Frontiers in Medicine最新文献

{"title":"Bibliometric analysis of pyroptosis in pathogenesis and treatment of acute lung injury.","authors":"Chun Wang, Na Liu","doi":"10.3389/fmed.2024.1488796","DOIUrl":"10.3389/fmed.2024.1488796","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to conduct a bibliometric analysis to assess the present state, thematic focus, and emerging developments in the research literature on the involvement of pyroptosis in the pathogenesis and treatment of acute lung injury (PFALI), as well as other pertinent research areas.</p><p><strong>Methods: </strong>This bibliometric study examined PFALI research published from 1 January 2004 to 24 May 2024, utilizing the Web of Science database. The analysis was conducted using CiteSpace, VOSviewer, R, and GraphPad Prism 8.0, and encompassed metadata on the countries, institutions, authors, journals, and keywords represented in the literature.</p><p><strong>Results: </strong>This study analyzed 1,495 publications, comprising 1,194 articles and 301 reviews, to assess the publication output on PFALI. China exhibited the highest output with 964 (64.48%) articles. Central South University was the most prolific institution, contributing 54 (3.61%) publications. Zhou, Yong had the greatest individual publication record, with 15 (3.59%) articles. The journal International Immunopharmacology published the most PFALI-related articles at 76 (5.09%). The identified research frontiers for upcoming years include \"iron,\" \"sirt1,\" \"repair,\" and \"alveolar macrophage pyroptosis.\"</p><p><strong>Conclusion: </strong>This bibliometric analysis comprehensively examined research trends and advancements related to PFALI, including the contributions of key authors, institutions, and countries.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1488796"},"PeriodicalIF":3.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11794077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of hypertension on liver fibrosis in patients with metabolic dysfunction-associated fatty liver disease.","authors":"Zhifeng Gao, Huan Deng, Bowen Qin, Liang Bai, Jiangwei Li, Jian Zhang","doi":"10.3389/fmed.2025.1539283","DOIUrl":"10.3389/fmed.2025.1539283","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the association between hypertension and the risk of fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD) patients, as well as to investigate the impact of hypertension on the progression of liver fibrosis within this population.</p><p><strong>Methods: </strong>We utilized data from the NHANES 2017 to March 2020. Multivariate logistic regression models were employed to control for sociodemographic and metabolic factors to determine the associations between hypertension, MASLD, and fibrosis.</p><p><strong>Results: </strong>Of the total cohort (<i>N</i> = 5,967) 57.92% had hypertension, 38.8% had MASLD, 25.88% had both MASLD and hypertension. Patients with MASLD were more likely to have hypertension (64.24% vs. 44.80%). There was a significant association between stage I (OR1.70, 95% CI: 1.15-2.53) and stage II hypertension (OR1.98, 95% CI: 1.38-2.85) and an increased risk of SF. After adjusting for multiple confounding factors, stage I (OR1.59, 95% CI: 1.09-2.24) and stage II hypertension (OR1.48, 95% CI: 1.06-2.06) remained significantly associated with the risk of SF. Patients with both MASLD and hypertension had higher rates of SF at 14.83% and AF at 7.47%. After adjusting for sociodemographic factors, those patients still had an 8.02-fold increased risk of SF (OR8.02, 95% CI: 4.47-14.39) and a 15.13-fold increased risk of AF (OR15.13, 95% CI: 7.09-32.3). Further adjustment for metabolic factors, those patients still had a significantly higher risk of SF (OR3.07, 95% CI: 1.83-5.14) and AF (OR4.01, 95% CI: 1.48-10.89).</p><p><strong>Conclusion: </strong>MASLD and hypertension are at risk for fibrosis, and the coexistence of the two has a more significant impact on the risk of fibrosis.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1539283"},"PeriodicalIF":3.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11794791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrauterine death from placental abruption: influence of labor duration and mode of delivery on maternal outcomes.","authors":"Louis Van Hees, Robin Danger, Caroline Turbelin","doi":"10.3389/fmed.2025.1530062","DOIUrl":"10.3389/fmed.2025.1530062","url":null,"abstract":"<p><strong>Introduction: </strong>Intrauterine fetal death (IUFD) caused by retroplacental hematoma (RPH) can lead to serious maternal complications including coagulopathies and hemorrhage. A prolonged diagnostic-to-expulsion delay may increase coagulation risks. Vaginal delivery (VD) prolongs this delay, while cesarean delivery poses higher hemorrhagic risks. This study aimed to assess the relationship between expulsion delay and complications, identify a time threshold for increased risks, and evaluate VD feasibility.