International Urology and Nephrology最新文献

{"title":"Prevalence, risk factors, and severity of erectile dysfunction following renal transplantation.","authors":"Adelina Miron, Ionuț Nistor, Corneliu Moroșanu, Lucian Sirițeanu, Catalin Pricop, Dragos Puia, Adrian Covic","doi":"10.1007/s11255-024-04299-9","DOIUrl":"10.1007/s11255-024-04299-9","url":null,"abstract":"<p><strong>Background: </strong>Sexual dysfunction is common among dialysis and transplant patients. Our study evaluated the prevalence, risk factors, and severity of erectile dysfunction (ED) post-transplant in a single center.</p><p><strong>Methods: </strong>We conducted a single-centre, observational, non-interventional study of adult male renal graft recipients. Sociodemographic and clinical data were collected, and erectile function was assessed with the International Index of Erectile Function (IIEF) questionnaire.</p><p><strong>Results: </strong>179 patients transplanted between 1995 and 2021 were enrolled (170 answered the questionnaire). Mild, moderate, and severe ED was noted in 33.5%, 20.6% and 10.6% of cases, respectively. ED prevalence increased with age (42.6% of patients < 40, 47.4% of patients aged 40-60, 78.9% of patients > 60). The total mean IIEF score was 16.32 ± 6.93 (erectile function 19.22 ± 7.9, orgasmic function 6.8 ± 2.9, sexual desire 6.43 ± 2.1, intercourse satisfaction 8.96 ± 3.7, overall satisfaction 6.78 ± 2.6). Age, alcohol consumption, type, time on dialysis pre-transplant, and donor type were significantly associated with erectile dysfunction (p < 0.05). Most patients (93.5%) were treated for comorbidities in addition to immunosuppression. Severe ED was significantly more common among patients taking alpha blockers and non-steroidal anti-inflammatory drugs.</p><p><strong>Conclusions: </strong>Self-reported erectile dysfunction post renal transplantation seems influenced by age, alcohol intake, dialysis history, donor type and certain drugs, but not by comorbidities (hypertension, diabetes, heart disease).</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1151-1173"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768774","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":"Experience of nine south eastern European transplant centers with testicular cancer in kidney transplant recipients.","authors":"Mirha Pjanic, Ivana Juric, Miha Arnol, Damir Rebic, Mirna Aleckovic-Halilovic, Marija Milinkovic, Danilo Radunovic, Zeljko Kastelan, Nikolina Basic-Jukic","doi":"10.1007/s11255-025-04488-0","DOIUrl":"https://doi.org/10.1007/s11255-025-04488-0","url":null,"abstract":"<p><strong>Purpose: </strong>Testicular cancer (TC) is the most common type of cancer among young men aged 25 to 45. This study represents the first population study of TC in kidney transplant recipients (KTRs).</p><p><strong>Methods: </strong>We conducted a multicentric, multinational, cross-sectional study across nine transplant centers in Croatia, Serbia, Montenegro, Slovenia, and Bosnia and Herzegovina. All KTRs over 18 years old who were regularly monitored at their transplant centers were included. Data were collected from electronic medical records at these centers.</p><p><strong>Results: </strong>Out of the 4426 KTRs who participated in our study, six (0.14%) developed TC after KT. Two of these patients had a history of malignancy before KT, while four had a positive family history of malignancy. The median age at diagnosis of TC was 41 years. Follow-up time ranged from 1 to 14 years. Most of the patients underwent surgical treatment and half received adjuvant chemotherapy and/or radiotherapy. Four patients had seminoma and two had non-seminoma. In most cases, the immunosuppressive therapy was adjusted. Half of the patients maintained stable kidney allograft function after TC treatment. One patient died due to COVID-19 and two required chronic dialysis 8-9 years after their TC diagnosis and treatment.</p><p><strong>Conclusions: </strong>In our study, TC occurred in the same age range as in the general population. A personal or family history of malignancy was identified as a significant risk factor. Outcomes for kidney allograft function and overall survival were excellent for patients whose disease was detected early and treated with orchiectomy. Switching from calcineurin to mTOR inhibitors also supported allograft survival.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752315","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":"Role of artificial intelligence in predicting the renal function after nephrectomy in renal cell carcinoma: a systematic review and meta-analysis.","authors":"Mohamed Javid, Mahmoud Eldefrawy, Sai Raghavendra Sridhar, Mukesh Roy, Muni Rubens, Murugesan Manoharan","doi":"10.1007/s11255-025-04467-5","DOIUrl":"https://doi.org/10.1007/s11255-025-04467-5","url":null,"abstract":"<p><strong>Purpose: </strong>To explore and assess the role of artificial intelligence (AI) in predicting the postoperative renal function in Renal Cell Carcinoma (RCC) patients undergoing nephrectomy.