Digestive Diseases最新文献

{"title":"Helicobacter pylori Diagnosis and Treatment in Africa: The First Lagos Consensus Statement of the African Helicobacter and Microbiota Study Group.","authors":"Stella I Smith, Christian Schulz, Rose Ugiagbe, Roland Ndip, Yakhya Dieye, Marcis Leja, Charles Onyekwere, Dennis Ndububa, Abraham Ajayi, Tolulope Funbi Jolaiya, Hyasinta Jaka, Mashiko Setshedi, Revathi Gunturu, Jesse Abiodun Otegbayo, Naima Lahbabi-Amrani, Anthony Oluwole Arigbabu, Violet Kayamba, Pueya Abdulrashid Nashidengo","doi":"10.1159/000537878","DOIUrl":"10.1159/000537878","url":null,"abstract":"<p><strong>Background: </strong>Helicobacter pylori (H. pylori) infection is the most prevalent type of bacterial infection. Current guidelines from different regions of the world neglect specific African conditions and requirements. The African Helicobacter and Microbiota Study Group (AHMSG), founded in 2022, aimed to create an Africa-specific consensus report reflecting Africa-specific issues.</p><p><strong>Summary: </strong>Eighteen experts from nine African countries and two European delegates supported by nine African collaborators from eight other countries prepared statements on the most important African issues in four working groups: (1) epidemiology, (2) diagnosis, (3) indications and prevention, and (4) treatment. Limited resources, restricted access to medical systems, and underdeveloped diagnostic facilities differ from those of other regions. The results of the individual working groups were presented for the final consensus voting, which included all board members.</p><p><strong>Key messages: </strong>There is a need for further studies on H. pylori prevalence in Africa, with diagnosis hinged on specific African situation. Treatment of H. pylori in the African setting should be based on accessibility and reimbursement, while indication and prevention should be defined in specific African countries.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"240-256"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140142998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Risk Factors of Disorders of Gut-Brain Interaction in Undergraduates and Postgraduates: Partially Mediated by Life Stress and Lifestyle.","authors":"Likun Zhong, Yunxiao Liang, Huikuan Chu, Xiujing Zhang, Jingzhi Zhang, Xiaohua Hou, Zhiyue Xu","doi":"10.1159/000539552","DOIUrl":"10.1159/000539552","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the prevalence of disorders of gut-brain interaction (DGBI) and life stress in college students, and explore risk factors of DGBI in college students and the role of life stress.</p><p><strong>Methods: </strong>A total of 2,578 college students filled up validated questionnaires assessing GI symptoms, lifestyle, and life stress. Participants were diagnosed as DGBI based on the Rome III criteria. Multivariate ordinal logistic regression analysis and mediation effect model were employed to explore potential risk factors of DGBI and the mediating role of life stress and lifestyle in DGBI.</p><p><strong>Results: </strong>A total of 437 of 2,578 (17.0%) college students were diagnosed with DGBI. College students with DGBI had higher levels of life stress, including eight specific categories. Females (1.709 [1.437, 2.033]), staying up late (1.519 [1.300, 1.776]), and life stress (1.008 [1.006, 1.010]) were risk factors for DGBI, while postgraduates (0.751 [0.578, 0.976]) and regular diet (0.751 [0.685, 0.947]) were protective factors. Males and poor family economic were associated with a higher risk of DGBI after controlling stress, while an association between grade and DGBI was mediated by stress, regular diet, and sleep habits.</p><p><strong>Conclusion: </strong>DGBI was common among college students. Life stress and lifestyle were associated with DGBI and mediated partial association between grade and DGBI in college students. More attention should be paid to undergraduates.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"391-398"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction Statement.","authors":"","doi":"10.1159/000539915","DOIUrl":"10.1159/000539915","url":null,"abstract":"","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"42 4","pages":"389"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Cirrhotic Patients by the EncephalApp Fails to Predict Low-Grade Hepatic Encephalopathy.","authors":"Rebecca Maria Neye, Gerald Kircheis, Daria Stratmann, Norbert Hilger, Stefan Lüth","doi":"10.1159/000538924","DOIUrl":"10.1159/000538924","url":null,"abstract":"<p><strong>Introduction: </strong>An early detection of low-grade hepatic encephalopathy (HE) is of high importance. The aim of the study was to compare a neuropsychological with a psychophysical test on the basis of the psychometric hepatic encephalopathy score (PHES) regarding effectiveness in diagnosing minimal HE (MHE).