Pub Date : 2026-01-01DOI: 10.1016/j.jaip.2025.11.016
Melody C. Carter MD , Magdalena Lange MD, PhD , Ivan Alvarez-Twose MD, PhD , Joanna Renke MD , Cristina Morales-Cabeza MD , Horacio Caligaris MD , Karin Hartmann MD
Mastocytosis is characterized by mast cell infiltration in various tissues and organs. More than half of the patients are children. Pediatric mastocytosis has several features that differentiate the disease from adult mastocytosis. Importantly, the disease, which usually starts in the first months of life or at birth, often shows a transient course with spontaneous resolution in adolescence. In most children, mastocytosis is limited to skin. Cutaneous involvement can present as maculopapular cutaneous mastocytosis, mostly with the polymorphic variant, cutaneous mastocytoma, or diffuse cutaneous mastocytosis. When children present with monomorphic maculopapular skin lesions, the variant typically seen in adults, this may indicate rare persistent disease until adulthood, often associated with systemic mastocytosis. Many pediatric patients suffer from symptoms of mast cell activation, ranging from pruritus to flushing and blistering. Children with cutaneous mastocytosis typically exhibit mutations in various regions of the KIT gene, whereas those with systemic disease predominantly carry KIT D816V. Diagnosis is mainly based on noninvasive measures, including skin inspection, elicitation of the Darier's sign, and analyses of the serum tryptase and KIT variant in blood. Treatment options encompass avoidance of triggers of mast cell activation, H1 and H2 antihistamines, cromolyn, and omalizumab. In children with systemic mastocytosis, tyrosine kinase inhibitors tailored to the specific KIT variant may be considered.
{"title":"Management of Mastocytosis and Mast Cell Activation in Children","authors":"Melody C. Carter MD , Magdalena Lange MD, PhD , Ivan Alvarez-Twose MD, PhD , Joanna Renke MD , Cristina Morales-Cabeza MD , Horacio Caligaris MD , Karin Hartmann MD","doi":"10.1016/j.jaip.2025.11.016","DOIUrl":"10.1016/j.jaip.2025.11.016","url":null,"abstract":"<div><div>Mastocytosis is characterized by mast cell infiltration in various tissues and organs. More than half of the patients are children. Pediatric mastocytosis has several features that differentiate the disease from adult mastocytosis. Importantly, the disease, which usually starts in the first months of life or at birth, often shows a transient course with spontaneous resolution in adolescence. In most children, mastocytosis is limited to skin. Cutaneous involvement can present as maculopapular cutaneous mastocytosis, mostly with the polymorphic variant, cutaneous mastocytoma, or diffuse cutaneous mastocytosis. When children present with monomorphic maculopapular skin lesions, the variant typically seen in adults, this may indicate rare persistent disease until adulthood, often associated with systemic mastocytosis. Many pediatric patients suffer from symptoms of mast cell activation, ranging from pruritus to flushing and blistering. Children with cutaneous mastocytosis typically exhibit mutations in various regions of the KIT gene, whereas those with systemic disease predominantly carry <em>KIT</em> D816V. Diagnosis is mainly based on noninvasive measures, including skin inspection, elicitation of the Darier's sign, and analyses of the serum tryptase and KIT variant in blood. Treatment options encompass avoidance of triggers of mast cell activation, H1 and H2 antihistamines, cromolyn, and omalizumab. In children with systemic mastocytosis, tyrosine kinase inhibitors tailored to the specific KIT variant may be considered.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 1","pages":"Pages 30-42"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jaip.2025.11.003
Tang Li MD, Tao Yu MD
{"title":"Reappraising self-harm risk linked to leukotriene receptor antagonists and inhaled corticosteroids","authors":"Tang Li MD, Tao Yu MD","doi":"10.1016/j.jaip.2025.11.003","DOIUrl":"10.1016/j.jaip.2025.11.003","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 1","pages":"Page 320"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jaip.2025.08.013
