Reumatologia clinica最新文献

{"title":"Can we predict the risk factors for switching due to ineffectiveness in the first year of therapy with bDMARD in patients with rheumatoid arthritis?","authors":"Ana Martins ,&nbsp;Sofia Pimenta ,&nbsp;Daniela Oliveira ,&nbsp;Rafaela Nicolau ,&nbsp;Alexandra Bernardo ,&nbsp;Teresa Martins Rocha ,&nbsp;Lúcia Costa ,&nbsp;Miguel Bernardes","doi":"10.1016/j.reumae.2024.07.008","DOIUrl":"10.1016/j.reumae.2024.07.008","url":null,"abstract":"<div><h3>Introduction</h3><p>Biological disease-modifying antirheumatic drugs (bDMARD) have improved the clinical course and quality of life of patients with rheumatoid arthritis (RA). However, some patients failed to respond or have an insufficient response to bDMARD early in the course of the treatment.</p></div><div><h3>Objectives</h3><p>To determine the percentage of RA patients who need to switch due to ineffectiveness in the first year of treatment and to identify specific baseline features as possible predictors of switch due to ineffectiveness in the first year of treatment.</p></div><div><h3>Materials and methods</h3><p>An observational retrospective study was conducted with patients with RA that started their first bDMARD. Demographic data, disease characteristics, disease activity data scores, laboratory parameters and treatment at baseline were collected. The proportion of patients who failed to respond and who switched to another bDMARD in the first year of treatment was calculated.</p></div><div><h3>Results</h3><p>A total of 437 (364 females, 83.3%) patients with RA were included. The majority of these patients started an anti-TNF-α agent (<em>n</em> <!-->=<!--> <!-->315, 72.1%). Forty-eight (11.0%) patients failed to respond to the bDMARD in the first year of treatment. There were significantly more current or former smokers (<em>p</em> <!-->=<!--> <!-->0.030), with a history of depression (<em>p</em> <!-->=<!--> <!-->0.003) and positive for RF at baseline (<em>p</em> <!-->=<!--> <!-->0.014) in the switch group.</p><p>In the multivariate analysis, anti-TNF-α agents use (OR 8.3, 95% CI 2.4–28.8, <em>p</em> <!-->=<!--> <!-->0.001), tobacco exposure (OR 2.3, 95% CI 1.1–4.8, <em>p</em> <!-->=<!--> <!-->0.02) and history of depression (OR 3.1, 95% CI 1.3–7.7) seem to predict the need to switch in the first year of treatment due to ineffectiveness.</p></div><div><h3>Discussion and conclusion</h3><p>In our study, tobacco exposure and depression appear to be modifiable risk factors associated with early switching due to ineffectiveness. Addressing these factors in daily clinical practice is crucial to enhance the overall response to therapy and improve the well-being of patients.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 7","pages":"Pages 380-385"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997571","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":"Cytokine storm in Chikungunya: Correspondence","authors":"H. Daungsupawong ,&nbsp;V. Wiwanitkit","doi":"10.1016/j.reumae.2024.07.009","DOIUrl":"10.1016/j.reumae.2024.07.009","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 7","pages":"Page 401"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997572","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":"Autoimmunity in patients with inborn errors of immunity: A case series","authors":"","doi":"10.1016/j.reumae.2024.06.001","DOIUrl":"10.1016/j.reumae.2024.06.001","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the prevalence of systemic and organ-specific autoimmunity among individuals with human inborn errors of immunity (IEI).</p></div><div><h3>Methods</h3><p>Retrospective study. We recorded demographic variables, type of immunodeficiency, and systemic and organ specific autoimmunity.</p></div><div><h3>Results</h3><p>We included 48 patients (54.1% men) with mean age of 32.1 years. The most common IEIs included combined immunodeficiency<span><span> with syndromic features (31.2%) and predominantly antibody deficiency (20.1%). We observed autoimmunity in 15 patients (31.2%): 12 organ-specific autoimmunity and 5 </span>systemic autoimmunity<span>, not mutually exclusive groups. Organ-specific autoimmunity preceded the onset of IEI in 5 patients, was concurrent in one patient, and developed after the diagnosis of IEI in 6 cases. From the systemic autoimmunity group, we observed polyarteritis nodosa (n = 2), antiphospholipid syndrome (APS) (n = 2), and overlap of limited systemic sclerosis/APS/Sjögren's syndrome (n = 1), and in all cases, this occurred after the IEI diagnosis.</span></span></p></div><div><h3>Conclusion</h3><p><span>Our findings confirm the coexistence of autoimmunity and IEI. This overlap may be attributed to B and T cell disorders, as well as potential alterations in the </span>microbiota in these patients.