Intestinal Failure (New York, N.Y.)最新文献

{"title":"Tailoring desensitization in intestinal transplants: C1q guided protocol for highly sensitized recipients.","authors":"Vighnesh Venkatasamy, Jennifer Garcia, Amay Banker, Mahmoud Morsi, Arinc Ozturk, Gennaro Selvaggi, Akin Tekin, Rafael Miyashiro, Hugo Kaneku, Phillip Ruiz, Rodrigo Vianna, Adela Mattiazzi","doi":"10.1016/j.intf.2026.100371","DOIUrl":"10.1016/j.intf.2026.100371","url":null,"abstract":"<p><strong>Background: </strong>Sensitized candidates for isolated intestinal or modified multivisceral transplantation (MMVT) face prolonged wait times and higher rejection risk from donor-specific antibodies (DSA). While desensitization is established in kidney transplantation, data in intestine/MMVT are limited.</p><p><strong>Case report: </strong>Three adults with cPRA ≥ 95% underwent desensitization with Rituximab, plasma exchange, and monthly infusions of IgG, guided by C1q DSA testing. All three patients were transplanted-two with negative crossmatches and one despite a positive B-cell crossmatch given C1q-negative DSAs. No early AMR occurred; one developed mild acute cellular rejection, responsive to therapy. Infectious complications were common but manageable. Outcomes varied: one died nearly four years post-transplant from non-adherence leading to infections and severe rejection, one succumbed to necrotizing fasciitis at 10 months with a functional graft, and one remains alive with excellent graft function.</p><p><strong>Conclusion: </strong>C1q-guided desensitization enabled successful transplantation in highly sensitized isolated intestine/MMVT recipients, supporting its feasibility. Further clinical studies are warranted.</p>","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"11 ","pages":"100371"},"PeriodicalIF":0.0,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059464","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":"Metabolic balance studies: A comprehensive protocol and methodological approach for assessing intestinal function.","authors":"Julie Hvid Møller Andersen, Astrid Verbiest, Mark Hvistendahl, Tim Vanuytsel, Palle Bekker Jeppesen","doi":"10.1016/j.intf.2026.100373","DOIUrl":"10.1016/j.intf.2026.100373","url":null,"abstract":"<p><p>Adequate absorption of nutrients, fluids, and electrolytes is essential for maintaining physiological function and overall health. Clinical evaluation of the intestinal absorptive capacity is therefore important for diagnosing and managing chronic gastrointestinal disorders with impaired nutrient absorption. To this end, metabolic balance studies (MBS), which assess the intestinal absorption of energy, macronutrients, fluids and electrolytes, are considered the gold standard. However, full MBS are performed in only a few specialized centers due to their complexity and high resource demands. This paper provides a detailed methodological practice guide to conducting MBS, covering the entire process from standardized sample collection to laboratory procedures such as homogenization and freeze-drying, followed by quantitative analysis of energy, fat, carbohydrates, protein (nitrogen content), wet weight, and electrolytes. By offering a clear and reproducible framework, the aim of this guide is to support the broader implementation of MBS as an objective tool for assessing digestive and absorptive capacity in patients with malabsorption.</p>","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"11 ","pages":"100373"},"PeriodicalIF":0.0,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044937","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":"Corrigendum to \"The changing landscape of intestinal transplantation: Insights from the first quarter of the 21st century of Eurotransplant experience\" [Intest Fail 9 (2026) 100349].","authors":"Mando D Filipe, Marit Kalisvaart, Manuel Maglione, Axel Jens, Stipislav Jadrijevic, Jan Willem Haveman, Andreas Pascher, Jacques Pirenne","doi":"10.1016/j.intf.2026.100375","DOIUrl":"https://doi.org/10.1016/j.intf.2026.100375","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1016/j.intf.2025.100349.].</p>","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"11 ","pages":"100375"},"PeriodicalIF":0.0,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13556037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922583","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":"Nutritional status and outcomes throughout the intestinal transplant journey: Experience from the Cambridge Intestinal Transplant Unit.","authors":"Pinal S Patel, Emma McKenzie, Rebecca Maddison, Htar H Hlaing, Irum Amin, Neil Russell, Andrew J Butler, Jeremy M Woodward, Dunecan Co Massey, Lisa M Sharkey, Charlotte S Rutter","doi":"10.1016/j.intf.2026.100370","DOIUrl":"10.1016/j.intf.2026.100370","url":null,"abstract":"<p><strong>Background: </strong>Guidance on the optimum nutritional management of patients receiving intestinal transplants (ITx) is limited. We aimed to i) describe the nutritional management of adult ITx patients in the immediate post-ITx period and ii) examine nutritional status using BMI across the ITx journey.