Annals of Surgical Oncology最新文献

{"title":"Characteristics and Outcomes of External Referral Patients Undergoing Cytoreductive Surgery at an International Peritoneal Surface Malignancy Program.","authors":"Edward A Joseph, Muhammad Muntazir Mehdi Khan, Catherine Lewis, David L Bartlett, Patrick L Wagner, Casey J Allen","doi":"10.1245/s10434-026-20115-3","DOIUrl":"10.1245/s10434-026-20115-3","url":null,"abstract":"<p><strong>Background: </strong>Peritoneal surface malignancy (PSM) patients often seek care outside their local health systems. Understanding the implications of care for these externally referred patients is critical for optimizing resource allocation and value-based care delivery.</p><p><strong>Patients and methods: </strong>Patients who underwent cytoreductive surgery ± heated intraperitoneal chemotherapy (CRS ± HIPEC) at an international PSM program between 2022 and 2024 were categorized as in-system (IS; referrals within our integrated network) or out-of-system (OOS; referrals from external institutions). Demographic, oncologic, surgical, and financial data were compared.</p><p><strong>Results: </strong>Among 171 patients (mean age: 56 ± 12 years; 57% female; 92% white), 59% (n = 101) were OOS. These patients had higher Peritoneal Carcinomatosis index (PCI) (18.5 [12.0-29.0] versus 13.0 [6.0-18.0]), longer operative time (518 [381-630] min versus 321 [214-490] min), and hospitalizations (14.0 [9.0-21.0] days versus 9.0 [6.0-15.0] days), all p < 0.050. There was no difference in completeness of cytoreduction (CC 0/1: 85.0% OOS versus 87.7% IS, p = 0.626), readmissions (20.8% OOS versus 15.7% IS, p = 0.403), or mortality (4.0% OOS versus 0.0% IS, p = 0.092). OOS patients incurred higher institutional costs (direct: $76,620 [$56,527-$99,072] versus $58,375 [$35,363-$82,635], p < 0.001; indirect: ($30,788 [$20,581-$40,037] versus $20,743 [$12,690-$35,887], p < 0.001). Notably, of 72 (71%) OOS patients previously deemed unresectable at outside institutions, 85% (n = 61) achieved complete and 10% (n = 7) received palliative cytoreduction.</p><p><strong>Conclusions: </strong>OOS patients with PSM present with higher disease burden, require more extensive surgery, and incur higher costs. Yet, most OOS patients previously deemed unresectable were able to achieve complete cytoreduction at a high-volume PSM program.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"10195-10204"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASO Author Reflections: Multi-Modal Prehabilitation and Outcomes After Gastroesophageal Cancer Surgery: A Cohort Study of Pulmonary Complications and Resilience to Major Postoperative Events.","authors":"David S Liu, Jesse Turner, Ashley Bigaran","doi":"10.1245/s10434-026-20480-z","DOIUrl":"10.1245/s10434-026-20480-z","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"10397-10398"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoughts on the Changing Trends of Perioperative Depressive Symptoms: Differences Between Breast/Prostate Cancer and Other Solid Tumors.","authors":"Wei Han, Lei Shi, Chun-Tao Shi","doi":"10.1245/s10434-026-19800-0","DOIUrl":"10.1245/s10434-026-19800-0","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"10768-10769"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of the Novel G-CMAP Score: A Preoperative Scoring System for Predicting Postoperative Complications After Gastrectomy for Gastric Cancer.","authors":"Keisuke Okuno, Masanori Tokunaga, Kei Ishihara, Toyoshi Oda, Toshiro Tanioka, Takashi Shigeno, Taichi Ogo, Kenro Kawada, Hisashi Fujiwara, Yusuke Kinugasa","doi":"10.1245/s10434-026-20350-8","DOIUrl":"10.1245/s10434-026-20350-8","url":null,"abstract":"<p><strong>Background: </strong>Postoperative complications after gastrectomy for gastric cancer (GC) increase mortality and delay recovery. Simple, objective tools for preoperative risk stratification using routine data remain limited. This study aimed to develop a clinically practical risk score to predict postoperative complications from standard preoperative laboratory tests.</p><p><strong>Methods: </strong>The study analyzed the data of 490 patients who underwent curative gastrectomy for GC between January 2017 and September 2025. Preoperative hematologic and biochemical parameters were systematically screened to predict postoperative complications of Clavien-Dindo grade II or higher. A composite predictive scoring system was developed, and model performance was assessed using multivariate logistic regression analysis and bootstrap internal validation.