</p><p><strong>Methods: </strong>In our prospective controlled observational study, we examined a total of 103 patients with liver cirrhosis for HE. The PHES, CFF, and EncephalApp were performed in all patients. Graduation was based on the result of the PHES. Patients without evidence for HE 1&amp;2 according to the mental state (West-Haven criteria) with a PHES <-4 value points and no clinical symptoms were defined as having MHE. Patients were considered as HE0 when in the PHES none of the psychometric subtest results was abnormal or with a PHES ≥-4 value points. Patients with clinical symptoms were considered HE 1&amp;2 patients. Different cut-off values were determined, and their specificity and sensitivity were calculated.</p><p><strong>Results: </strong>Ninety-six of the involved patients had liver cirrhosis and 25 acted as a healthy control group. The ROC analysis for the classification resulted in an AUC of 0.806, with the highest Youden index for the cut-off time >224 s, for which the sensitivity was 82% and the specificity 75%. Cases of withdrawals were seen in 10.74% of all tested patients.</p><p><strong>Conclusion: </strong>The EncephalApp distinguishes well between HE0 and MHE but has its limitations in grading higher forms of HE. Diagnosis using only the EncephalApp is not sufficient.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"567-575"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological Features of Early Gastric Cancer Complicated by Autoimmune Gastritis.","authors":"Kosuke Nomura, Daisuke Kikuchi, Yusuke Kawai, Yorinari Ochiai, Takayuki Okamura, Yugo Suzuki, Junnosuke Hayasaka, Yutaka Mitsunaga, Hiroyuki Odagiri, Satoshi Yamashita, Akira Matsui, Shu Hoteya","doi":"10.1159/000539639","DOIUrl":"10.1159/000539639","url":null,"abstract":"<p><strong>Introduction: </strong>In the post-Helicobacter pylori era, autoimmune gastritis (AIG) is attracting increasing attention as an origin of gastric cancer. Here, we performed clinicopathological examination of gastric cancer complicating AIG treated in our hospital.</p><p><strong>Methods: </strong>Eighty-six early gastric cancer lesions complicating AIG in 50 patients were treated by endoscopic submucosal dissection (ESD) at our hospital in 2008-2022. Their clinicopathological characteristics were compared with those of a control group comprising 2,978 early gastric cancer lesions (excluding lesions in the remnant stomach after surgery) in 2,278 patients treated by ESD during the same period.</p><p><strong>Results: </strong>Mean age was significantly higher in the AIG group than in the control group (74.7 years vs. 70.9 years; p &lt; 0.01). In the respective groups, the occurrence rate of synchronous/metachronous lesions was 38.0% and 20.4% (p &lt; 0.01), the ratio of longitudinal cancer locations (upper/middle/lower third [U/M/L]) was 27/32/27 and 518/993/1,467 (p &lt; 0.01), the ratio of circumferential cancer locations (lesser curvature/greater curvature/anterior wall/posterior wall) was 25/31/12/18 and 1,259/587/475/657 (p &lt; 0.01), the ratio of major macroscopic types (I/IIa/IIb/IIc) was 13/38/5/30 and 65/881/220/1,812 (p &lt; 0.01). The rates of multiple gastric cancer and cancers in the U region, at the greater curvature, and of protruding types were significantly higher in the AIG group.</p><p><strong>Conclusion: </strong>The occurrence rate of multiple gastric cancer was significantly higher in gastric cancer complicating AIG (approximately 40%), and compared with the control group, the proportions of cancers at the U region, at the greater curvature, and of protruding types were significantly higher.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"407-413"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory Bowel Disease: From Conventional Immunosuppression to Biologic Therapy.","authors":"Aleksandra Sokic-Milutinovic, Tomica Milosavljevic","doi":"10.1159/000535647","DOIUrl":"10.1159/000535647","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel diseases (IBDs) are chronic, recurrent inflammatory diseases with partly understood etiology and pathogenesis. The course of IBD, both ulcerative colitis and Crohn's disease, is characterized by periods of relapse and remission with the possible occurrence of extraintestinal manifestations.</p><p><strong>Summary: </strong>During the last decades, therapeutic goals in IBD evolved toward endoscopic remission and mucosal healing creating the need for early administration of disease-modifying agents (DMAs). DMAs include conventional immunosuppressants (thiopurines, methotrexate), biologic drugs (anti-TNF, anti-integrin, and anti-IL-12/23 monoclonal antibodies), and small molecules (JAK inhibitors, S1P receptor modulators). Patients with aggressive course of disease and risk factors for poor prognosis should be treated with biologic therapy early, while conventional immunomodulators should be used in those with milder course of disease in the absence of risk factors.