Monaldi Archives for Chest Disease最新文献

{"title":"Role of interleukin-4 receptor α polymorphism in patients with asthma and its correlation with asthma severity.","authors":"Nidhi Girdhar, Karan Sharma, Satyajit Deshpande, Siddharth Sharma, Vishal Chopra, Anil Sontakke","doi":"10.4081/monaldi.2025.3095","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3095","url":null,"abstract":"<p><p>Asthma is a heterogeneous disease characterized by chronic airway inflammation. It is defined by the history of respiratory symptoms such as wheeze, shortness of breath, chest tightness, and cough that vary over time and intensity, together with variable expiratory airflow limitation. A personal history or a family history of allergy is the factor most strongly associated with the development of asthma. Our primary aim was to investigate interleukin-4 receptor α (IL-4Rα) polymorphism to determine whether the presence of the R576 IL-4Rα allele was associated with asthma and whether the presence of the R576 allele influenced the severity of asthma in affected individuals. The data obtained indicated asthmatic patients were characterized by a higher prevalence of positive family history of asthma (p<0.001) as compared to controls. It was found that the patients homozygous for mutant alleles had a 1.39-fold increased risk of asthma compared with individuals not homozygous for R576. Also, we found that females had higher odds (1.61-fold) of significant association with asthma (p=0.09; odds ratio=1.58). While this report clearly necessitates a more detailed study, it is plausible that IL-4 mutation has a significant role in the development of asthma and, thus, can play an important role in developing targeted therapy.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance of N-terminal pro-B-type natriuretic peptide levels in lung cancer.","authors":"Sinem İnan, Semra Bilaçeroğlu, Burcu Uludağ Artun","doi":"10.4081/monaldi.2025.3174","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3174","url":null,"abstract":"<p><p>High blood levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) have been shown in various malignancies. In lung cancer, the importance of NT-proBNP is not clear. In this study, we aimed to investigate the significance of the correlation of NT-proBNP levels in lung cancer with tumor stage, tumor diameter, histopathology, and specific sites of mediastinal metastasis: lymphadenopathy; pericardial, cardiac, major vessel, other mediastinal organ or lymphatic involvement/invasion. A total of 105 lung cancer and 120 control patients (chronic obstructive lung disease, interstitial lung disease, pulmonary thromboembolism, and pneumonia; 30/subgroup) with measured NT-proBNP levels were included retrospectively. Demographics, comorbidities, and echocardiographic findings in all patients, as well as histologic subtype, diameter, stage, and radiologic and/or pathologic mediastinal involvement/invasion of the tumor to the mediastinum in patients with lung cancer, were studied with regards to blood NT-proBNP levels. When lung cancer and control groups were compared globally or as subgroups with comorbidities, NT-proBNP levels did not show meaningful differences. However, NT-proBNP levels were determined to be 249 pg/mL and 88 pg/mL in lung cancer (n=68) and control subgroups (n=58) without comorbidities, respectively (p=0.001). Among lung cancer patients without comorbidities and those with cardiac, pericardial, major vascular, or other mediastinal involvement/invasion (lymphadenopathy, lymphatic, or other organ invasion) (n=27), the NT-proBNP level was 303 pg/mL, whereas it was 166 pg/mL in those without these mediastinal invasions (n=41) (p=0.031). There is a need for much larger, randomized studies to obtain evidence for the potential role of NT-proBNP as a helpful diagnostic biomarker for lung cancer. Clinical suspicion of malignancy may be posed if high NT-proBNP levels cannot be explained by all other risk factors and disorders or diseases. Furthermore, pericardial, cardiac, major vessel, or other mediastinal invasion/involvement should be sought when high NT-proBNP levels are determined in lung cancer patients without any comorbidities or risk factors for high NT-proBNP levels.