Salman Siddiqui MBBS, PhD , Christopher Brightling FMedSci , Dave Singh MD , Janwillem Kocks MD, PhD , Leonardo M. Fabbri MD , Alberto Papi MD , Klaus F. Rabe MD, PhD , Marielle van der Deijl MSc , Maarten van den Berge MD, PhD , Monica Kraft MD
Small airway dysfunction (SAD) is both common and clinically relevant in patients with asthma. However, there is no recognized "gold standard" approach for the identification of SAD in clinical practice. The ATLANTIS (AssessmenT of smalL Airways involvemeNT In aSthma) study was a prospective (1-year follow-up), multicenter, international observational study that aimed to identify the best, or best combination of biomarkers, physiological tests, and imaging markers for the determination of the presence of SAD, and to evaluate the contribution of SAD across all asthma severities to meaningful clinical asthma outcomes. A large number of analyses from the ATLANTIS study have been conducted or are planned. This narrative review summarizes the key findings to date and the future directions. Perhaps the most important finding so far is that a "toolbox" of spirometry, oscillometry, and a small airways dysfunction questionnaire can detect SAD with high accuracy (area under the receiver operating characteristic curve 0.96 and positive likelihood ratio 12.8). Further, collaboration with other consortia has demonstrated the use of oscillometry to identify asthma phenotypes. We advocate the adoption of the ATLANTIS toolbox into interventional studies in asthma—and if validated, this could form a useful part of research and daily clinical practice.
{"title":"Detecting Small Airways Dysfunction in Asthma: Rationale, Findings, and Future of ATLANTIS","authors":"Salman Siddiqui MBBS, PhD , Christopher Brightling FMedSci , Dave Singh MD , Janwillem Kocks MD, PhD , Leonardo M. Fabbri MD , Alberto Papi MD , Klaus F. Rabe MD, PhD , Marielle van der Deijl MSc , Maarten van den Berge MD, PhD , Monica Kraft MD","doi":"10.1016/j.jaip.2025.08.013","DOIUrl":"10.1016/j.jaip.2025.08.013","url":null,"abstract":"<div><div>Small airway dysfunction (SAD) is both common and clinically relevant in patients with asthma. However, there is no recognized \"gold standard\" approach for the identification of SAD in clinical practice. The ATLANTIS (AssessmenT of smalL Airways involvemeNT In aSthma) study was a prospective (1-year follow-up), multicenter, international observational study that aimed to identify the best, or best combination of biomarkers, physiological tests, and imaging markers for the determination of the presence of SAD, and to evaluate the contribution of SAD across all asthma severities to meaningful clinical asthma outcomes. A large number of analyses from the ATLANTIS study have been conducted or are planned. This narrative review summarizes the key findings to date and the future directions. Perhaps the most important finding so far is that a \"toolbox\" of spirometry, oscillometry, and a small airways dysfunction questionnaire can detect SAD with high accuracy (area under the receiver operating characteristic curve 0.96 and positive likelihood ratio 12.8). Further, collaboration with other consortia has demonstrated the use of oscillometry to identify asthma phenotypes. We advocate the adoption of the ATLANTIS toolbox into interventional studies in asthma—and if validated, this could form a useful part of research and daily clinical practice.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 1","pages":"Pages 56-66"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jaip.2025.10.049
Shamsa Naveed MBBS, MRCP (London), PhD
Obesity is one of the most prevalent comorbidities in adults with asthma and is consistently associated with greater symptom burden, reduced response to inhaled corticosteroids, and increased health care use. Despite this, structured obesity management remains an uncommon feature of routine asthma care. The study by Olayiwola et al,1 “Management of patients with comorbid asthma and obesity: a large language model evaluation of clinical documentation,” offers a timely and thought-provoking lens on this persistent gap between evidence and practice.