</p><p><strong>Results: </strong>Postoperative complications of Clavien-Dindo grade II or higher occurred for 89 patients (18%). Based on discriminative performance, the C-reactive protein level, monocyte count, serum albumin level, and prothrombin time-international normalized ratio were identified as independent predictors of postoperative complications. An 8-point scoring system, termed the G-CMAP score, was constructed using odds ratio-based weighting. The G-CMAP score demonstrated modest predictive ability (area under the curve, 0.68) and remained an independent predictor in multivariate analysis (odds ratio, 3.42; 95% confidence interval, 2.08-5.61; P < 0.001). Finally, bootstrap internal validation confirmed good discrimination and calibration, with minimal overfitting.</p><p><strong>Conclusions: </strong>The G-CMAP score is a simple and objective blood-based tool that enables modest preoperative prediction of postoperative complications after gastrectomy for GC.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"10445-10453"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transperitoneal Laparoscopic Adrenalectomy for Schwannoma with Severe Renal Vein Adhesion.","authors":"Yuqi Wu, Menjiang Tu, Song Wu, Teng Hou","doi":"10.1245/s10434-026-20336-6","DOIUrl":"10.1245/s10434-026-20336-6","url":null,"abstract":"<p><strong>Background: </strong>Renal hilum neurogenic tumors predominantly comprising schwannomas, ganglioneuromas, and paragangliomas, present formidable surgical challenges owing to their intimate association with the renal pedicle vasculature.¹ Critical difficulties arise from tumor encasement of renal arteries/veins and the anatomical constraints of the hilum \"sandwich\" (tumor-vessel interface spacing often < 1 cm), necessitating precision techniques for complete oncologic resection while preserving renal function.^2,3 Minimally invasive approaches for these complex lesions remain underexplored despite their potential for nephron sparing.</p><p><strong>Patient and methods: </strong>This video presents a 66-year-old male with asymptomatic renal hilar mass detected incidentally during routine surveillance ultrasound. Preoperative computed tomography (CT) demonstrated a 5-cm soft tissue mass with irregular borders, encasing the hilar vessels, and revealed two renal arteries originating from the aorta posterior to the renal vein. The surgical technique emphasized critical refinements: preoperative vascular mapping, sharp tumor enucleation without renal hilar clamping, and silk-loop tagging of the renal artery to preserve vascular integrity.</p><p><strong>Results: </strong>En bloc resection of the tumor with the adrenal gland was completed, ensuring intact surgical margins. Operative time was 115 min, and estimated blood loss was 120 ml. The patient's recovery was uneventful without complications, and he was discharged on postoperative day 2. Final pathology confirmed schwannoma, with negative margins and no recurrence at 12-month follow-up.</p><p><strong>Conclusions: </strong>Transperitoneal laparoscopic resection represents a feasible and nephron-sparing alternative to radical surgery for selecting renal hilar tumors, particularly in cases of solitary kidney or high surgical risk. Success depends on careful preoperative planning, meticulous sharp enucleation, and advanced vascular control techniques.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"10495"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASO Author Reflections: From Feasibility to Implementation: Establishing Indocyanine Green as a Single-Tracer Strategy for Sentinel Lymph Node Biopsy in Breast Cancer.","authors":"Vassilis Pitsinis, Nadia Khitab, Lee Jordan, Alessio Vinci, Rahul Kanitkar, Emad Elseedawy, Jennifer Smith","doi":"10.1245/s10434-026-20444-3","DOIUrl":"10.1245/s10434-026-20444-3","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"10588-10589"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Initial Biopsy Modality and Provider Credentials on Upstaging and Management Changes in Cutaneous Melanoma.","authors":"Amelia Stapleton Van Doren, Hemali Shah, Ruthia Chen, Dia Shah, Samantha King, Lucie Joerg, Ekaterina Sazon, Francisco Alicandri, Aasim Jaffri, Lindy Davis","doi":"10.1245/s10434-026-20386-w","DOIUrl":"10.1245/s10434-026-20386-w","url":null,"abstract":"<p><strong>Background: </strong>A timely, high-quality biopsy is essential for the accurate staging and prompt treatment of invasive cutaneous melanoma. While excisional biopsies are considered to be the gold standard, biopsy techniques vary. In parallel, the proportion of Advanced Practice Providers (APPs) in dermatologic practice has increased. We aimed to evaluate the relationship between biopsy type, deep margin status, and pathologic T (pT) category upstaging on an individual patient level as well as regional biopsy trends stratified by provider credentials.