Ginekologia polska最新文献

{"title":"Letrozole in ectopic pregnancy: exploring a promising frontier in non-surgical therapy - a narrative review.","authors":"Rashad Mammadov, Lara Sawah, Ismet Gun","doi":"10.5603/gpl.108493","DOIUrl":"https://doi.org/10.5603/gpl.108493","url":null,"abstract":"<p><strong>Background: </strong>Ectopic pregnancy (EP) is a potentially life-threatening condition affecting 1-2% of pregnancies, traditionally managed via surgical or methotrexate (MTX)-based medical approaches. However, MTX is associated with significant systemic side effects and potential impairment of ovarian reserve. Aromatase inhibitors (AIs), particularly letrozole, have recently emerged as promising fertility-preserving alternatives.</p><p><strong>Objective: </strong>To synthesize and evaluate the available evidence regarding the efficacy, safety, and mechanistic rationale for the use of letrozole in the medical management of EP, and to compare outcomes with those of conventional MTX therapy.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, ScienceDirect, and Web of Science was conducted for English-language studies published from 1990 to April 2025. Eligible studies included randomized trials, prospective cohorts, or case reports that evaluated letrozole, MTX, or their combination for the treatment of tubal ectopic pregnancy and reported extractable clinical outcomes. Descriptive statistics and chi-square tests were used for comparative analysis.</p><p><strong>Results: </strong>Seven studies met the inclusion criteria, encompassing 249 patients treated with letrozole and 206 with MTX. The overall treatment success rate was 74.7% for letrozole and 80.1% for MTX (p = 0.172), with comparable surgical intervention rates (13.1% vs 13.4%, p = 0.941). The highest success rate with letrozole (90.5%) was observed with a 10-day 5 mg twice-daily regimen. Combination therapy with MTX and letrozole demonstrated superior outcomes (90.6% success, 9.4% surgery) compared to monotherapy. Letrozole was associated with minimal side effects and no observed detriment to ovarian reserve.</p><p><strong>Conclusion: </strong>Letrozole represents a safe, non-cytotoxic alternative to MTX for managing selected cases of unruptured ectopic pregnancy, particularly in fertility-conscious populations. While current evidence is encouraging, further randomized controlled trials are essential to establish optimal dosing regimens, long-term reproductive outcomes, and treatment algorithms.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841750","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":"The efficacy of microbiome transplantation in treating vaginosis and its impact on vaginosis recurrence: a meta-analysis of randomized controlled trials.","authors":"Shanshan Yang, Chuang Guo, Jingxin Zhang, Ming Ma, Jinlong Tian, Yixiang Zhang","doi":"10.5603/gpl.106234","DOIUrl":"https://doi.org/10.5603/gpl.106234","url":null,"abstract":"<p><strong>Objectives: </strong>Bacterial vaginosis (BV) is a recurrent condition with significant health implications. Microbiome transplantation has emerged as a potential treatment strategy. This meta-analysis assesses its efficacy in treating vaginosis and preventing recurrence.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating microbiome transplantation for vaginosis treatment were conducted. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for short- and long-term efficacy. Sensitivity and publication bias analyses were performed.</p><p><strong>Results: </strong>In the short-term follow-up, microbiome transplantation significantly reduced vaginosis recurrence (pooled RR = 0.628, 95% CI: 0.543-0.726, p < 0.001). However, heterogeneity was moderate (I² = 60.8%). Sensitivity analyses confirmed the robustness of findings. Long-term follow-up results showed a pooled RR of 0.746 (95% CI: 0.670-0.831, p < 0.001), though with higher heterogeneity (I² = 72.8%). After sensitivity adjustments, meta-analysis yielded a pooled RR of 0.865 (95% CI: 0.735-1.019, p = 0.083), suggesting reduced long-term efficacy. No significant publication bias was detected.</p><p><strong>Conclusions: </strong>Microbiome transplantation effectively reduces short-term vaginosis recurrence. However, long-term efficacy diminishes upon sensitivity adjustment, necessitating further investigation.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687190","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":"The association between percentage body fat and lipid profiles in different phenotypes of PCOS.","authors":"Dagmara Pluta, Jakub Daniluk, Tahar Ben Rhaiem, Roksana Biskup, Zofia Szota, Pawel Prus, Maciej Migacz","doi":"10.5603/gpl.108116","DOIUrl":"https://doi.org/10.5603/gpl.108116","url":null,"abstract":"<p><strong>Objectives: </strong>Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder linked to metabolic disturbances and increased cardiovascular risk. While the Rotterdam criteria classify PCOS into distinct phenotypes, the impact of percentage body fat (PBF) on lipid profiles across these subtypes remains unclear. This study aims to assess whether the association between PBF and lipid parameters differs among PCOS phenotypes. The research question is: \"Does the relationship between PBF and lipid profile vary across PCOS phenotypes defined by the Rotterdam criteria?