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhaled corticosteroids in asthma and chronic obstructive pulmonary disease combined phenotype: when to use and what to expect?","authors":"Srishankar Bairy, Tarun Tiwari, Himanshu Mittal, Neeraj Gupta, Meghana M","doi":"10.4081/monaldi.2025.3129","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3129","url":null,"abstract":"<p><p>The term \"asthma-chronic obstructive pulmonary disease (COPD) combined phenotype\" describes patients with persistent airflow limitation and features of both asthma and COPD. There is a lack of data on effective treatments for this group, often excluded from asthma or COPD trials. Inhaled corticosteroids (ICS) are standard for asthma, while bronchodilators are key for COPD. This study is a prospective interventional study that included 43 patients diagnosed with the asthma-COPD overlap phenotype, as per Sin et al. criteria, who were treated as COPD priorly and followed over one year. These patients received additional treatment with a moderate-dose ICS metered dose inhaler beclamethasone 800 mcg daily, in addition to their optimal inhaled bronchodilator therapy. Follow-up spirometry along with reversibility, fractional exhaled nitric oxide (FeNO), blood investigations like total eosinophil count (TEC) and immunoglobulin E (IgE) were done; sputum eosinophils were measured, and a history of exacerbations was noted. These parameters were compared with baseline values obtained prior to the initiation of ICS to evaluate the impact of the intervention. Among the 43 individuals in the study population, the majority fell within the age group of 60-69 years. The addition of ICS to bronchodilators over a one-year period resulted in significant improvements in their forced expiratory volume in one second. Additionally, there was a notable reduction in the FeNO level, along with decreases in the TEC, serum IgE levels, and sputum eosinophils. Although the number of exacerbations decreased during the study period in this subgroup, this reduction did not reach statistical significance. Based on these findings, the study suggests that ICS should be considered as an adjunct to inhaled bronchodilators for the management of stable COPD patients exhibiting features of the asthma-COPD combined phenotype.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ghostly intrusion on a frightful Halloween night: a case report of dual valve endocarditis.","authors":"Margarida Castro, Mariana Tinoco, Rafael Martins, Mário Jorge Amorim, Luísa Pinheiro, Marina Fernandes, Filipa Cardoso, Filipa Almeida, Paulo Pinho, João Português, António Lourenço","doi":"10.4081/monaldi.2025.3228","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3228","url":null,"abstract":"<p><p>Multivalvular endocarditis (MVE) is an uncommon presentation and mostly involves mitral and aortic valves. Here, we present a case of an MVE with an unusual and bizarre presentation on a Halloween night with a massive degree of valve destruction and right- and left-side involvement requiring emergent surgery. A 51-year-old male patient with intravenous drug usage presented with anorexia, fever, and dyspnea, rapidly progressing to septic shock with multiorgan dysfunction. Initial blood cultures detected meticillin-sensitive Staphylococcus aureus, and antibiotic therapy was started. Transesophageal echocardiography revealed extensive valve destruction of both mitral and tricuspid valves, namely a mitral valve with large vegetation resembling a ghostly figure, causing severe mitral regurgitation. The patient was transferred for emergent mitral and tricuspid surgery. The particularity of this case, besides the bizarre images, is that, as a drug user, there are specific considerations regarding surgical strategy and options in this scenario that we discussed here.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An unexpected and tumultuous diagnosis of a left atrial mass.","authors":"Catarina Amaral Marques, Carlos Xavier Resende, João Rebelo, Paulo Pinho, Mariana Vasconcelos, Rui André Rodrigues","doi":"10.4081/monaldi.2025.3221","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3221","url":null,"abstract":"<p><p>This case presents a curious diagnosis in a young male presenting with chest pain. The first imaging tests suggested the presence of a hypovascular left atrial tumor. After cardiac magnetic resonance and the exclusion of extra-cardiac lesions, sarcoma emerged as the main diagnostic hypothesis. Unexpectedly, the histopathological study revealed the absence of malignancy, identifiable inflammatory and cardiac muscle tissue, and fibrosis. This pattern was compatible with inflammatory myofibroblastic tumor diagnosis, a rare entity with uncertain behavior but a known risk of recurrence and/or potentially fatal complications. This is a unique case of an unexpected finding at presentation, as well as a complex diagnostic work-up and a surprisingly unusual final diagnosis. It also highlights the increasing importance of the multimodality imaging approach, as well as the critical role of multidisciplinary discussion in optimizing patient management in such complex cases.