{"title":"Unlocking Asthma Control: Integrating Obesity Management Through Artificial Intelligence–Driven Insight","authors":"Shamsa Naveed MBBS, MRCP (London), PhD","doi":"10.1016/j.jaip.2025.10.049","DOIUrl":"10.1016/j.jaip.2025.10.049","url":null,"abstract":"<div><div>Obesity is one of the most prevalent comorbidities in adults with asthma and is consistently associated with greater symptom burden, reduced response to inhaled corticosteroids, and increased health care use. Despite this, structured obesity management remains an uncommon feature of routine asthma care. The study by Olayiwola et al,<span><span><sup>1</sup></span></span> “Management of patients with comorbid asthma and obesity: a large language model evaluation of clinical documentation,” offers a timely and thought-provoking lens on this persistent gap between evidence and practice.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 1","pages":"Pages 151-152"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jaip.2025.11.019
James G. Krings MD, MSc , Hannu Kankaanranta MD, PhD
{"title":"Rethinking High-Dose Inhaled Corticosteroid Therapy in Asthma: When More Is Not Better","authors":"James G. Krings MD, MSc , Hannu Kankaanranta MD, PhD","doi":"10.1016/j.jaip.2025.11.019","DOIUrl":"10.1016/j.jaip.2025.11.019","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 1","pages":"Pages 136-137"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jaip.2025.09.018
Johannes Lübke MD , Nicole Naumann PhD , Vito Dangelo MD , Alice Fabarius PhD , Georgia Metzgeroth MD , Hans-Peter Horny MD , Karl Sotlar MD , Wolf-Karsten Hofmann MD , Martina Rudelius MD , Juliana Schwaab MD , Andreas Reiter MD
Background
Leukocytosis, monocytosis, and eosinophilia (L/M/E) are recurrent findings in systemic mastocytosis (SM).
Objective
To investigate the prevalence of L/M/E in SM and assess their association with clinical phenotype, mutational profile, and overall survival (OS) in advanced SM (AdvSM).
Methods
Within the German Registry on Disorders of Eosinophilia and Mast Cells, 596 patients with SM (91% KIT D816V positive; 270 AdvSM, 326 non-AdvSM) were analyzed for L/M/E.
Results
In comparison with non-AdvSM, patients with AdvSM had significantly higher leukocyte (median 9.4 vs 6.9 × 109/L), monocyte (median 0.7 vs 0.5 × 109/L), and eosinophil counts (median 0.3 vs 0.1 × 109/L; all P < .001), with the highest counts (leukocytes: 10.2 × 109/L, monocytes: 0.9 × 109/L, and eosinophils: 0.3 × 109/L; all P < .001) being observed in SM with associated hematologic neoplasm (SM-AHN). High counts of L/M/E correlated with an increased number of additional somatic mutations (P = .012, P < .001, and P = .020), with monocytosis being specially associated with mutations in ASXL1 (odds ratio [OR]: 2.91; 95% confidence interval [CI]: 1.5-5.8), SRSF2 (OR: 2.2; 95% CI: 1.2-4.0), and TET2 (OR: 2.2; 95% CI: 1.2-4.0). In AdvSM, optimal OS cutoff values based on maximally selected rank statistics were ≥16.8 × 109/L for leukocytosis (median OS: 1.6 vs 4.7 years, P < .001), ≥1.1 × 109/L for monocytosis (2.9 vs 4.8 years, P < .001), and ≥1.5 × 109/L for eosinophilia (1.7 vs 5.0 years, P < .001). Monocytosis and/or eosinophilia defined a 3-tiered risk model (median OS: 1.60 vs 3.04 vs 6.94 years, P < .001).
Conclusions
Elevated counts of L/M/E are indicative of AdvSM and within AdvSM associated with additional somatic mutations, a subtype of SM-AHN and poor prognosis.