\".</p><p><strong>Material and methods: </strong>A cross-sectional analysis was conducted on 343 PCOS patients, categorized into four phenotypes using the Rotterdam criteria. Body composition was assessed using bioelectrical impedance analysis (InBody 170). Clinical and laboratory data were analyzed to explore phenotype-specific metabolic differences.</p><p><strong>Results: </strong>Results show that higher PBF correlates with adverse lipid profiles, including elevated triglycerides (TG) and low-density lipoproteins (LDL) levels and decreased high-density lipoproteins (HDL) levels. Phenotype A exhibited the strongest inverse relationship between PBF and HDL, while Phenotype D showed the most pronounced positive correlation between PBF and triglycerides. These findings highlight the heterogeneity in metabolic risk among Rotterdam phenotypes of PCOS patients.</p><p><strong>Conclusions: </strong>There is phenotype-specific association between PBF and lipid components in PCOS. Phenotype A is particularly vulnerable to HDL reduction, while phenotype D shows the strongest triglyceride elevation. This study underscores the importance of individualized management strategies targeting body fat reduction to improve lipid profiles and reduce cardiovascular risk in PCOS patients. Specific interventions tailored based on phenotype and body composition may optimize treatment outcomes.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665060","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":"Diminished ovarian reserve (DOR) - a step-by-step overview of the IVF procedure based on current knowledge.","authors":"Jakub Wyroba, Magdalena Imiolek, Andzelika Krol-Mika, Kamil Kiecka, Teresa Wojtowicz, Katarzyna Kostarczyk, Joanna Kochan","doi":"10.5603/gpl.112176","DOIUrl":"https://doi.org/10.5603/gpl.112176","url":null,"abstract":"<p><p>Review of current knowledge of the in vitro fertilization (IVF) procedure in patients with diminished ovarian reserve (DOR). Patients with DOR who undergo IVF require special care and an individualized approach due to the poor prognosis. The IVF procedure is multi-stage, and each step should be carefully planned, with treatments tailored to DOR patients. The review article was prepared based on an analysis of the latest research findings and ESHRE recommendations for all stages of in vitro fertilization in patients with DOR. The article discusses the results of 32 articles published over the last 5 years, including 23 articles published in 2024-2026. Clinical stages such as prediction of ovarian reserve, hormonal stimulation of the ovaries, and embryo transfer, and laboratory stages such as the quality and quantity of obtained oocytes and embryos, results of preimplantation genetic testing (PGT-A), and finally implantation potential and live birth rate in DOR patients were discussed.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623172","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":"The evaluation of pharmacotherapy in endometriosis: changes, challenges and difficulties.","authors":"Monika Kopec, Agnieszka Wankowicz, Ivan Golubka, Jan Kotarski, Marek Gogacz","doi":"10.5603/gpl.111016","DOIUrl":"https://doi.org/10.5603/gpl.111016","url":null,"abstract":"<p><strong>Objectives: </strong>Endometriosis presents a multitude of challenges for individuals. Current treatment of the disease is based on pharmacotherapy that aims to relieve pain, improves future fertility, potentially slows disease progression and lessen the likelihood of recurrence. The present review outlines recent reports on the importance of Gonadotropin-Releasing Hormone antagonists/antagonists and a new prospective as a significant second- line treatment option.</p><p><strong>Material and methods: </strong>A review of the literature from the last 5 years was conducted. The search included the following medical subject: \"endometriosis\", \"GnRh agonists\", \"GnRh antagonists\", \"pharmacotherapy\".The articles published in English were included. Publications without full text access and duplicates were rejected.</p><p><strong>Results: </strong>Current researches no longer focuse exclusively on finding new GnRH agonists/antagonists, but rather on maximizing their usage, in favour of the latter ones . Multiple active substances are now being combined into one tablet, which makes it easier for patients to take their medication and improves their adherence to treatment recommendations. 24 months monotherapy of linzagolix did not indicate any clinically relevant impact on overall bone condition in comparison to placebo group. Relugolix combination therapy maintained bone mass density over two years while effectively alleviating pain symptoms.