</p><p><strong>Patients and methods: </strong>Medical records of patients referred to our academic center for invasive melanoma treatment from 2017 to 2022 were retrospectively reviewed.</p><p><strong>Results: </strong>Shave biopsies (67%) were most commonly used for diagnosing melanoma and were significantly more likely to yield a positive deep margin (74%) compared with punch (46%) and excisional biopsies (34%). Despite our high overall positive deep margin rate, pT category upstaging (9%) and hypothetical management changes after definitive excision (4%) represented single-digit percentages. Provider-dependent differences in biopsy technique were also observed, with physicians performing significantly more excisional biopsies and APPs performing significantly more punch biopsies.</p><p><strong>Conclusions: </strong>Although excisional biopsy remains the gold standard for melanoma diagnosis, universal excisional biopsy of all suspicious melanocytic lesions is impractical. Our observational findings suggest no significant increase in pT upstaging associated with shave biopsies, supporting their use in appropriate clinical contexts. However, in cases of high clinical suspicion for melanoma, excisional biopsy should be strongly considered to optimize pT staging accuracy and minimize the risk of subsequent management changes.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"10791-10799"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-modal Prehabilitation and Outcomes after Gastroesophageal Cancer Surgery: A Cohort Study of Pulmonary Complications and Resilience to Major Postoperative Events.","authors":"David S Liu, Khang Duy Ricky Le, Jaimee Cacic, Bianca Ukovic, Christie Mellerick, Blake Binion, Greta Ishak, Jesse Turner, Carlene Wilson, Liam Johnson, Neha Suryanarayan, Laurence Weinberg, Marissa Ferguson, Celia Lanteri, Danny Brazzale, Ronald Ma, Amanda Dalyell, Katheryn Hall, Linda Watson, Brooke Chapman, Benjamin Keong, Krinal Mori, Ahmad Aly, Darren Wong, Ashley Bigaran","doi":"10.1245/s10434-026-19934-1","DOIUrl":"10.1245/s10434-026-19934-1","url":null,"abstract":"<p><strong>Background: </strong>Esophago-gastric cancer surgery frequently results in substantial morbidity. Prehabilitation, an approach to optimize an individual's preoperative physical, nutritional, and mental health, may decrease postoperative complications. Here, we present perioperative and allied health findings from a multimodal prehabilitation study (ACTRN12623000183684).</p><p><strong>Methods: </strong>This single-center observational study recruited patients with esophago-gastric cancer undergoing curative-intent treatment between 2017 and 2024. Patients who did and did not receive multimodal prehabilitation were compared. Prehabilitation involved personalized medical, physical, nutritional, and psychological optimization before surgery. The primary endpoint was the rate of postoperative respiratory complications. Secondary endpoints included other postoperative complications and allied health outcomes.</p><p><strong>Results: </strong>In total, 164 participants (control n=121, prehabilitation n=43) underwent esophago-gastric cancer resection. More minimally invasive surgeries were performed in the prehabilitation group, but the baseline characteristics were otherwise similar between groups. Prehabilitation improved physical fitness and decreased malnutrition rates. Importantly, prehabilitation resulted in fewer postoperative respiratory (43.8% vs 20.9%, p=0.010), cardiac (22.3% vs 7.0%, p=0.037), hepatic (9.1% vs 0.0%, p=0.031), and renal (9.9% vs 0.0%, p=0.037) complications than in the control group. Moreover, prehabilitation was associated with diminished intensive care unit stays (median [IQR] 1 day [1.0-6.5] vs 1 day [1.0-3.0]; p=0.005) and hospital stays (14 days [9-24] vs 11 days [8-16]; p<0.001) and higher rates of adjuvant chemotherapy usage (51.0% vs 80.6%, p=0.004). Multivariate and sensitivity analyses demonstrated that prehabilitation, rather than surgical technique (laparoscopic vs open surgery), was independently associated with perioperative outcomes.</p><p><strong>Conclusion: </strong>This study demonstrates that multimodal prehabilitation improves perioperative outcomes for patients with esophago-gastric cancer, thus supporting routine integration of prehabilitation into perioperative care pathways.