</p><p><strong>Methods: </strong>A retrospective analysis included all adult-recipients of an intestine-containing graft at Addenbrooke's Hospital, Cambridge between 2007 and 2024. Data collected included nutritional routes immediately post-ITx (parenteral nutrition-PN, enteral nutrition-EN and oral feeding-OF) and BMI at ITx and 1 yr post-ITx. Associations between baseline BMI (at-ITx) and 1 yr post-transplant (1yr-ITx) were examined using logistic-regression for the risk of being overweight-obese at 1yr-Tx (BMI:<25 vs. ≥25 kg/m²).</p><p><strong>Results: </strong>166 patients (median age 45 yrs (IQR: 34-53), and 49% female) were included in the study. Duration of PN, EN, and time to OF post-ITx was 24 days (IQR: 14-35); 38days (IQR: 15-82), 13 days (IQR: 9-24), respectively. Median weight loss 3 months post-ITx was 9% of Tx-weight, reducing to 2% at 6 months. In logistic-regression, baseline-BMI (<25 kg/m² vs. ≥25 kg/m²) predicted 1yr-BMI (<25 kg/m² vs. ≥25 kg/m²) [OR:4.9, 95%CI:1.88-12.77], in adjusted analyses. 24% patients with a healthy baseline-BMI became overweight or obese at 1yr-Tx (P < 0.0001).</p><p><strong>Conclusion: </strong>Our study shows that i) weight loss occurs within the first 3 months post-ITx, though mostly re-gained within 6months; ii) post-MVTx oral diet is initiated by 2 weeks; and iii) baseline BMI is the only significant predictor of 1 yr post-ITx BMI. However, 1 in 4 ITx patients with a healthy baseline BMI were observed to become overweight or obese at 1 yr. Further research is required to elucidate what mechanisms lead to the development of obesity after transplant.</p>","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"10 ","pages":"100370"},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937091","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":"Indirect calorimetry compared with predictive equations for resting energy expenditure in patients with intestinal failure.","authors":"Nicola Wyer, Ellen Reynolds, Laura Norrie, Laura Woodend, Holly Richardson, Eleanor Ferguson","doi":"10.1016/j.intf.2026.100374","DOIUrl":"10.1016/j.intf.2026.100374","url":null,"abstract":"<p><strong>Background: </strong>Accurate assessment of energy requirements is essential for patients with intestinal failure (IF) to avoid complications associated with parenteral nutrition. Predictive equations are commonly used in clinical practice to estimate resting energy expenditure (REE), however, evidence supporting their accuracy in IF patients is limited. Indirect calorimetry (IC) is the gold standard for measuring REE but is not routinely available. This study evaluated the agreement between routinely used predictive methods in the UK and IC-measured REE in patients with IF.</p><p><strong>Material and methods: </strong>A service evaluation was conducted at a tertiary IF centre. Adult inpatients with IF had REE estimated using predictive equations based on PENG and ESPEN guidance, followed by IC measurement. Agreement between predicted and measured REE was assessed using mean bias, Bland-Altman analysis, and proportion of estimates within ±10% of IC values. Associations between prediction accuracy and IF aetiology, age, sex, and body mass index (BMI) were explored using ANOVA/linear regression.</p><p><strong>Results and conclusion: </strong>Indirect calorimetry was performed in 91 patients (mean age 55 ± 17.4 years, mean BMI 21.6 ± 5.8 kg/m²). Mean measured REE was 1449 ± 297 kcal/day. Predictive equations showed poor agreement with IC at an individual level, with wide limits of agreement. Mean bias was + 18.6 kcal/day (-585 to +622 kcal/day) for PENG and + 94.9 kcal/day (-620 to +809 kcal/day) for ESPEN. Only 33.7 (PENG) and 30.4% (ESPEN) of estimates were within ±10% of measured REE. Predictive equations are inaccurate in IF patients, supporting routine use of IC to enable precise, individualised energy prescription.</p>","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"11 ","pages":"100374"},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848869","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":"Wet beriberi in intestinal failure due to change from intravenous to enteral supplementation - Time to focus on water-soluble vitamins.","authors":"Benjamin Loel, Julia Fox, Katie Zajac, Looi Ee, Jonathan Hind","doi":"10.1016/j.intf.2026.100372","DOIUrl":"10.1016/j.intf.2026.100372","url":null,"abstract":"<p><strong>Background: </strong>Thiamine deficiency is a rare but life-threatening complication for which children on long term parenteral nutrition (PN) are at higher risk.