</p><p><strong>Conclusions: </strong>Despite being effective, all of treatments may have additional negative effects. The best approach to pharmacotherapy depends on the individual patient's needs and circumstances. Taking into consideretion potential effects, an appropriate dose or a combination of the above options should be performed. The treatment options of Relugolix and Linzagolix are both promising and well-tolerated. Further researches should focuse on long-term bone health monitoring strategies and its safety profile.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364449","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":"Identification and validation of novel marker genes to predict potential gestational diabetes mellitus patients by WGCNA and machine learning.","authors":"Shasha Yu, Huayun Tan","doi":"10.5603/gpl.101605","DOIUrl":"10.5603/gpl.101605","url":null,"abstract":"<p><strong>Objectives: </strong>To identify novel marker genes to predict potential gestational diabetes mellitus (GDM) patients.</p><p><strong>Material and: </strong>METHODS: Based on Gene Expression Omnibus (GEO) datasets, the differentially expressed genes (DEGs) between control and GDM were identified, followed by enrichment analysis and protein-protein interaction (PPI) network construction. Then, Weighted gene co-expression network analysis (WGCNA) was conducted to screen the key module genes, then the important genes were obtained. In addition, Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression, Support Vector Machine - Recursive Feature Elimination (SVM-RFE), and random forest (RF) were employed to identify the key genes. Receiver operating characteristic (ROC) analysis was performed to assess the diagnostic efficacy of key genes, and a nomogram was developed. The correlation between key genes and immune cells was analyzed, and miRNA-mRNA-TF network was constructed.</p><p><strong>Results: </strong>A total of 257 DEGs were screened between control and GDM groups, and these DEGs were involved in p53 signaling pathway, cell cycle and oocyte meiosis pathways. Then PPI network was constructed, including 163 nodes and 5502 interaction relationships. After WGCNA and machine learning, a total of 4 key genes were obtained, including SNRPD3, NGDN, ANKRD36 and TAS2R20, followed by a nomogram was constructed. SNRPD3 was positively correlated with CD8 T cells. miRNA-mRNA-TF network was conducted, including 56 miRNAs, 4 mRNAs, and 32 TFs. Besides, luteolin PC3 UP, alsterpaullone PC3 UP, and solanine HL60 UP were associated with NGDN, and MeIQx CTD 00001739 was related to TAS2R20.</p><p><strong>Conclusions: </strong>Four key marker genes for predicting potential GDM were identified, including SNRPD3, NGDN, ANKRD36 and TAS2R20, and a nomogram was established for predicting potential GDM patients.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":"261-271"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338402","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":"Eclampsia - stairway to heaven.","authors":"Szymon Bednarek, Michal Migda, Estera Mieczkowska, Malgorzata Swiatkowska-Freund, Krzysztof Preis","doi":"10.5603/gpl.104931","DOIUrl":"10.5603/gpl.104931","url":null,"abstract":"","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":"344-345"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517611","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":"3D ultrasound mesh position and long-term outcomes after TVT surgery.","authors":"Arif Onur Atay, Ismail Mete Itil, Ahmet Ozgur Yeniel, Feride Atay","doi":"10.5603/gpl.108193","DOIUrl":"10.5603/gpl.108193","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the long-term outcomes after tension-free vaginal tape (TVT) surgery and examined whether 3D transvaginal ultrasound (US) mesh position parameters (providing multiplanar visualization and improved measurement reproducibility compared with 2D imaging) are associated with urinary symptoms and quality-of-life changes in women with stress urinary incontinence (SUI). We hypothesized that mesh position would correlate with long-term patient-reported outcomes.</p><p><strong>Material and methods: </strong>In this retrospective cohort, 30 women underwent TVT surgery for SUI between 2012 and 2014 at a tertiary referral center. In 2024, at a median follow-up of 11 years (interquartile range [IQR] 10-12), all patients had clinical evaluation, completed the Urinary Distress Inventory-6 (UDI-6), Incontinence Impact Questionnaire-7 (IIQ-7), and Overactive Bladder Questionnaire Short Form (OAB-q SF), and underwent 3D transvaginal US to measure total urethral length, mesh-to-bladder neck distance, mesh-to-midurethra ratio, and minimal mesh-to-urethral lumen distance. Preoperative and follow-up scores were compared using paired t-tests or Wilcoxon signed-rank tests. Correlations between mesh parameters and score changes were analyzed with Spearman's correlation.</p><p><strong>Results: </strong>Long-term treatment success was achieved in all patients, with negative postoperative stress tests and no retreatment. UDI-6, IIQ-7, and OAB-q SF scores improved significantly from baseline (p < 0.001 for all). No mesh erosion occurred. De novo overactive bladder (OAB) developed in six patients (20%). No strong correlations were found between mesh parameters and score changes (all |ρ| < 0.30).