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"10259-10269"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148366639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival Comparison of Proximal and Total Gastrectomy after Neoadjuvant Therapy in Siewert Type II/III Gastric Adenocarcinoma: A Real-World Multicenter Cohort Study.","authors":"Ze-Lin Wen, Hu Ren, Peng-Hui Niu, Xiao-Jie Zhang, He Fei, Dong-Shuai Jing, Ze-Feng Li, Diliyaer Adili, Hong-Xu Nie, Lei Zhou, De-Chun Liu, Dong-Bing Zhao","doi":"10.1245/s10434-026-19957-8","DOIUrl":"10.1245/s10434-026-19957-8","url":null,"abstract":"<p><strong>Background: </strong>The optimal extent of gastrectomy after neoadjuvant therapy for Siewert II/III gastric adenocarcinoma remains unclear. The objective of this study was to compare survival after proximal versus total gastrectomy and to assess the prognostic impact of distal nodal station metastasis (nos. 4d, 5, 6, and 12a).</p><p><strong>Patients and methods: </strong>We retrospectively analyzed 824 patients with Siewert II/III gastric adenocarcinoma who received neoadjuvant chemotherapy and underwent proximal gastrectomy (PG) or total gastrectomy (TG) at three Chinese centers (2010-2025). Following propensity score matching, survival analysis was performed on a balanced cohort of 518 patients. Overall survival (OS) and progression-free survival (PFS) were assessed using Kaplan-Meier analysis and Cox regression.</p><p><strong>Results: </strong>PG and TG achieved comparable OS and PFS (OS P = 0.54; PFS P = 0.86), with consistent findings across Siewert subtype, pathologic T stage, and TNM stage strata. No significant differences were observed in N0 or N⁺ subgroups. Survival remained similar between procedures regardless of neoadjuvant response or immunotherapy exposure. Metastasis to distal lymph node stations increased with advancing ypTNM stage, particularly in stage III disease. In multivariable analyses, gastrectomy type was not an independent prognostic factor (P = 0.117), whereas advanced pathological stage independently predicted worse survival (all P < 0.05). Other clinicopathologic variables were not independently associated with outcome.</p><p><strong>Conclusions: </strong>PG provides survival comparable to TG after neoadjuvant therapy. The distal key station exhibits a significantly higher metastatic incidence in patients with stage III gastric cancer.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"10661-10674"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Delays in Breast Cancer Surgery Among Patients From Neighboring Hawaiian Islands Treated on O'ahu.","authors":"Doris Yang, Sarah Abdul-Ghani, Marissa Miyagi, Hideko Yamauchi, Ashley Marumoto","doi":"10.1245/s10434-026-20770-6","DOIUrl":"https://doi.org/10.1245/s10434-026-20770-6","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer patients from neighboring Hawaiian Islands face challenges including limited access to specialists and geographic isolation. Surgical delays longer than 8 weeks from diagnosis can negatively impact survival. Time from diagnosis to surgery (TTS) and predictors of delay are unknown for this population.</p><p><strong>Methods: </strong>Retrospective chart review was performed on breast cancer patients from neighboring Hawaiian Islands who underwent upfront surgery on O'ahu categorized as TTS of 8 weeks or longer. Demographic and clinical characteristics were evaluated. Chi-square and Fisher's exact tests were used for categorical analyses. Binary logistic regression adjusted for confounding variables.</p><p><strong>Results: </strong>The study reviewed 221 breast cancer patients (2014-2024) from neighboring Hawaiian Islands. The mean TTS was 9.4 weeks. In the univariate analysis, TTS longer than 8 weeks was associated with post-pandemic diagnosis versus during and before the pandemic (41.8 vs. 16.3 vs. 418%), preoperative diagnostic testing compared with no testing (79.6 vs. 20.4%), plastic surgery consultation compared with no consultation (51.0 vs. 49.0%,), and mastectomy compared with breast-conserving surgery (61.2 vs. 37.8%) (all p < 0.005). Multivariate analysis showed post-pandemic diagnosis (odds ratio [OR], 2.84; 95% CI, 1.15-7.00; p = 0.023), time from biopsy to consultation (OR, 1.32; 95% CI, 1.13-1.56; p < 0.001), and preoperative diagnostic testing (OR, 3.22; 95% CI, 1.27-8.16; p = 0.014) as significant predictors of TTS longer than 8 weeks.</p><p><strong>Conclusion: </strong>Nearly half of neighboring Hawaiian Islands breast cancer patients experienced delay in surgery. Streamlining preoperative management could meaningfully shorten the time from biopsy to surgery and improve access to care and outcomes for this population.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}