背景：白细胞增多症、单核细胞增多症和嗜酸性粒细胞增多症（L/M/E）是系统性肥大细胞增多症（SM）的反复表现。目的：探讨L/M/E在SM中的患病率，并评估其与晚期SM （AdvSM）临床表型、突变谱和总生存期（OS）的关系。方法：在德国嗜酸性粒细胞增多和肥大细胞疾病登记处（GREM）中，对596例SM患者（91%的KIT D816V阳性；270例AdvSM， 326例非AdvSM）进行L/M/E分析。结果：与非AdvSM相比，AdvSM患者的白细胞（中位数为9.4 vs. 6.9×109/L）、单核细胞（中位数为0.7 vs. 0.5×109/L）和嗜酸性粒细胞计数(中位数为0.3 vs. 0.1×109/L；所有P9/L，单核细胞：0.9×109/L，嗜酸性粒细胞：0.3×109/L；白细胞增多症的P9/L(中位OS: 1.6 vs. 4.7年，单核细胞增多症的P9/L （2.9 vs. 4.8年），嗜酸性粒细胞增多症的P9/L （1.7 vs. 5.0年）。结论：L/M/E计数升高表明AdvSM和AdvSM内与额外的体细胞突变、SM-AHN亚型和不良预后相关。
{"title":"Leukocytosis, Monocytosis, and Eosinophilia in Systemic Mastocytosis: Analysis of Phenotype, Genetics and Prognosis in 596 Patients From the GREM Registry","authors":"Johannes Lübke MD , Nicole Naumann PhD , Vito Dangelo MD , Alice Fabarius PhD , Georgia Metzgeroth MD , Hans-Peter Horny MD , Karl Sotlar MD , Wolf-Karsten Hofmann MD , Martina Rudelius MD , Juliana Schwaab MD , Andreas Reiter MD","doi":"10.1016/j.jaip.2025.09.018","DOIUrl":"10.1016/j.jaip.2025.09.018","url":null,"abstract":"<div><h3>Background</h3><div>Leukocytosis, monocytosis, and eosinophilia (L/M/E) are recurrent findings in systemic mastocytosis (SM).</div></div><div><h3>Objective</h3><div>To investigate the prevalence of L/M/E in SM and assess their association with clinical phenotype, mutational profile, and overall survival (OS) in advanced SM (AdvSM).</div></div><div><h3>Methods</h3><div>Within the German Registry on Disorders of Eosinophilia and Mast Cells, 596 patients with SM (91% <em>KIT</em> D816V positive; 270 AdvSM, 326 non-AdvSM) were analyzed for L/M/E.</div></div><div><h3>Results</h3><div>In comparison with non-AdvSM, patients with AdvSM had significantly higher leukocyte (median 9.4 vs 6.9 × 10<sup>9</sup>/L), monocyte (median 0.7 vs 0.5 × 10<sup>9</sup>/L), and eosinophil counts (median 0.3 vs 0.1 × 10<sup>9</sup>/L; all <em>P</em> < .001), with the highest counts (leukocytes: 10.2 × 10<sup>9</sup>/L, monocytes: 0.9 × 10<sup>9</sup>/L, and eosinophils: 0.3 × 10<sup>9</sup>/L; all <em>P</em> < .001) being observed in SM with associated hematologic neoplasm (SM-AHN). High counts of L/M/E correlated with an increased number of additional somatic mutations (<em>P</em> = .012, <em>P</em> < .001, and <em>P</em> = .020), with monocytosis being specially associated with mutations in <em>ASXL1</em> (odds ratio [OR]: 2.91; 95% confidence interval [CI]: 1.5-5.8), <em>SRSF2</em> (OR: 2.2; 95% CI: 1.2-4.0), and <em>TET2</em> (OR: 2.2; 95% CI: 1.2-4.0). In AdvSM, optimal OS cutoff values based on maximally selected rank statistics were ≥16.8 × 10<sup>9</sup>/L for leukocytosis (median OS: 1.6 vs 4.7 years, <em>P</em> < .001), ≥1.1 × 10<sup>9</sup>/L for monocytosis (2.9 vs 4.8 years, <em>P</em> < .001), and ≥1.5 × 10<sup>9</sup>/L for eosinophilia (1.7 vs 5.0 years, <em>P</em> < .001). Monocytosis and/or eosinophilia defined a 3-tiered risk model (median OS: 1.60 vs 3.04 vs 6.94 years, <em>P</em> < .001).</div></div><div><h3>Conclusions</h3><div>Elevated counts of L/M/E are indicative of AdvSM and within AdvSM associated with additional somatic mutations, a subtype of SM-AHN and poor prognosis.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 1","pages":"Pages 103-113.e9"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
“Treatable traits” (TT) have been proposed as a new paradigm for asthma but never applied to anaphylaxis. Hymenoptera venom–induced anaphylaxis (HVA) is one of the leading causes of anaphylaxis worldwide.