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 7","pages":"Pages 398-400"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545728","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":"Can microvascular damage predict disease severity in patients with systemic sclerosis?","authors":"Ana Martins ,&nbsp;Sofia Pimenta ,&nbsp;Daniela Oliveira ,&nbsp;Raquel Miriam Ferreira ,&nbsp;Miguel Bernardes ,&nbsp;Lúcia Costa ,&nbsp;Georgina Terroso","doi":"10.1016/j.reumae.2024.07.006","DOIUrl":"10.1016/j.reumae.2024.07.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Systemic sclerosis (SSc) is characterized by progressive fibrosis of the skin and internal organs, microvascular damage and cellular and humoral immunity abnormalities. Microvascular damage can be easily detected through nailfold videocapillaroscopy (NVC).</p></div><div><h3>Materials and methods</h3><p>A retrospective study of patients with SSc and a NVC performed within the first 6 months after diagnosis was conducted. Visceral involvement in the first 3 years of the disease and NVC findings were collected. The severity of microvascular damage was classified into four categories, according to the worsening of the NVC patterns. The severity of organ involvement was assessed by the disease severity scale of Medsger for each organ and as a global measure of disease severity, the simple summation was used.</p></div><div><h3>Results</h3><p>A total of 86 patients with SSc were included. A moderate correlation was found between the severity of microvascular damage and the global measure of disease severity (<em>r</em> <!-->=<!--> <!-->0.55, <em>p</em> <!-->&lt;<!--> <!-->0.001), the severity of peripheral vascular involvement (<em>r</em> <!-->=<!--> <!-->0.43, <em>p</em> <!-->&lt;<!--> <!-->0.001) and the severity of skin involvement (<em>r</em> <!-->=<!--> <!-->0.34, <em>p</em> <!-->=<!--> <!-->0.001).</p><p>The presence of a late scleroderma pattern in NVC were predictive in univariate analysis of digital ulcers (OR 6.03, 95% CI 1.52–23.86, <em>p</em> <!-->=<!--> <!-->0.01), muscular involvement (OR 13.09, 95% CI 1.09–156.78, <em>p</em> <!-->=<!--> <!-->0.04), calcinosis (OR 27.22, 95% CI 5.56–133.33, <em>p</em> <!-->&lt;<!--> <!-->0.001) and worse global disease severity score (OR 1.67, 95% CI 1.17–2.38, <em>p</em> <!-->=<!--> <!-->0.005). Multivariate analysis adjusted for disease duration and gender confirmed late pattern as an independent predictor of calcinosis (OR 42.89, 95% CI 5.53–332.85, <em>p</em> <!-->&lt;<!--> <!-->0.001).</p></div><div><h3>Discussion and conclusion</h3><p>In this study, the worsening of NVC pattern in SSc was associated with the overall disease severity, the severity of peripheral vascular involvement and extension of skin involvement. This study highlights the importance of NVC as a prognostic tool and a possible predictor of systemic visceral involvement.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 7","pages":"Pages 366-371"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997614","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":"Exploring the link between inflammatory myopathies and cancer: A comprehensive retrospective analysis in a Colombian cohort","authors":"Juan D. Bolaños ,&nbsp;Robert Rivera-Londoño ,&nbsp;Leidy Johanna Hurtado-Bermúdez ,&nbsp;Ivana Nieto-Aristizábal ,&nbsp;Karol D. Enriquez ,&nbsp;Santiago Zura-Rodríguez ,&nbsp;Andrés Hormaza-Jaramillo ,&nbsp;David Aguirre-Valencia","doi":"10.1016/j.reumae.2024.07.004","DOIUrl":"10.1016/j.reumae.2024.07.004","url":null,"abstract":"<div><h3>Background</h3><p>This study investigates the association between inflammatory myopathies (IM), and their correlation with cancer. There are several potential causes behind the association of cancer and inflammatory myopathies. The positivity of specific antibodies for myositis plays a significant role. Our objective is to describe cancer and inflammatory myopathies in Colombia, focusing on demographics, clinical characteristics, and laboratory data.</p></div><div><h3>Methods</h3><p>We retrospectively analyzed 112 IM patients diagnosed at Fundación Valle del Lili in Cali, Colombia, the cases met the EULAR/ACR criteria. Data included demographics, clinical signs, laboratory findings, and malignancy. Malignancy associations were explored using logistic regression. The survival analysis was assessed using Kaplan–Meier curves and the Log-Rank test.</p></div><div><h3>Results</h3><p>Dermatomyositis was the most common subtype (45.5%), with a female predominance (66.1%). Cancer diagnosis occurred in 11.6% of cases, predominantly thyroid cancer. The median time from myopathy onset to cancer diagnosis was 11 months, with 75% of cases within the first year. Bivariate analysis indicated associations between cancer and age, Gottron's papules, digital ulcers, and heliotrope rash. However, multivariate analysis identified age as the only significant malignancy risk factor. Survival analysis showed better rates in younger patients.