</p><p><strong>Conclusions: </strong>TVT surgery provided excellent long-term outcomes with sustained symptom and quality-of-life improvement. Mesh position measured by 3D US at long-term follow-up was not strongly associated with patient-reported outcomes.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":"97 5","pages":"369-374"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207279","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":"Endometriosis in adolescent: a review of current diagnostic and therapeutic guidelines and expert consensus.","authors":"Katarzyna Wilk-Sikora, Agnieszka Drosdzol-Cop","doi":"10.5603/gpl.110361","DOIUrl":"10.5603/gpl.110361","url":null,"abstract":"<p><strong>Objectives: </strong>Endometriosis is a widespread gynecological condition characterized by the presence of endometrial like tissue outside the uterine cavity. According to the literature, the frequency of endometriosis in adolescents remains unclear; however, studies suggest that histologically confirmed disease may be present in up to 47% of girls with chronic pelvic pain (CPP) and in nearly 70% of girls with primary dysmenorrhoea unresponsive to nonsteroidal anti-inflammatory drugs (NSAIDs) or hormonal therapy. The aim of this study was to review and compare current diagnostic and therapeutic recommendations and expert consensus for adolescent endometriosis.</p><p><strong>Material and methods: </strong>A descriptive qualitative review of the clinical guidelines and expert consensus statements by the American College of Obstetricians and Gynecologists (ACOG), the European Society of Human Reproduction and Embryology (ESHRE), the North American Society for Pediatric and Adolescent Gynecology (NASPAG), and the Polish Society of Gynecologists and Obstetricians (PTGiP) was conducted. NASPAG guaidance present a textbook-based expert consensus and was included due to the limited availability of high-quality evidence in adolescent populations.</p><p><strong>Results: </strong>Adolescent endometriosis remains underrecognized and insufficiently studied. Current clinical guidelines and expert consensus statements emphasize the importance role of through symptom assessment and detailed medical history in the diagnostic process. The reviewed literature supports a clinical diagnosis based on symptoms presentations and response to hormonal therapy, without routine laparoscopic confirmation.</p><p><strong>Conclusions: </strong>Endometriosis in adolescents requires an age-specific diagnostic and therapeutic process. Adherence to current clinical guidelines and expert consensus may help reduce diagnostic delays, limit unnecessary invasive procedures, and improve long-term quality of life.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":"146-153"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954724","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":"Impact of single blastocyst selection strategy on pregnancy outcomes in frozen embryo transfer.","authors":"Jiao Xu, Ning Yang, Huaiyun Tang","doi":"10.5603/gpl.105798","DOIUrl":"10.5603/gpl.105798","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the impact of cleavage stage embryo ratings on pregnancy outcomes following frozen embryo transfer (FET) and their correlation with blastocyst grades.</p><p><strong>Material and methods: </strong>A retrospective cohort study was conducted on 854 FET cycles from January 2018 to August 2024. Participants were women undergoing FET with cryopreserved embryos. Exclusion criteria included multiple initial in vitro fertilization (IVF) attempts, advanced age, chromosomal abnormalities, and uterine anomalies. Embryo quality was assessed at the cleavage and blastocyst stages, and FET protocols were tailored to each patient. The primary outcome was clinical pregnancy rate, defined by ultrasound-detected fetal heartbeat. Data was analyzed using SPSS 19.0, with logistic regression to adjust for confounders.</p><p><strong>Results: </strong>The overall pregnancy rate was 53.98% (461/854). Significant differences in pregnancy rates were observed among blastocyst grades, with Grade 1 achieving the highest rate (60.37%). Lower cleavage stage embryo grades (Grade 3 and Grade 4) were associated with reduced pregnancy odds (OR = 0.63 and OR = 0.50, respectively, p < 0.05). Other factors influencing pregnancy outcomes included female age and anti-Müllerian hormone (AMH) levels. The study underscores the importance of cleavage stage embryo ratings, particularly for Grade 2 embryos, in the context of FET procedures using ovulation induction cycle (OIC) and intracytoplasmic sperm injection (ICSI).</p><p><strong>Conclusions: </strong>Cleavage stage embryo ratings significantly affect pregnancy outcomes following FET. Higher ratings correlate with better pregnancy rates, highlighting the importance of comprehensive embryo quality assessment.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":"312-317"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147380195","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}