</div><div><em>Results:</em> Neither BMC estimates (R²: 0.72; RMSE: 376 g) nor BMC z-scores (R²: 0.55; RMSE: 1.09 SD) produced from the existing propriety prediction equation demonstrated equivalence with DXA in the combined sample. Moreover, the existing prediction equation had a 69.6 % accuracy of identifying <em>low BMC</em>. LASSO regression for the newly developed smartphone prediction model produced the following equation:</div><div>BMC (g) = -2020.769 + 60.902(<em>Black=1, 0=all other races</em>) – 180.364(<em>Asian=1, 0=all other races</em>) + 24.433(<em>height</em>) + 1.702(<em>weight</em>) + 2.92(<em>shoulder circumference</em>) + 0.258(<em>arm surface area</em>) – 715.29(<em>waist circumference/(BMI^2/3 x height^1/2)</em>).</div><div>BMC (R²: 0.91; RMSE: 209 g) and BMC z-scores (R²: 0.85; RMSE: 0.61) produced from the newly developed equation in the testing sample demonstrated equivalence with DXA and had a 92.5 % accuracy of identifying <em>low BMC</em>.</div><div><em>Conclusions:</em> Smartphone anthropometrics provide accurate and clinically relevant BMC measurements outside of an advanced setting through the use of our newly-developed smartphone prediction model.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 1","pages":"Article 101537"},"PeriodicalIF":1.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593320","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":"Opportunistic Screening for Low Bone Mineral Density in Routine Computed Tomography Scans: A Brazilian Validation Study","authors":"Felipe Welter Langer ,&nbsp;Giovanni Brondani Torri ,&nbsp;Fernando Schaffazick ,&nbsp;Guilherme Maia ,&nbsp;Camila Piovesan Wiethan ,&nbsp;Carlos Jesus Haygert ,&nbsp;Marcos Cordeiro d'Ornellas","doi":"10.1016/j.jocd.2024.101539","DOIUrl":"10.1016/j.jocd.2024.101539","url":null,"abstract":"<div><div><em>Introduction/background:</em> Osteoporotic fractures are a major health concern worldwide due to high mortality rates, deterioration in quality of life, and elevated healthcare costs related to hospital treatment. However, most patients who sustain an osteoporotic fracture have never been formally screened for osteoporosis. Opportunistic screening of osteoporosis through conventional computed tomography (CT) scans performed for unrelated reasons could help identify patients with low bone mass. There are currently no studies validating the opportunistic screening of low bone mass through CT in South America. The aim of our study is to assess whether conventional CT scans could be used for the opportunistic screening of osteopenia and osteoporosis in Brazilian patients.</div><div><em>Methodology:</em> Patients who underwent unenhanced CT and dual-energy X-ray absorptiometry (DXA) scans within a six-month interval were assessed retrospectively. Mean CT attenuation was measured in the first lumbar vertebra (L1) in axial, coronal, and sagittal planes and compared to their respective DXA T-scores; vertebral fractures were assessed in the sagittal plane. Potential thresholds suggestive of low bone mass density (BMD) were established using receiver operating characteristics analysis.</div><div><em>Results:</em> 491 patients were included (93.2 % female; mean age of 64.1 ± 9.8 years; mean interval of 63.5 days between scans). Mean L1 CT attenuation was significantly lower in osteopenic and osteoporotic patients in all CT planes (<em>p</em> &lt; 0.001). Positive linear correlations were found between DXA T-scores and the average L1 attenuations in all CT planes (<em>p</em> &lt; 0.001). An average L1 attenuation equal or below 100 Hounsfield Units (HU) in the sagittal plane identified low BMD (osteopenia or osteoporosis) with a specificity of 96.3 % and a positive predictive value of 96 %. In contrast, an average L1 attenuation above 180 HU demonstrated a sensitivity of 97.6 % and a negative predictive value of 94.9 % for detecting osteoporosis. Patients with L1 sagittal attenuation at or below 100 HU exhibited a significantly higher prevalence of vertebral fractures (prevalence ratio: 8.67; <em>p</em> &lt; 0.001). An online calculator based on the results of this study is freely available at <span><span>www.osteotc.com.br</span><svg><path></path></svg></span>.</div><div><em>Conclusions:</em> Routine CT scans can identify probable low bone density (osteopenia or osteoporosis) in Brazilian patients without additional costs or radiation exposure. Opportunistic CT screening does not substitute formal bone mineral density assessment; instead, it assists in identifying patients who may benefit from it.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 1","pages":"Article 101539"},"PeriodicalIF":1.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644668","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":"Comparison of the Effect of Selective Serotonin and Norepinephrine Reuptake Inhibitors on Bone Mineral Density with Selective Serotonin Reuptake Inhibitors and Healthy Controls","authors":"Süheyla Doğan Bulut ,&nbsp;Gamze Zengin İspir ,&nbsp;Serdar Bulut ,&nbsp;Emine AK Aygün","doi":"10.1016/j.jocd.2024.101538","DOIUrl":"10.1016/j.jocd.2024.101538","url":null,"abstract":"<div><div><em>Purpose:</em> This study investigated the association between selective serotonin reuptake inhibitor (SSRI) and selective serotonin and norepinephrine reuptake inhibitor (SNRI) use and the risk of decreased bone mineral density in postmenopausal women.</div><div><em>Methods:</em> Sixty-three patients diagnosed with GAD (Generalized Anxiety Disorder) were treated with venlafaxine or duloxetine from the SNRI group, and sixty patients treated with SSRIs were enrolled. Social demographic features, the Hamilton Anxiety Scale (HAS) results, and the Hamilton Depression Scale (HDS) scores of all the patients were assessed. The BMD (bone mineral density) of the patients was measured by dual-energy X-ray absorptiometry (DXA) at the femoral and lumbar regions. The BMD of the patients was compared with that of 40 healthy controls.</div><div><em>Results:</em> Bone measurements in the SNRI and SSRI users were similar to those of the healthy controls. However, osteopenic values were observed in the SSRI users, while normal bone density was found in the SNRI users. Also, the bone mineral densities were compared between patients using duloxetine and venlafaxine with healthy controls, showing similar T-score and Z-score values with no significant differences compared to the control group. However, while the lumbar region T-scores of those using duloxetine were within normal values, they were within the osteopenia range of venlafaxine and healthy controls.</div><div><em>Conclusion:</em> SNRIs may have a lower risk of developing osteoporosis than SSRIs. Of the SNRIs, duloxetine appears to be safer than venlafaxine. Further randomized controlled studies are warranted to determine whether SNRI use is risky.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 1","pages":"Article 101538"},"PeriodicalIF":1.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631786","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}