</p></div><div><h3>Conclusion</h3><p>This study provides into the link between IM and cancer in the Colombian population. Thyroid cancer predominated, with a slightly higher proportion of female cancer diagnoses. Age emerged as a significant risk factor for malignancy. Understanding this association is crucial for early detection and improving patient outcomes related to IM-associated malignancies.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 7","pages":"Pages 353-359"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141998263","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":"Biomarkers: how to consolidate them in clinical practice","authors":"María Jesús García de Yébenes Prous,&nbsp;Loreto Carmona Ortells","doi":"10.1016/j.reumae.2024.07.002","DOIUrl":"10.1016/j.reumae.2024.07.002","url":null,"abstract":"<div><p>An inadequate biomarker validation can affect many patients' diagnosis, treatment, and follow-up. Therefore, special interest should be placed on performing these analyses correctly so that biomarkers can be applicable to patients and evidence of their clinical usefulness can be generated. A methodological work on the concept of biomarkers is presented, as well as the difficulties associated with the methodological approach to their development, validation, and implementation in clinical practice.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 7","pages":"Pages 386-391"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617801","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":"VEXAS syndrome: A 2-case series report","authors":"Adrián Mayo-Juanatey ,&nbsp;María José Fernández-Llavador ,&nbsp;María del Mar Fernández-Garcés ,&nbsp;Elia Valls-Pascual ,&nbsp;Juan José Alegre-Sancho","doi":"10.1016/j.reumae.2024.05.006","DOIUrl":"10.1016/j.reumae.2024.05.006","url":null,"abstract":"<div><p>VEXAS syndrome is a rare entity secondary to UBA1 gene mutations, located on the X chromosome. This mutation generates, as a consequence, a characteristic vacuolation on haematopoietic stem-cells. It is characterized by multiple autoinflammatory and haematologic manifestations, which respond and end up being dependent on corticosteroid treatment. In this publication we present a 2-case series diagnosed at our hospital and make a brief literature review of the published evidence so far.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 6","pages":"Pages 341-344"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452584","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":"Serum leukemia inhibitory factor (LIF) levels in patients with Takayasu's and Giant cell arteritis: A cross-sectional study","authors":"Rahime Aksoy ,&nbsp;Tahsin Murat Turgay ,&nbsp;Recep Yilmaz ,&nbsp;Serdar Sezer ,&nbsp;Müçteba Enes Yayla ,&nbsp;Emine Uslu Yurteri","doi":"10.1016/j.reumae.2024.02.013","DOIUrl":"https://doi.org/10.1016/j.reumae.2024.02.013","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>In this study, we aimed to evaluate LIF levels and its possible relationship with disease activity in patients with Takayasu's (TAK) and Giant cell arteritis (GCA) patients.</p></div><div><h3>Materials and methods</h3><p>23 Takayasu's arteritis, 9 Giant cell arteritis patients and 25 healthy volunteers were included in the study. Serum LIF levels were measured ELISA.</p></div><div><h3>Results</h3><p>The mean age of Giant cell arteritis patients was statistically significantly higher than the other groups (<em>p</em> <!-->&lt;<!--> <!-->0.001). The rate of women was found to be higher in Takayasu's arteritis (<em>p</em> <!-->=<!--> <!-->0.021). When healthy control, patients with GCA and Takayasu arteritis were compared, there was a difference in LIF values (<em>p</em> <!-->=<!--> <!-->0.018). In subgroup analyzes, LIF values were found to be higher in GCA patients compared to healthy controls (<em>p</em> <!-->&lt;<!--> <!-->0.05). There was no statistically significant correlation between LIF and CRP (Rho<!--> <!-->=<!--> <!-->−0.038, <em>p</em> <!-->=<!--> <!-->0.778), ESR (Rho<!--> <!-->=<!--> <!-->0.114, <em>p</em> <!-->=<!--> <!-->0.399) and ITAS (Rho<!--> <!-->=<!--> <!-->−0.357, <em>p</em> <!-->=<!--> <!-->0.094). While CRP was statistically significantly higher in patients with disease activity (<em>p</em> <!-->=<!--> <!-->0.003), there was no statistically significant difference between patients in terms of ESR and LIF values. While there was a statistically significant relationship between CRP (OR<!--> <!-->=<!--> <!-->1.19 [1.03–1.37], <em>p</em> <!-->=<!--> <!-->0.018) and disease activity in univariate analyses, no statistically significant variable was found in multivariable analyses.