</p><p><strong>Material and methods: </strong>We conducted a retrospective single-center study at the University Hospital of Martinique, including all patients presenting with RPH and IUFD between January 2003 and December 2022. Complications were defined by a composite criterion, including the need for blood transfusion, severe anemia or admission to an intensive care unit.</p><p><strong>Results: </strong>VD was attempted in 26 of the 27 patients included and successfully achieved in 85% of the cases. All cesarean deliveries resulted in complications (<i>p</i> = 0.12), with 50% experiencing severe hemorrhage, compared to 21.7% of VD cases (<i>p</i> = 0.23). No statistically significant association was found between the expulsion delay and the occurrence of complications (<i>p</i> = 0.20). A low fibrinogen level upon admission was associated with an increased risk of severe hemorrhage (<i>p</i> = 0.01) and complications (<i>p</i> = 0.01).</p><p><strong>Conclusion: </strong>In this study, no evidence was found to suggest an association between the diagnostic-to-expulsion interval and maternal complications. Low fibrinogen levels at admission appear to be a prognostic factor for severe hemorrhage and could have therapeutic implications. Vaginal delivery remains feasible even in the presence of coagulopathies at admission.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1530062"},"PeriodicalIF":3.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11794112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions and future perspectives of medical students on the use of artificial intelligence based chatbots: an exploratory analysis.","authors":"Juan José Gualda-Gea, Lourdes Estefanía Barón-Miras, Maria Jesús Bertran, Anna Vilella, Isabel Torá-Rocamora, Andres Prat","doi":"10.3389/fmed.2025.1529305","DOIUrl":"10.3389/fmed.2025.1529305","url":null,"abstract":"<p><strong>Background: </strong>Artificial Intelligence (AI) has made a strong entrance into different fields such as healthcare, but currently, medical degree curricula are not adapted to the changes that adopting these types of tools entitles. It is important to understand the future needs of students to provide the most comprehensive education possible.</p><p><strong>Objective: </strong>The aim of this teaching improvement project is to describe the knowledge, attitudes, and perspectives of medical students regarding the application of AI and chatbots with patients, also considering their ethical perceptions.</p><p><strong>Methods: </strong>Descriptive cross-sectional analysis in which the participants were students enrolled in the subject \"Preventive Medicine, Public Health and Applied Statistics\" during the second semester of the 2023/24 academic year, corresponding to the fifth year of the Degree in Medicine at the University of Barcelona. The students were invited to complete a specific questionnaire anonymously and voluntarily, which they could respond to using their mobile devices by scanning a QR code projected on the classroom screen, we used Microsoft Forms to perform the survey.</p><p><strong>Results: </strong>Out of the 61 students enrolled in the subject, 34 (56%) attended the seminar, of whom 29 (85%) completed the questionnaire correctly. Of those completing the questionnaire, 20 (69%) had never used chatbots for medical information, 19 (66%) expressed a strong interest in the practical applications of AI in medicine, 14 (48%) indicated elevated concern about the ethical aspects, 17 (59%) acknowledged potential biases in these tools, and 17 (59%) expressed at least moderate confidence in chatbot-provided information. Notably, 24 (83%) agreed that acquiring AI-related knowledge will be essential to effectively perform their future professional roles.</p><p><strong>Conclusion: </strong>Surveyed medical students demonstrated limited exposure to AI-based tools and showed a mid-level of awareness about ethical concerns, but they recognized the importance of AI knowledge for their careers, emphasizing the need for AI integration in medical education.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1529305"},"PeriodicalIF":3.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11794270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of macular and peripheral ocular microvascular changes after carotid artery revascularization using widefield SS-OCTA.","authors":"Ting Luo, Lu Wang, Li Zhang","doi":"10.3389/fmed.2025.1530867","DOIUrl":"10.3389/fmed.2025.1530867","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate microvascular changes in the macular and peripheral regions, as well as alterations in the foveal avascular zone (FAZ) of the ipsilateral eye using widefield swept-source optical coherence tomography angiography (SS-OCTA) in patients with severe carotid artery stenosis (SCAS) after carotid artery revascularization (CAR).