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across multiple databases, including PubMed, Embase, Scopus, and Web of Science. PRISMA guidelines were followed throughout the systematic review and meta-analysis. The studies that used AI models to predict renal function after nephrectomy were included in our review. The details of different AI models, the input variables used to train and validate them, and the output generated from these models were recorded and analysed. The risk of bias was assessed using the Prediction Model Study Risk of Bias Assessment Tool (PROBAST).</p><p><strong>Results: </strong>After the screening, a total of nine studies were included for the final analysis. The most common AI algorithms that were used to predict were based on machine learning models, namely Random Forest (RF), support vector machine (SVM) and XGBoost. Different performance metrics of various AI models were analysed. The pooled AUROC (area under the receiver operating curve) of the AI models was 0.79 (0.75-0.84), I² = 15.26%.</p><p><strong>Conclusion: </strong>AI models exhibit significant potential for determining postoperative renal function in RCC patients. They integrate multimodal data to generate more accurate results. However, standardising the methodologies and reporting, utilising diverse datasets, and improving model interpretability can lead to widespread clinical adaptation.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763939","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":"Comparison of suction technique and non-suction technique in retrograde intrarenal stone surgery: a systematic review and meta-analysis.","authors":"Pengan Chen, Gaoshen Mi, Jixiang Chen, Yu Liu, Zhongyu Jian, Xi Jin, Kunjie Wang","doi":"10.1007/s11255-024-04280-6","DOIUrl":"10.1007/s11255-024-04280-6","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical efficacy of retrograde intrarenal stone surgery (RIRS) using the vacuum suction technique for the treatment of upper urinary calculi.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across multiple databases, including PubMed, Embase, Sino Med, CNKI, WANFANG DATA, and Cochrane. We included studies comparing vacuum suction RIRS with non-vacuum RIRS. Following the PRISMA guidelines, we performed a meta-analysis of the selected studies. Inclusion criteria were randomized controlled trials (RCTs), case-control studies, and retrospective studies evaluating the efficacy of these techniques. Key outcomes analyzed included operative time, hospitalization duration, stone-free rates, and complication rates. Statistical analyses were conducted using mean differences (MD) for continuous variables and odds ratios (OR) for dichotomous outcomes, with corresponding 95% confidence intervals (CI).</p><p><strong>Results: </strong>Sixteen studies (6 RCTs, 1 case-control study, and 9 retrospective studies) involving a total of 2029 patients were included. Meta-analysis revealed that the vacuum suction technique significantly reduced operative time (MD = - 14.45 min, 95% CI [- 18.45; - 10.44], P < 0.00001) and hospital stay (MD = - 0.54 days, 95% CI [- 0.80; - 0.28], P < 0.00001). In addition, patients in the vacuum suction group had a higher stone-free rate (OR = 3.57, 95% CI [2.57; 4.95], P < 0.00001) and lower complication rates, particularly in reducing postoperative fever.</p><p><strong>Conclusion: </strong>The application of the vacuum suction technique in RIRS significantly improves clinical outcomes by reducing operative time and hospitalization duration, enhancing stone-free rates, and lowering postoperative complication rates. This technique demonstrates a clear clinical advantage over non-vacuum RIRS and should be considered a preferred option for the management of upper urinary tract stones.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1051-1062"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800695","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":"Discussion on the treatment of diabetic kidney disease based on the \"gut-fat-kidney\" axis.","authors":"Yaping He, Dengke Jia, Wenying Chen, Juan Liu, Congrong Liu, Xiaowei Shi","doi":"10.1007/s11255-024-04283-3","DOIUrl":"10.1007/s11255-024-04283-3","url":null,"abstract":"<p><p>Diabetic kidney disease is the main cause of end-stage renal disease, and its prevention and treatment are still a major clinical problem. The human intestine has a complex flora of hundreds of millions of microorganisms, and intestinal microorganisms, and their derivatives are closely related to renal inflammatory response, immune response, and material metabolism. Brown adipose tissue is the main part of adaptive thermogenesis. Recent studies have shown that activating brown fat by regulating intestinal flora has good curative effects in diabetic kidney disease-related diseases. As an emerging medical concept, the \"gut-fat-kidney\" axis has received increasing attention in diabetic kidney disease and related diseases. However, the specific mechanism involved needs further study. A new theoretical basis for the prevention and treatment of diabetic kidney disease is presented in this article, based on the \"gut-fat-kidney\" axis.