Objective
Our aim was to propose TT for HVA based on evidence-based data.
Methods
This is a historic-prospective study based on the Hymenoptera venom–induced allergy and hypersensitivity database fed regularly by allergists at the Montpellier University hospital. Patients were classified as having “mild anaphylaxis” (MA), “moderate-severe anaphylaxis” (MSA), or “nonanaphylaxis” (NA), following Ring and Messmer Severity Score, and characteristics have been evaluated for each group. The potential risk factors have been classified as modifiable/controllable (MCRF) and nonmodifiable (NRF), and TT have been proposed from a preventive perspective.
Results
Of overall 602 patients, 54.2% were men, with a mean age of 42.3 years. A total of 218 patients (36.2%) developed MA, 159 (26.4%) MSA, and 213 (35.4%) NA. Age and atopic and cardiovascular diseases were identified as significant NRF. Symptoms appeared within 5 minutes (P < .01) and less than 1 hour in MSA. Skin tests and in vitro ves v5 (P < .0355) were significant and sensitive tools for the diagnosis. Occupational exposure (30%), along with the use of adrenaline, and venom immunotherapy were considered MCRF.
Conclusions
Our results brought the evidence to TT through HVA data and tailored adapted preventive strategies to all severity degrees of HVA. This article based on real-life data is a wake-up call for actions. Step forward implementation of actions among specialists and the general population should be put in place to reduce the morbimortality induced by HVA.
{"title":"Treatable Traits of Hymenoptera Venom–Induced Anaphylaxis: A Real-Life–Based Study","authors":"Audrey Kamga MD , Jean Luc Bourrain MD , Pascal Demoly MD, PhD , Luciana Kase Tanno MD, PhD","doi":"10.1016/j.jaip.2025.10.045","DOIUrl":"10.1016/j.jaip.2025.10.045","url":null,"abstract":"<div><h3>Background</h3><div>“Treatable traits” (TT) have been proposed as a new paradigm for asthma but never applied to anaphylaxis. Hymenoptera venom–induced anaphylaxis (HVA) is one of the leading causes of anaphylaxis worldwide.</div></div><div><h3>Objective</h3><div>Our aim was to propose TT for HVA based on evidence-based data.</div></div><div><h3>Methods</h3><div>This is a historic-prospective study based on the Hymenoptera venom–induced allergy and hypersensitivity database fed regularly by allergists at the Montpellier University hospital. Patients were classified as having “mild anaphylaxis” (MA), “moderate-severe anaphylaxis” (MSA), or “nonanaphylaxis” (NA), following Ring and Messmer Severity Score, and characteristics have been evaluated for each group. The potential risk factors have been classified as modifiable/controllable (MCRF) and nonmodifiable (NRF), and TT have been proposed from a preventive perspective.</div></div><div><h3>Results</h3><div>Of overall 602 patients, 54.2% were men, with a mean age of 42.3 years. A total of 218 patients (36.2%) developed MA, 159 (26.4%) MSA, and 213 (35.4%) NA. Age and atopic and cardiovascular diseases were identified as significant NRF. Symptoms appeared within 5 minutes (<em>P</em> < .01) and less than 1 hour in MSA. Skin tests and <em>in vitro</em> ves v5 (<em>P</em> < .0355) were significant and sensitive tools for the diagnosis. Occupational exposure (30%), along with the use of adrenaline, and venom immunotherapy were considered MCRF.</div></div><div><h3>Conclusions</h3><div>Our results brought the evidence to TT through HVA data and tailored adapted preventive strategies to all severity degrees of HVA. This article based on real-life data is a wake-up call for actions. Step forward implementation of actions among specialists and the general population should be put in place to reduce the morbimortality induced by HVA.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 1","pages":"Pages 260-273"},"PeriodicalIF":6.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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