</p><p><strong>Design: </strong>This study employed a prospective study design.</p><p><strong>Methods: </strong>SCAS patients were examined using widefield SS-OCTA, which covered an area of 16 × 16 mm centered on the fovea. These examinations were conducted both before and after CAR to assess changes in retinal and choroidal blood flow in the macular and peripheral regions, as well as alterations in the characteristics of the FAZ.</p><p><strong>Results: </strong>A total of 56 patients and their corresponding 56 ipsilateral eyes were included in this study. In the macular area, a significant increase in the vessel density of the retinal superficial vascular complex (VDRSVC) was found, while a significant decrease was noted in the vessel density of the retinal deep vascular complex (VDRDVC) after CAR. Additionally, both the area and circumference of the FAZ decreased significantly after CAR. In the peripheral regions, significant increases were detected in both VDRSVC and the three-dimensional choroidal vascularity index (3D-CVI) post-CAR.</p><p><strong>Conclusion: </strong>The findings of this study demonstrated that CAR can improve perfusion in both the macular and peripheral fundus and lead to a decreased area and circumference of the FAZ in the ipsilateral eye. The observed decrease in the VDRDVC after CAR may be attributed to microvascular embolization and ischemia within the deep capillary plexus (DCP).</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1530867"},"PeriodicalIF":3.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11794486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Infections in the intensive care unit, volume II.","authors":"Lihui Wang, Bin Lin, Zhongheng Zhang, Yuetian Yu","doi":"10.3389/fmed.2025.1550303","DOIUrl":"10.3389/fmed.2025.1550303","url":null,"abstract":"","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1550303"},"PeriodicalIF":3.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of acute promyelocytic leukemia with myeloid sarcoma of the lumbar spine and literature review.","authors":"Yiwen Du, Kun Yang, Yantao Ling, Ying Zhang, Yuping Gong","doi":"10.3389/fmed.2024.1507716","DOIUrl":"10.3389/fmed.2024.1507716","url":null,"abstract":"<p><p>Acute promyelocytic leukemia (APL) presenting solely as myeloid sarcoma (MS) is extremely rare. This report describes a 53-year-old male who presented with low back pain and a movement disorder in his lower limbs. MRI and PET/CT scans of the lumbar spine revealed an intraspinal mass. Pathological analysis of the surgically resected mass identified it as myeloid in origin. Routine blood tests were unremarkable, and bone marrow smears and immunophenotyping showed no evidence of abnormal myeloblasts or promyelocytes. However, bone marrow aspirates testing for acute leukemia fusion genes by qPCR revealed the presence of the <i>PML::RARA</i> fusion. Further investigation via FISH confirmed the fusion in both the bone marrow and the extramedullary mass. The patient was ultimately diagnosed with isolated promyelocytic extramedullary sarcoma (MS/APL). Treatment with all-trans retinoic acid and arsenic trioxide alleviated the back pain and restored the patient's mobility. After 1 year of consolidation therapy, bone marrow smears confirmed sustained remission, and the <i>PML::RARA</i> fusion gene was undetectable. In addition to this case, we review 41 other APL patients with extramedullary sarcoma as their first symptom (MS/APL) at the time of diagnosis and provide an analysis of these cases.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1507716"},"PeriodicalIF":3.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11794277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baricitinib treatment for hospitalized patients with severe COVID-19 on invasive mechanical ventilation: a propensity score-matched and retrospective analysis.","authors":"Yanxiong Mao, Anyi Guo, Ying Zhang, Jianxing Lai, Dian Yuan, Hao Zhang, Wenqi Diao, Weisong Chen, Fugui Yan","doi":"10.3389/fmed.2025.1445809","DOIUrl":"10.3389/fmed.2025.1445809","url":null,"abstract":"<p><strong>Introduction: </strong>Baricitinib is a selective inhibitor of Janus kinase (JAK)1 and JAK2, which is associated with clinical improvement in non-severe COVID-19 patients. But in severe COVID-19 patients, the effectiveness of baricitinib is still controversial.</p><p><strong>Methods: </strong>A propensity score-matched and retrospective study was conducted to evaluate the effectiveness of baricitinib in severe COVID-19 patients requiring invasive mechanical ventilation (IMV).