</p><p><strong>Key messages: </strong>Challenges in the treatment of IBD patients include the choice of effective yet safe drug and prevention or overcoming loss of response.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"325-335"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forty Years of Helicobacter pylori: The African Perspective.","authors":"Hyasinta Jaka, Stella Ifeanyi Smith","doi":"10.1159/000535263","DOIUrl":"10.1159/000535263","url":null,"abstract":"<p><strong>Background: </strong>Helicobacter pylori colonises 50% of the world population and is a causative agent of gastritis, peptic ulcer disease, mucosa associate lymphoid tissue lymphoma and gastric cancer.</p><p><strong>Summary: </strong>In Africa, the prevalence rate has been found to be the highest in comparison to other parts of the world. Despite its high prevalence there are low rates of gastric cancer recorded in Africa. This African perspective gives an insight into the history of H. pylori in Africa and also examines the issue of the so-called \"African Enigma,\" it's diagnosis and treatment and where we are now.</p><p><strong>Key messages: </strong>Our vision is to have an African community that is free from H. pylori infections and complications. To this end, the African Helicobacter and Microbiota Study Group was initiated in 2021 and launched on the June 27, 2022 in Lagos, Nigeria (<ext-link ext-link-type=\"uri\" xlink:href=\"https://ahmsg-africa.org/\" xmlns:xlink=\"http://www.w3.org/1999/xlink\">https://ahmsg-africa.org/</ext-link>). The African perspective includes the need for more detailed information on actual community and hospital prevalence, resistance data, and standardizing processes and algorithms to enable comparative diagnosis and therapy of H. pylori infections using a multi-pronged approach with international support.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"161-165"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138828745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis Value of the Blood Urea Nitrogen-to-Creatinine Ratio in Determining the Need for Intervention of Acute Upper Gastrointestinal Bleeding.","authors":"Hong Liu, Yan Li, Chunliang Liu, Zheng Liu, Kailin Chen","doi":"10.1159/000538366","DOIUrl":"10.1159/000538366","url":null,"abstract":"<p><strong>Introduction: </strong>The blood urea nitrogen (BUN)-to-creatinine (Cr) ratio (BUN/Cr ratio) may be used to evaluate the need for intervention of acute upper gastrointestinal bleeding (AUGIB). This study aimed to explore the predictive value of the BUN/Cr ratio in the need for intervention of AUGIB.</p><p><strong>Methods: </strong>This retrospective observational study included patients with AUGIB in the hospital's emergency department between August 2019 and May 2023. The patients were grouped according to whether they underwent an intervention for AUGIB. Patients treated between August 2019 and May 2022 were selected as the training set and the others as the validation set.</p><p><strong>Results: </strong>A total of 466 patients (328 males, 138 females) with AUGIB were enrolled in the intervention group (n = 167) and the no-intervention group (n = 299). In the training set, multivariable logistic regression showed that the BUN/Cr ratio (odds ratio [OR]: 1.013, 95% confidence interval [CI]: 1.003-1.023, p = 0.009), hemoglobin (OR: 0.989, 95% CI: 0.981-0.997, p = 0.010), and a previous history of esophageal variceal bleeding (OR: 6.898, 95% CI: 3.989-11.929, p &lt; 0.001) were independently associated with intervention for AUGIB. The area under receiver operating characteristic curve of BUN/Cr ratio and the prediction model based on logistic regression to predict the need for intervention of AUGIB were 0.604 (95% CI: 0.544-0.664) and 0.759 (95% CI: 0.706-0.812) in the training set and 0.634 (95% CI: 0.529, 0.740) and 0.708 (95% CI: 0.609, 0.806) in the validation set, respectively.</p><p><strong>Conclusion: </strong>The BUN/Cr ratio was associated with the need for AUGIB intervention. Combining it with other parameters might improve its diagnostic value to predict the need for intervention of AUGIB.