Journal of studies on alcohol and drugs最新文献

{"title":"Return to alcohol use among patients who are in recovery from alcohol use disorder with pharmacologically treated vs untreated insomnia.","authors":"Jaromir Mikl, Tiange Yu, Sachin Singh, Xin Zhao, Steven Wang, Amie Devlin, Raymond F Anton, Valentine Pascale","doi":"10.15288/jsad.24-00354","DOIUrl":"https://doi.org/10.15288/jsad.24-00354","url":null,"abstract":"<p><strong>Objective: </strong>Patients with alcohol use disorder (AUD) often experience sleep disturbances in early and sustained recovery, and patients with AUD and sleep disturbances are at an increased risk of returning to alcohol use.</p><p><strong>Method: </strong>This study was a retrospective claims analysis with a nested case-control design utilizing data from the Merative™ MarketScan®, Commercial, and Medicare Supplemental databases. Adults aged 18 to 80 years with ≥1 AUD remission diagnosis and a subsequent insomnia diagnosis were included. In patients with AUD who were in remission and had a subsequent insomnia diagnosis, the odds of return to alcohol use were compared between those who received pharmacotherapeutic intervention for insomnia and those who did not receive such treatment. Odds ratios (ORs) were calculated using a multivariable logistic regression model with adjustment for potential confounders.</p><p><strong>Results: </strong>Among the 6,002 patients who met the inclusion criteria within the Commercial and Medicare Supplemental databases, the adjusted OR comparing odds of return to alcohol use in patients who received treatment for insomnia compared to those who did not was 0.81 (95% CI [confidence interval]: 0.69, 0.96; <i>p</i> = .01).</p><p><strong>Conclusions: </strong>These data suggest that patients with AUD who are in remission and have insomnia experience a lower odds of return to alcohol use following pharmacotherapy for insomnia compared with patients who did not receive pharmacotherapy, underscoring the importance of identifying insomnia and carefully considering the risk-benefit of treatment interventions, including pharmacologic approaches where appropriate, to decrease the risk of return to alcohol use.</p>","PeriodicalId":17159,"journal":{"name":"Journal of studies on alcohol and drugs","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harm Reduction in Substance Use Research, Policy, and Practice at a Crucial Public Health Juncture.","authors":"Jennifer P Read","doi":"10.15288/jsad.25-00174","DOIUrl":"https://doi.org/10.15288/jsad.25-00174","url":null,"abstract":"","PeriodicalId":17159,"journal":{"name":"Journal of studies on alcohol and drugs","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Perceived Accessibility of Cannabis Products among Underage Young Adults, 2019-2023.","authors":"Yvonne M Terry-McElrath, Yuk C Pang, Megan E Patrick","doi":"10.15288/jsad.25-00026","DOIUrl":"https://doi.org/10.15288/jsad.25-00026","url":null,"abstract":"<p><strong>Objective: </strong>Using a national U.S. underage young adult sample, we examined prevalence of smoking, vaping, eating, drinking, and dabbing cannabis; perceived accessibility by product type; and perceived accessibility correlates (adolescent cannabis use, state cannabis policy context, sociodemographic characteristics).</p><p><strong>Method: </strong>Data were obtained from young adults under age 21 participating in the U.S. national Monitoring the Future Panel study from 2019-2023. Cannabis use prevalence by smoking, vaping, edibles, drinking, and dabbing was measured (n=3,075; 52.9% female). Perceived accessibility was measured for smoking, vaping, and edibles (n=1,227; 52.1% female). Covariate and accessibility associations were modeled using logistic regression.</p><p><strong>Results: </strong>Multiple cannabis use modalities were reported by 23.3% of all respondents and 63.5% of those reporting past-12-month use. Among all respondents, smoking (30.7%), vaping (19.7%) and edibles (18.2%) were the most prevalent; fewer reported dabbing (10.4%) or drinking (2.8%). Perceiving easy access to smoking, vaping, and edibles was reported by 95.0%, 91.3%, and 86.7% of those reporting past-12-month use (77.5%, 71.2%, and 71.8% of those reporting no use). Among those reporting no 12-month use, state recreational use policy was associated with perceiving easier access for smoking and edibles; full-time 4-year college attendance was associated with easier perceived access across modalities (vs. part-time/2-year college or not attending).</p><p><strong>Conclusions: </strong>Underage U.S. young adults are not legally able to purchase cannabis but reported easy access across products; those who used cannabis typically used multiple products. Among those reporting no past-12-month use, state policy and college attendance were strongly associated with perceived accessibility across products.</p>","PeriodicalId":17159,"journal":{"name":"Journal of studies on alcohol and drugs","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of alcohol use over time among older different-sex couples: Implications for health.","authors":"Angela Turkelson, Kira S Birditt, Courtney A Polenick, James A Cranford, Frederic C Blow","doi":"10.15288/jsad.24-00013","DOIUrl":"https://doi.org/10.15288/jsad.24-00013","url":null,"abstract":"<p><strong>Objective: </strong>Longitudinal patterns of alcohol use among older couples may have important implications for health. This study identified trajectories of alcohol use among different-sex couples and their associations with health over 24 years.</p><p><strong>Method: </strong>Participants included 9,823 older married/cohabiting different-sex couples from the Health and Retirement Study (HRS), in which participants complete surveys every 2 years. We included couples with at least three waves of alcohol and health data between 1996 and 2020.