</p><p><strong>Results: </strong>A total number of 48 patients treated with baricitinib were included, and 48 patients were assigned to control group by propensity score matching. The mean ages were high in both group (baricitinib group vs. control group: 78.80 ± 9.04 vs. 82.57 ± 9.27), and most were unvaccinated (62.5% vs. 66.7%. Baricitinib group had a higher proportion of patients with hypertension (73.9% vs. 45.5%, <i>p</i> = 0.006). Control group had higher level of creatine kinase-myocardial band (247.50 vs. 104.50, <i>p</i> = 0.021). Patients in the baricitinib group were more likely to receive nirmatrelvir/ritonavir (39.6% vs. 16.7%, <i>p</i> = 0.017) and intravenous immunoglobin (14.6% vs. 0, <i>p</i> = 0.007). Baricitinib group had significantly lower all-cause 28-days mortality than control group (72.9% vs. 89.6%, <i>p</i> = 0.004).</p><p><strong>Conclusion: </strong>The present study revealed baricitinib reduced 28-days mortality in severe COVID-19 patients on IMV. The effectiveness of baricitinib in treating patients with severe COVID-19 on IMV needs to be further investigated through future studies.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1445809"},"PeriodicalIF":3.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11794113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging applications of NLP and large language models in gastroenterology and hepatology: a systematic review.","authors":"Mahmud Omar, Salih Nassar, Kassem SharIf, Benjamin S Glicksberg, Girish N Nadkarni, Eyal Klang","doi":"10.3389/fmed.2024.1512824","DOIUrl":"10.3389/fmed.2024.1512824","url":null,"abstract":"<p><strong>Background and aim: </strong>In the last years, natural language processing (NLP) has transformed significantly with the introduction of large language models (LLM). This review updates on NLP and LLM applications and challenges in gastroenterology and hepatology.</p><p><strong>Methods: </strong>Registered with PROSPERO (CRD42024542275) and adhering to PRISMA guidelines, we searched six databases for relevant studies published from 2003 to 2024, ultimately including 57 studies.</p><p><strong>Results: </strong>Our review of 57 studies notes an increase in relevant publications in 2023-2024 compared to previous years, reflecting growing interest in newer models such as GPT-3 and GPT-4. The results demonstrate that NLP models have enhanced data extraction from electronic health records and other unstructured medical data sources. Key findings include high precision in identifying disease characteristics from unstructured reports and ongoing improvement in clinical decision-making. Risk of bias assessments using ROBINS-I, QUADAS-2, and PROBAST tools confirmed the methodological robustness of the included studies.</p><p><strong>Conclusion: </strong>NLP and LLMs can enhance diagnosis and treatment in gastroenterology and hepatology. They enable extraction of data from unstructured medical records, such as endoscopy reports and patient notes, and for enhancing clinical decision-making. Despite these advancements, integrating these tools into routine practice is still challenging. Future work should prospectively demonstrate real-world value.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1512824"},"PeriodicalIF":3.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-related immunosenescence and Epstein-Barr virus-positive mucocutaneous ulcer presenting as oral cancer: a case report.","authors":"Jiayuan Ye, Shengqiang Ji, Zhouxiao Wu, Genhua Ma, Jing Chen, Shimin Wu, Yilian Xie","doi":"10.3389/fmed.2024.1458606","DOIUrl":"10.3389/fmed.2024.1458606","url":null,"abstract":"<p><p>Epstein-Barr virus-positive mucocutaneous ulcer (EBVMCU) is a rare condition characterized by skin or mucosal lesions resulting from defective immune surveillance of EBV due to immunosuppression, which can be iatrogenic or age-related. It represents a benign lymphoproliferative disorder that clinically may mimic malignant tumors. However, EBVMCU typically progresses slowly and often resolves spontaneously without specific treatment, emphasizing the critical need for differential diagnosis from malignancies. In this study, we report a case of EBVMCU in an elderly patient demonstrating ulcers on the oral mucosa, buccal area, and maxillary mucosa, with associated bone destruction, which was initially suspected to be an oral malignancy but was confirmed as EBVMCU through biopsy. This case underscores the importance of considering EBVMCU in elderly patients with unexplained persistent mucosal ulcers to exclude malignancies. In addition, attention should be given to unhealthy lifestyle habits such as smoking and drinking, as well as poor oral hygiene, which are potential factors that increase the risk of this disease and contribute to worse prognoses.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"11 ","pages":"1458606"},"PeriodicalIF":3.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}