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1233-1243"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644112","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":"Harnessing AI for real-time monitoring and precision medicine: enhancing cardiovascular risk prediction in CKD management through panimmune-inflammation value.","authors":"Anshal Ahmad, Rayyan Nabi, Dure Shehwar","doi":"10.1007/s11255-025-04482-6","DOIUrl":"https://doi.org/10.1007/s11255-025-04482-6","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752516","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":"Preoperative neutrophil-to-lymphocyte ratio (NLR) value as a predictor of recurrence of non-muscle-invasive bladder cancer.","authors":"Davor Ivanić, Haris Đug, Samed Jagodić, Samir Delibegović","doi":"10.1007/s11255-024-04297-x","DOIUrl":"10.1007/s11255-024-04297-x","url":null,"abstract":"<p><strong>Purpose: </strong>To predict oncological outcomes and select appropriate treatments for non-muscle-invasive bladder cancer (NMIBC), pre-treatment predictors such as neutrophil-to-lymphocyte ratio (NLR) are being used. This study aims to evaluate whether NLR is an independent predictor of disease and disease recurrence in NMIBC patients.</p><p><strong>Methods: </strong>In this prospective clinical study, from March 2018 to March 2023, preoperative NLR values were monitored in 99 patients newly diagnosed with NMIBC, who were initially treated with trans-urethral resection of bladder tumor (TURBT) and adjuvant intravesical therapy. To evaluate the best NLR cutoff points to predict recurrence, the ROC (receiver operating characteristic) curve and the Youden index were used. The monitoring period was 24 months.</p><p><strong>Results: </strong>With the cutoff value of NLR = 1.73, there is a statistically significant correlation (p = 0.008) between the NLR value and the increased risk of recurrence. Univariate and multivariate Cox regression analyses show the significant prognostic impact of NLR on the recurrence of the disease.</p><p><strong>Conclusion: </strong>The value of NLR > 1.73 is a significant preoperative predictor in risk assessment and will help with proper selection of treatment in the high- and intermediate-risk groups of patients.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1143-1149"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728733","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":"Gut microbiota may mediate the causality of statins on diabetic nephropathy: a mediation Mendelian randomization study.","authors":"Xiaoli Wen, Gaosi Xu","doi":"10.1007/s11255-024-04321-0","DOIUrl":"10.1007/s11255-024-04321-0","url":null,"abstract":"<p><strong>Background: </strong>Increasing evidence indicates that statins may increase the risk of developing diabetic nephropathy (DN). As the gut-kidney axis concept gains traction, it remains unclear whether statins contribute to the onset and progression of DN by modulating gut microbiota.</p><p><strong>Objective: </strong>To investigate the association between statins and DN and the proportion of this association mediated through gut microbiota.</p><p><strong>Method: </strong>This study utilized a two-sample Mendelian randomization (MR) approach and a cross-sectional observational design to investigate the causal relationships among statins, 473 gut microbiota, and DN. Furthermore, mediation MR analysis was employed to explore the potential mediating effects of gut microbiota in the statins-DN relationship.</p><p><strong>Results: </strong>HMGCR inhibitors were causally linked to the increased incidence of DN (odds ratio [OR]: 0.732, 95% confidence interval [CI] 0.647, 0.828, P_FDR = 0.000004). Supporting results from a cross-sectional study based on the Medical Information Marketplace in Intensive Care (MIMIC-IV) database also indicated this association (OR: 0.74, 95% CI: 0.61, 0.91, P = 0.004). Among the 473 identified gut microbiota species, 13 (P_FDR < 0.05) were causally associated with DN. The mediation MR analysis revealed that 10 gut microbiota mediated the relationship between statins and DN, acting as either protective or risk factors (P < 0.05). In addition, HMGCR and related proteins may be involved in lipid metabolism, insulin resistance, and AMPK signaling pathway.</p><p><strong>Conclusion: </strong>Statins may become a risk factor for DN by increasing or decreasing the abundance of specific gut microbiota. These specific gut bacteria have the potential to become a new indicator for guiding the clinical use of statins in diabetic patients.