</p><p><strong>Case report: </strong>We describe a 13-year-old male with intestinal failure secondary to Filamin A mutation who presented with one-week of oedema and orthopnoea. He was fully dependent on PN and his intravenous multivitamin supplementation was replaced with enteral vitamins due to a national shortage. On presentation he was tachycardic, tachypnoeic, hypotensive, and fluid overloaded. Investigations revealed hyponatraemia, hypoalbuminaemia, metabolic acidosis, and a significantly elevated lactate. Chest radiography showed bilateral pleural effusions. Intravenous thiamine and oral vitamin C supplementation led to rapid clinical improvement and testing confirmed low thiamine and vitamin C levels. His presentation was consistent with wet beriberi due to thiamine deficiency.</p><p><strong>Conclusion: </strong>This case highlights the risk of water-soluble vitamin deficiency in PN-dependent children during intravenous vitamin shortages and the need for biochemical monitoring.</p>","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"10 ","pages":"100372"},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848899","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":"Clinicians' attitudes and perceptions of healthcare approaches to environmental sustainability within clinical nutrition: An international survey.","authors":"A Bond, D Cardenas, S Lal","doi":"10.1016/j.intf.2026.100369","DOIUrl":"10.1016/j.intf.2026.100369","url":null,"abstract":"<p><strong>Introduction: </strong>As global awareness of environmental challenges grows, integrating sustainability into clinical nutrition practices is essential to support both human and planetary health. Within healthcare systems internationally there are a number of barriers to enhanced sustainability which need to be understood, in order for them to be overcome.</p><p><strong>Method: </strong>A bespoke questionnaire-based survey was developed and disseminated internationally to healthcare professionals working in the sphere of clinical nutrition. Quantitative and qualitative analysis was performed on the recorded responses. Included within the survey was the Sustainability Attitudes Scale (SAS).</p><p><strong>Results: </strong>A total of 126 responses were collated from 18 countries worldwide. Dietitians comprised the largest represented profession with 35%, followed by doctors 32%. There was a strong opinion that sustainability in a very important aspect of respondents considerations, both in and outside of their working lives. 99% stated they would be in support of changes aimed at making their clinical practice less harmful to the environment. 87% stated that they had never received any formal training in improving sustainability, with a lack of knowledge or experience being recognized as a significant barrier to sustainability focused working practices. 4% stated that it would not be acceptable to consider bearing the potential higher financial cost.</p><p><strong>Conclusion: </strong>The findings highlight a clear enthusiasm among clinical nutrition professionals for integrating sustainability into practice, despite widespread gaps in formal training and knowledge. Addressing these educational and systemic barriers is crucial to empowering healthcare providers to adopt environmentally responsible approaches.</p>","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"10 ","pages":"100369"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13112476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794864","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":"Addressing gaps in pediatric resident education on the management of intestinal failure in the United States: Creation and implementation of a targeted curriculum.","authors":"Sirine Belaid, Maeve Reidy, Kimberly Ackerman, Tracey Campagna, Sarah Fox, Feras Alissa, Jeffrey Rudolph, Vikram Raghu","doi":"10.1016/j.intf.2026.100368","DOIUrl":"10.1016/j.intf.2026.100368","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric residents at our institution manage patients with intestinal failure (IF), but report associated anxiety due to clinical inexperience and lack of formal education in this field. This pilot project aimed to identify knowledge gaps and address them through a targeted educational intervention.</p><p><strong>Methods: </strong>A needs assessment survey was distributed to all pediatric residents via QR codes and email. The survey included Likert-scale, multiple-choice, open-ended, and rating questions to assess confidence in IF-related care. Survey results informed a targeted curriculum that addressed key deficit areas through an in-person lecture, workshops, and a reference guide aligned with residents' preferred learning formats. A post-intervention survey, modeled after the initial assessment, was distributed five months later to evaluate the curriculum's impact.</p><p><strong>Results: </strong>Of the 131 residents, 40 (31%) completed the initial survey. Residents reported lowest confidence (<4/10) in calculating and ordering home Total Parenteral Nutrition (TPN) and TPN-like fluids, understanding remaining anatomy, managing central access loss and poor catheter blood flow, identifying signs of D-lactic acidosis and small intestinal bacterial overgrowth (SIBO), and ensuring proper stoma care. Conversely, they felt more confident managing feeding intolerance and central line-associated infections (5-6/10), and signs of shock (>7/10). Five months post-implementation, twenty residents (15%) completed the post-intervention survey, showing improved confidence in managing IF patients, particularly in TPN management (p = 0.0083) and enteral/stoma care (p = 0.0393). Interest in IF education increased from 64% to 85%.