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smoking patterns and outcomes of severe sars-CoV-2 infection: a retrospective cohort study.","authors":"Branko Beronja, Aleksandra Karan, Biljana Lukic, Ivana Milosevic, Jelena Dotlic, Tatjana Gazibara","doi":"10.4081/monaldi.2025.2916","DOIUrl":"https://doi.org/10.4081/monaldi.2025.2916","url":null,"abstract":"<p><p>The purpose of this study was to analyze the association between the number of cigarettes smoked and the length of smoking with mortality among patients who were hospitalized in the intensive care unit (ICU) due to SARS-CoV-2 infection. This retrospective cohort study was conducted at the General Hospital in Sombor (Serbia). Patients who were hospitalized because of severe SARS-CoV-2 infection between March 2021 and March 2023 were included in this study. Data were retrieved from electronic medical records, including those on smoking status, duration of smoking, and the number of cigarettes smoked per day. Of 307 patients whose medical records were analyzed, 40.7% were current smokers. Current smokers more often required treatment in the ICU, where they also had a higher mortality rate compared to current non-smokers. Longer duration of smoking was independently associated with dying of SARS-CoV-2 infection in the ICU. The Kaplan-Meier survival curve showed that hospitalized patients with SARS-CoV-2 infection who smoked had poorer survival compared to current non-smokers. According to the receiver operating characteristic curve, patients who smoked for more than 40 years had a 73.9% chance of dying from SARS-CoV-2 infection. Current smokers who smoked 22.5 cigarettes per day had a 75.4% chance of dying from SARS-CoV-2 infection in the ICU. Smokers with severe SARS-CoV-2 infection had a higher likelihood of having poor outcomes. Longer duration of smoking was an independent predictor of SARS-CoV-2 mortality. Smoking prevention and smoking cessation are of paramount importance in the prevention of SARS-CoV-2-related mortality.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency of viral etiology in community-acquired pneumonia.","authors":"Zain Ahmad Khan, Akbar Shoukat Ali, Imran Ahmed, Joveria Farooqi, Muhammad Irfan","doi":"10.4081/monaldi.2025.3161","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3161","url":null,"abstract":"<p><p>The identification of etiology is very important when managing patients with community-acquired pneumonia (CAP). In Pakistan, studies regarding the viral etiology in CAP are scarce. The main objective of this study was to evaluate the frequency of viral etiology in CAP patients and analyze the clinical features and their impact on prognosis. Medical records of CAP patients admitted to Aga Khan University Hospital (Karachi, Pakistan) from March 2022 to February 2023 were retrospectively reviewed, patients who had microbiological tests performed within 48 hours of the hospital admission were included, and the frequency of viral and bacterial etiology was calculated. Patients who were immunocompromised were excluded. Epidemiological and clinical characteristics were examined, and the impact on prognosis was explored. A total of 166 patients were included; 115 (69.3%) patients were identified as having pneumonia with known causative microorganisms. A total of 83 (72.1%) patients had a viral etiology alone, 18 (15.6%) had only bacterial infection, and 14 (12.2%) had a viral and bacterial co-infection. Influenza A was most frequently detected (n=46/97; 47.4%), followed by Rhinovirus/Enterovirus (n=19/97; 19.6%). Staphylococcus aureus accounted for the majority (n=18; 56.3%) of cases among bacteria. Bacterial and viral-bacterial co-infection was significantly higher among non-survivors (38.1% vs. 16.6%, p=0.034). Confusion-Urea-Respiratory Rate-Blood Pressure-Age of 65 scores of 3-5 [odds ratio (OR) 4.234; 95% confidence interval 1.156-15.501], leukocytosis (OR 0.137; 0.030-0.636), high C-reactive protein (>10mg/L) (OR 1.008; 1.001-1.014), high serum procalcitonin level (≥0.5 ng/mL) (OR 10.731; 3.018-38.153), and mechanical ventilation required (OR 47.104; 13.644-162.625) were associated with mortality. Mechanical ventilation requirement was independently associated with increased odds of mortality (OR 43.407; 8.083-233.085). Of 166 patients, 21 (12.7%) had died, with the highest percentage (28.6%) seen in the viral-bacterial coinfection group (p=0.046). To conclude, respiratory viruses are increasingly being recognized as an important etiology in CAP, with higher mortality seen in bacterial infection, whether alone or with viral co-infection.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Downhill: a new rehabilitation frontier. A systematic review of the literature.","authors":"Matteo Tamburlani, Rossana Cuscito, Alessio D'Angelo, Giovanni Galeoto, Leonardo Papi, Ilaria Ruotolo, Francesca Santini, Annamaria Servadio, Edoardo Tirelli, Giovanni Sellitto","doi":"10.4081/monaldi.2025.3071","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3071","url":null,"abstract":"<p><p>In the last few years, we have seen the gradual spread of a new treadmill training modality, which involves walking not on the flat but downhill, also known as \"downhill\". This review aims to qualitatively assess the efficacy of downhill treatment on different patient populations and outline treatment routes for future efficacy studies. We searched five different databases: MEDLINE, SCOPUS, Web of Science, PEDro, and