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"285-291"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to the Mediterranean Diet Is Associated with Decreased Fecal Calprotectin Levels in Children with Crohn's Disease in Clinical Remission under Biological Therapy.","authors":"Rotem Sigall Boneh, Amit Assa, Raffi Lev-Tzion, Manar Matar, Dror Shouval, Chen Shubeli, Tsachi Tsadok Perets, Gabriel Chodick, Raanan Shamir","doi":"10.1159/000535540","DOIUrl":"10.1159/000535540","url":null,"abstract":"<p><strong>Introduction: </strong>Adherence to the Mediterranean diet (MD) was shown to be associated with decreased disease activity in adult patients with Crohn's disease (CD). Nevertheless, data on its association with fecal calprotectin (FC), particularly in children, remain limited. This study aimed to assess the association between adherence to the MD and FC as an indicator of mucosal healing in patients who are predominantly in remission while undergoing biological therapy.</p><p><strong>Methods: </strong>This was a cross-sectional study among children with CD. Adherence to MD was evaluated using both the KIDMED questionnaire and a food frequency questionnaire (FFQ). Israeli Mediterranean Diet Adherence Screener (I-MEDAS) score was calculated, and FC samples were obtained.</p><p><strong>Results: </strong>Of 103 eligible patients, 99 were included (mean age 14.3 ± 2.6 years; 38.4% females); 88% were in clinical remission, and 30% presented with elevated FC. The mean KIDMED score was higher among patients who had FC &lt;200 μg/g compared to patients with FC &gt;200 μg/g (5.48 ± 2.58 vs. 4.37 ± 2.47, respectively; p = 0.04). A moderate correlation between the KIDMED score and the I-MEDAS score was observed (r = 0.46; p = 0.001). In a multivariate regression analysis, adherence to MD was associated with decreased calprotectin levels, OR 0.75 [95% CI: 0.6-0.95], p = 0.019. Vegetable consumption was found to be inversely associated with elevated FC (0.9 portion/day [0.3-2.9] in FC &gt;200 μg/g vs. 2.2 portions/day [0.87-3.82] in FC &lt;200 μg/g; p = 0.049).</p><p><strong>Conclusions: </strong>In children with CD who are mostly in clinical remission under biological therapy, high adherence to MD is associated with decreased FC levels. Encouraging vegetable consumption, especially during remission, may benefit these patients.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"199-210"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10997263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138476935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mac-2-Binding Protein Glycosylation Isomer to Albumin Ratio Predicts Bacterial Infections in Cirrhotic Patients.","authors":"Pei-Shan Wu, Yun-Cheng Hsieh, Pei-Chang Lee, Tsung-Chieh Yang, Yu-Jen Chen, Ying-Ying Yang, Hui-Chun Huang, Shao-Jung Hsu, Teh-Ia Huo, Kuei-Chuan Lee, Han-Chieh Lin, Ming-Chih Hou","doi":"10.1159/000535325","DOIUrl":"10.1159/000535325","url":null,"abstract":"<p><strong>Introduction: </strong>Mac-2-binding protein glycosylation isomer (M2BPGi) is a novel biomarker for liver fibrosis, but little is known about its role in cirrhosis-associated clinical outcomes. This study aimed to investigate the predictive role of M2BPGi in cirrhosis-associated complications.</p><p><strong>Methods: </strong>One hundred and forty-nine cirrhotic patients were retrospectively enrolled. Patients were followed up for 1 year, and cirrhosis-associated clinical events were recorded. Receiver operating characteristic curve (ROC) analysis was used to establish the values of the predictive models for cirrhotic outcomes, and Cox proportional hazards regression models were used to identify predictors of clinical outcomes.</p><p><strong>Results: </strong>Sixty (40.3%) patients experienced cirrhosis-associated clinical events and had higher M2BPGi levels compared to those without events (8.7 vs. 5.1 cutoff index, p &lt; 0.001). The most common cirrhosis-associated complications were bacterial infections (24.2%). On ROC analysis, M2BPGi to albumin ratio (M2BPGi/albumin) had comparable discriminant abilities for all cirrhosis-associated events (area under the ROC curve [AUC] = 0.74) compared with M2BPGi, Child-Pugh, model for end-stage liver disease, albumin-bilirubin scores, and neutrophil-to-lymphocyte ratio and was superior to M2BPGi alone for all bacterial infectious events (AUC = 0.80). Cox regression analysis revealed that the M2BPGi/albumin, but not M2BPGi alone, independently predicted all cirrhosis-associated events (hazard ratio [HR] = 1.34, p = 0.038) and all bacterial infectious events (HR = 1.51, p = 0.011) within 1 year. However, M2BPGi/albumin did not predict other cirrhotic complications and transplant-free survival.</p><p><strong>Discussion/conclusion: </strong>M2BPGi/albumin might serve as a potential prognostic indicator for patients with cirrhosis, particularly for predicting bacterial infections.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"166-177"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}