</p><p><strong>Conclusion: </strong>The needs assessment highlighted critical gaps in resident IF education. A targeted, resident-informed curriculum improved confidence and engagement. Next step is national dissemination.</p>","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"10 ","pages":"100368"},"PeriodicalIF":0.0,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731116","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":"High dose fish oil lipid emulsion (FOLE) use in pediatric patients: A case series.","authors":"Sean Coyne, Uyen Le, Margaret Murphy, Kathleen M Gura","doi":"10.1016/j.intf.2026.100367","DOIUrl":"10.1016/j.intf.2026.100367","url":null,"abstract":"<p><p>Intestinal Failure-Associated Liver Disease (IFALD) presents significant challenges in pediatric patients on long-term parenteral nutrition (PN).</p><p><strong>Case report: </strong>We conducted a case series to evaluate safety and efficacy of administering higher dose (2 g/kg/day) Omegaven® (Fresenius Kabi AG, Bad Homburg, Germany), a fish oil-based lipid emulsion (FOLE), in pediatric patients with IFALD. Ten patients at Boston Children's Hospital were found to have received FOLE at 2 g/kg/day. Data was retrospectively collected from electronic health records, including demographics, laboratory values, and treatment outcomes.</p><p><strong>Conclusion: </strong>All patients using higher dose FOLE successfully transitioned to 20-hour PN cycles with FOLE 2 g/kg/day, meeting daily caloric requirements and preventing hypoglycemia. No adverse reactions were reported. For most patients, liver function markers remained within normal limits. Our findings suggest higher dose FOLE can facilitate PN cycling and promote growth. Further studies are warranted to validate these findings and establish optimal dosing for this patient population.</p>","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"10 ","pages":"100367"},"PeriodicalIF":0.0,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641259","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":"Physical function, physical activity, muscle strength, and body composition: Clinical practice recommendations in pediatric intestinal failure and transplantation-position statement of the International Intestinal Rehabilitation and Transplant Association Allied Health Committee.","authors":"Catherine Patterson, Stephanie So, Dianna Yanchis, Taru Palsa, Jemma Mears, Dorsa Fathianpour, Sydney Dempster, Bianca Bondi, Esther Neelis, Christina Belza","doi":"10.1016/j.intf.2026.100366","DOIUrl":"10.1016/j.intf.2026.100366","url":null,"abstract":"<p><strong>Background: </strong>Pediatric survival rates in intestinal failure (IF) and transplant (ITx) have improved over time. However, surgery and prolonged hospitalization can impact motor function and levels of physical activity (PA), which is an essential health behaviour for physical, social, and mental health. This position paper provides clinical recommendations to optimize PA, strength, and exercise in children with IF and ITx.</p><p><strong>Methods: </strong>A working group of the IIRTA Allied Health committee conducted a literature review, identifying relevant articles between 2000 and 2023. Key recommendations were based on scientific evidence and expert-informed opinion.</p><p><strong>Results: </strong>Research indicates children with IF have altered body composition and lower physical function, PA, and muscle strength compared to healthy peers. They also have a higher prevalence of motor delays and an increased risk of sarcopenia pre-and post-ITx. Although exercise can potentially improve these outcomes, parents report unique barriers to PA including central lines and medical appliances. Key recommendations include:1) Early intervention with rehabilitation specialists in hospital and on discharge to the community.2) Education related to PA guidelines including aerobic intensity and strengthening activities.3) Provision of individualized exercise plans with communication and support in school/community settings.4) Ongoing screening at out-patient visits to monitor body composition, strength, and PA and address potential barriers and safety issues.5) Prioritizing multi-center research on PA benefits and effective interventions.</p><p><strong>Conclusions: </strong>This position paper offers actionable steps to optimize physical function, PA, and exercise, and highlights the need for research on exercise efficacy, safety, and intervention in this population.</p>","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"10 ","pages":"100366"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635634","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}