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1337-1348"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800700","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":"Elevated lipoprotein-associated phospholipase A2 as a biomarker for cognitive impairment in chronic kidney disease.","authors":"Sujuan Feng, Yanfeng Lin, Rong Wang, Xingxing Fang, Jiaqi Shi, Xiameng Gu, Yang Yu","doi":"10.1007/s11255-025-04469-3","DOIUrl":"https://doi.org/10.1007/s11255-025-04469-3","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the relationship between serum lipoprotein-associated phospholipase A2 (Lp-PLA2) levels and cognitive impairment (CI) in patients with chronic kidney disease (CKD).</p><p><strong>Methods: </strong>A total of 125 patients with CKD treated in the Department of Nephrology, The Second Affiliated Hospital of Nantong University from July 2022 to May 2023 were selected and divided into observation group (44 patients with CI) and control group (81 patients with normal cognitive function). Multivariate logistic regression analysis was performed to analyze the risk factors of CI, and Spearman rank correlation analysis was used to analyze the correlation between serum Lp-PLA2 and Montreal Cognitive Assessment Scale (MoCA) score. The truncation value of Lp-PLA2 in CKD patients with CI was analyzed by receiver operating characteristic curve (ROC).</p><p><strong>Results: </strong>Serum Lp-PLA2 levels were significantly elevated in the observation group compared to the control group (P < 0.05). The area under the ROC curve for Lp-PLA2 was 0.849, with a cutoff value of 232 ng/mL for identifying CI in patients with CKD. Lp-PLA2 levels were independently associated with CI in patients with CKD (odds ratio [OR] = 0.988, 95% confidence interval [CI]: 0.982-0.993, P < 0.001).</p><p><strong>Conclusion: </strong>Elevated serum Lp-PLA2 levels serve as an independent risk factor for CI in patients with CKD.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751934","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":"The effect of urinary diversion on kidney function in posterior urethral valves and ureterovesical obstruction.","authors":"Hamid Arshadi, Iman Menbari Oskouie, Mahsa Ghozatloo, Masoumeh Majidi Zolbin, Hossein Amirzargar, Seyed Mohammad Ghahestani, Abdol-Mohammad Kajbafzadeh, Pooya Hekmati","doi":"10.1007/s11255-024-04287-z","DOIUrl":"10.1007/s11255-024-04287-z","url":null,"abstract":"<p><strong>Introduction: </strong>Posterior urethral valves (PUV) and ureterovesical junction obstruction (UVJO) are common etiologies of lower urinary tract obstruction. The primary objective of therapy is to alleviate the obstruction in the urinary system. Temporary urinary diversion may be necessary in certain situations, such as Urinary tract infection (UTI), sepsis, and unchanging hydronephrosis. This study, aims to assess kidney parameters after urinary diversion (either pyelostomy or ureterostomy) in patients with PUV and UVJO.</p><p><strong>Method: </strong>We conducted a retrospective analysis of all patients diagnosed with PUV or UVJO and treated with urinary diversion following urinary undiversion at our facility between 2015 and 2020. The following variables were collected: demographic details, surgical interventions (type of diversion), serum creatinine throughout follow-up, anterior-posterior diameter of the pelvis (APP), anterior-posterior diameter of the ureter (APU), and sonographic findings of renal parenchymal thickness (PT) as documented by a pediatric radiologist. Additionally, before and after urinary diversion, a Dimercapto succinic acid (DMSA) nuclear renal scan was conducted to assess renal function.</p><p><strong>Result: </strong>We analyzed 67 patients, with a mean follow-up of 38.3 months, undergoing either ureterostomy (42 patients) or pyelostomy (25 patients). This included 38 patients with PUV and 29 with UVJO. In PUV patients, significant improvements were observed in APP (MD = 5.56 ± 11.6, p = 0.0194), APU (MD = 5.57 ± 7.28, p < 0.001), and PT (MD = 3.66 ± 2.75, p < 0.001). Similarly, UVJO patients experienced significant improvements in APP (MD = 12.18 ± 18.63, p = 0.005), APU (MD = 7.82 ± 8.98, p = 0.001), and PT (MD = 2.79 ± 3.33, p = 0.001). DMSA scores did not significantly change in either group (p > 0.05). Notably, APP improved more in UVJO patients compared to PUV patients (p = 0.047).</p><p><strong>Conclusion: </strong>Our study suggests that urinary diversion could improve APP, APU, and renal parenchymal thickness in PUV and UVJO patients. The improvement of APP in UVJO patients was greater than in the PUV group. We propose further multi-center studies with longer durations of follow-up and more detailed additional data to support and confirm our results.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1083-1090"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620798","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}