LILACS for studies to include. Only randomized controlled trials (RCTs) published in English were considered. PEDro scales and Risk of Bias 2 (RoB 2) assessment were used to evaluate the risk of bias. Forty-one RCTs were included, and three articles remained to be analyzed; the included studies showed 110 participants for three RCTs; of these, two were performed on patients diagnosed with chronic obstructive pulmonary disease (COPD), while one was for treating people with multiple sclerosis (MS). The outcome measures used in the studies were the pulmonary function test, the cardiopulmonary exercise test, the 6-Minute Walking Test, and the St. George Respiratory Questionnaire. In patients diagnosed with COPD, downhill training appears effective on functional capacity and symptoms of dyspnea and fatigue, while in people with MS, it increases strength and activity performance when compared to other walking training modalities. RoB 2 tool shows good methodological quality for all studies included in the review; when evaluated with the PEDro scale, all presented a score of 8. Downhill could be such an effective, safe, and feasible eccentric training modality that it can be considered a new rehabilitation strategy that could be implemented for patients with low exercise tolerance.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mucus production and chronic obstructive pulmonary disease, a possible treatment target: zooming in on N-acetylcysteine.","authors":"Federico Baraldi, Tommaso Bigoni, Maria Pia Foschino Barbaro, Claudio Micheletto, Giulia Scioscia, Alessandro Vatrella, Alberto Papi","doi":"10.4081/monaldi.2025.3159","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3159","url":null,"abstract":"<p><p>Mucus hypersecretion is a trait of chronic obstructive pulmonary disease (COPD) associated with poorer outcomes. As it may be present before airway obstruction, its early treatment may have a preventive role. This narrative review of the literature presents the role of mucus dysfunction in COPD, its pathophysiology, and the rationale for the use of N-acetylcysteine (NAC). NAC can modify mucus rheology, improving clearance and reducing damage induced MUC5AC expression. It exerts a direct and indirect (glutathione replenishment) antioxidant mechanism; it interferes with inflammatory molecular pathways, including inhibition of nuclear factor-kB activation in epithelial airway cells and reduction in the expression of cytokine tumor necrosis factor α, interleukin (IL)-6, and IL-10. Some clinical experiences suggest that the adjunctive use of NAC may reduce symptoms and improve outcomes for patients with COPD. In conclusion, NAC may be a candidate drug for the early treatment of subjects at risk of COPD development.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An epidemiological assessment of health status among a cohort of tuberculosis survivors: prospective research in a western Indian city.","authors":"Venu Shah, Viral Dave, Vaidehi Gohil, Hardika Khanpara","doi":"10.4081/monaldi.2025.3163","DOIUrl":"10.4081/monaldi.2025.3163","url":null,"abstract":"<p><p>Long-term follow-up of tuberculosis (TB) is important to monitor treatment outcomes, prevent relapse, and improve patient care. The aims of the current study are: i) to assess various epidemiological parameters among TB survivors, like mortality and morbidity, with emphasis on recurrence status during pre-defined long-term follow-up; ii) to assess factors responsible for the recurrence of TB among study participants. A prospective observational study was conducted among cured cases of pulmonary TB registered at the TB unit of Ahmedabad City, India. As per the calculated sample size, 180 study participants were recruited by systematic random sampling from a list of cured TB cases from July to September 2021. Follow-ups of participants were conducted at 6, 12, 18, and 24 months post-recruitment. The status of cured cases was assessed by a pre-validated questionnaire. Factors significantly associated with the likelihood of TB were analyzed using logistic regression. Of the total 180 cured TB cases, 22 (12.2%) developed recurrent TB, and 12 (6.6%) deaths were recorded during the entire follow-up duration of 2 years. Among the cases assessed, 106 (71.6%) were found to be asymptomatic in the context of TB at 2 years post-treatment completion. Around 17 (77.2%) recurrent cases were diagnosed within a year of treatment completion. Factors significantly associated with recurrence were age (p=0.01), body mass index (p=0.02), and socio-economic status (p=0.03) of the study population. Overall recurrence assessed during 2 years of post-treatment follow-up among the cohort of TB survivors was 12.2%. As per the study findings, socio-demographic and nutritional factors play a significant role in the development of recurrent TB, highlighting the importance of targeted interventions.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}