</p></div><div><h3>Conclusions</h3><p>LIF values were significantly higher in patients with Giant cell arteritis compared to healthy controls.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 6","pages":"Pages 287-290"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582073","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":"Approach to interstitial lung disease associated with systemic sclerosis—A survey to pulmonologists and rheumatologists in Colombia","authors":"Javier Leonardo Galindo ,&nbsp;Olga Milena García ,&nbsp;Diana Rocío Gil ,&nbsp;Luis Javier Cajas ,&nbsp;Emily Rincón-Álvarez ,&nbsp;Manuela Rubio","doi":"10.1016/j.reumae.2023.12.010","DOIUrl":"https://doi.org/10.1016/j.reumae.2023.12.010","url":null,"abstract":"<div><h3>Introduction</h3><p>Interstitial lung disease is a leading cause of mortality in patients with systemic sclerosis. Currently, there is a lack of consensus regarding screening, rescreening, diagnosis, and follow-up practices in interstitial lung disease associated with systemic sclerosis (SSc-ILD) in Colombia.</p></div><div><h3>Methods</h3><p>A structured survey focused on clinical practices in patients with SSc-ILD was conducted. Members of the Asociación Colombiana de Neumología y Cirugía de Tórax (Asoneumocito) and the Asociación Colombiana de Reumatología (Asoreuma) were invited to participate from March 2023 to May 2023.</p></div><div><h3>Results</h3><p>We surveyed 51 pulmonologists and 44 rheumatologists. Overall, 51.6% reported having access to multidisciplinary team discussion in ILD. Among the 95 participants, 78.9% would routinely perform a high-resolution computed tomography scan of the chest once a diagnosis of systemic sclerosis was established. This practice is more frequent among rheumatologists (84.1%) than among pulmonologists (74.5%). Approximately half of the participants would rescreen patients annually with computed tomography scan (56.8%) if baseline images were negative.</p><p>Spirometry (81.1%), diffusing capacity of the lung for carbon monoxide (80.0%), and 6-min walk test (55.8%) were the most frequently performed tests upon diagnosis of systemic sclerosis. During follow-up, participants would consider repeating pulmonary function tests mostly every 6 months.</p></div><div><h3>Conclusions</h3><p>Screening of SSc-ILD is high among pulmonologists and rheumatologists. Decision-making on diagnosis and follow-up is similar between specialties, but there are variations in their frequency and indications. Further research is needed to evaluate how to adapt recommendations for assessing SSc-ILD in different settings.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 6","pages":"Pages 334-340"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582548","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":"Development of a care protocol in pregnancy and chronic inflammatory arthritis, in a multidisciplinary work group","authors":"Andrea Pluma ,&nbsp;Laia Alsina ,&nbsp;Estefanía Moreno ,&nbsp;Rafael Touriño ,&nbsp;Manel Casellas ,&nbsp;Dolors Grados ,&nbsp;Grup de Treball de Societat Catalana de Reumatologia FEMCAT","doi":"10.1016/j.reumae.2024.03.001","DOIUrl":"10.1016/j.reumae.2024.03.001","url":null,"abstract":"<div><h3>Objective</h3><p>To design a care protocol in Chronic Inflammatory Arthritis during the pre-conceptional period, pregnancy, postpartum and lactation. This protocol aims to be practical and applicable in consultations where patients with chronic inflammatory rheumatological diseases are treated, thus helping to better control these patients. Likewise, recommendations are offered on when patients could be consulted/referred to a specialized center by the physician.</p></div><div><h3>Methods</h3><p>A multidisciplinary panel of expert physicians from different specialties identified the key points, analyzed the scientific evidence, and met to develop the care protocol.</p></div><div><h3>Results</h3><p>The recommendations prepared have been divided into three blocks: rheumatology, gynecology and pediatrics. The first block has been divided into pre-pregnancy, pregnancy and postpartum visits.</p></div><div><h3>Conclusions</h3><p>This protocol tries to homogenize the follow-up of the patients from the moment of the gestational desire until the year of life of the infants. It is important to perform tests in patients of childbearing age and use drugs compatible with pregnancy. If appropriate, the patient should be referred to specialized units. Multidisciplinarity (rheumatology, gynecology and pediatrics) is essential to improve the control and monitoring of these patients and their offspring.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 6","pages":"Pages 320-325"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452583","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}