</p><p><strong>Results: </strong>Dual-trajectory latent class growth analysis revealed five longitudinal couple-level trajectories of alcohol use: concordant infrequent/abstaining, concordant light, concordant moderate, discordant husband heavy wife light, and discordant husband moderate wife infrequent/abstaining. Self-rated health was higher on average but decreased more rapidly over time for concordant moderate compared to concordant infrequent/abstaining husbands and wives. On average, chronic health conditions were higher for concordant infrequent/abstaining compared to concordant light and concordant moderate couples. The number of conditions increased more rapidly over time for concordant infrequent/abstaining and discordant husband heavy wife light compared to concordant light and discordant husband moderate wife infrequent/abstaining couples.</p><p><strong>Conclusions: </strong>These findings reveal the importance of considering couple patterns of drinking amount and drinking concordance to understand the impact of alcohol use on health among older couples.</p>","PeriodicalId":17159,"journal":{"name":"Journal of studies on alcohol and drugs","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Designing an Online and Text-Messaging Intervention to Enhance Protective Behavioral Strategy Utilization at the Daily Level Among Young Adults Engaged in Alcohol and Cannabis Use.","authors":"Melissa A Lewis, Dana M Litt, Anne M Fairlie, Scott Graupensperger, Allison Cross, Rachel Stankus, Jennifer Murphy, Jason R Kilmer","doi":"10.15288/jsad.24-00434","DOIUrl":"https://doi.org/10.15288/jsad.24-00434","url":null,"abstract":"<p><strong>Objective: </strong>This article describes the development of an online and text-messaging intervention aimed at augmenting protective behavioral strategy (PBS) utilization at the daily level among young adults engaged in alcohol and cannabis use. PBS, encompassing tips and strategies to moderate alcohol and cannabis use and reduce associated risks, have been integral components of personalized feedback interventions. The quality and consistency of PBS use have been underexplored in intervention frameworks.</p><p><strong>Method: </strong>We describe 6 initial focus groups and 13 cognitive interviews that were conducted with young adults who use alcohol and cannabis to learn the motivations underpinning alcohol and cannabis PBS utilization, barriers impeding PBS use, and PBS use with high quality and consistency. This step served as the cornerstone for crafting targeted intervention strategies. Drawing from the insights from the focus groups and cognitive interviews, we developed an interactive online intervention and text message platform. We then conducted 3 additional focus groups and 9 cognitive interviews with young adults who use alcohol and cannabis to gain insight on intervention content and to implement any needed changes.</p><p><strong>Results: </strong>We present the final iteration of the intervention, which consisted of a brief, web-based intervention followed by text messages 3 days a week for 8 consecutive weeks as well as two monthly daily-level summaries of behaviors reported across 8 weeks.</p><p><strong>Conclusions: </strong>This article shares our process for designing an intervention using daily-level data, aimed at reducing alcohol and cannabis use among young adults and fostering quality and consistent use of PBS.</p>","PeriodicalId":17159,"journal":{"name":"Journal of studies on alcohol and drugs","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased delta connectivity within brain networks as a biomarker of adherence to a rTMS-based treatment program in a sample of cocaine use disorder patients.","authors":"Elena De Rossi, Luis J Gómez Pérez, Stefano Cardullo, Giuseppe Alessio Carbone, Giulia Carla Zaffaina, Benedetto Farina, Alberto Terraneo, Chiara Massullo, Claudio Imperatori, Luigi Gallimberti","doi":"10.15288/jsad.24-00441","DOIUrl":"https://doi.org/10.15288/jsad.24-00441","url":null,"abstract":"<p><strong>Objective: </strong>We have investigated the association between the adherence to a repetitive transcranial magnetic stimulation (rTMS)-based treatment program and resting-state (RS) functional connectivity within two large-scale networks [i.e., the Frontoparietal Network (FPN) and the Default Mode Network (DMN)] in a sample of patients with cocaine use disorder (CUD; N= 33, 32 males).</p><p><strong>Method: </strong>Each participant underwent a psychopathological assessment and a RS electroencephalography (EEG) recording before starting the treatment protocol. EEG connectivity analysis was performed using the exact Low-Resolution Brain Electromagnetic Tomography (eLORETA) software comparing dropout patients (i.e., treatment program abandonment within 3 months) and adherence patients.</p><p><strong>Results: </strong>Compared to dropout group, the adherence group showed increased pre-treatment delta connectivity within the FPN (T= 4.562, <i>p</i>= 0.010, Cohen's <i>d</i>= 0.819) and the DMN (T= 4.045, <i>p</i>= 0.036, Cohen's <i>d</i>= 0.726). Multivariable Cox proportional hazard models showed that both DMN (HR= 0.41, <i>p</i>= 0.015) and FPN connectivity data (HR= 0.54, <i>p</i>= 0.007) were significantly related to prolonged treatment adherence. Increased functional connectivity within the FPN decreased the probability of dropout before the first 12 weeks of treatment (OR= 0.36, <i>p</i>= 0.019).</p><p><strong>Conclusions: </strong>Our results may reflect enhanced goal-driven cognitive integration in adherence patients. Providing effective neurophysiological predictors of treatment outcomes, such as relapse and dropout, could allow the timely implementation of additional support measures for CUD patients.</p>","PeriodicalId":17159,"journal":{"name":"Journal of studies on alcohol and drugs","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Graduating with an alcohol problem? Associations between drinking, willingness to experience consequences, protective behavioral strategies, and repeated alcohol problems across the senior year of college.","authors":"Kimberly A Mallett, Veronica L Richards, Shannon D Glenn, Michael A Russell, Sarah Ackerman, Rob Turrisi","doi":"10.15288/jsad.24-00176","DOIUrl":"https://doi.org/10.15288/jsad.24-00176","url":null,"abstract":"<p><strong>Objective: </strong>Research shows a high proportion of college seniors experience alcohol problems repeatedly. The present study examined associations between behavioral willingness to experience alcohol consequences (BW), protective behavioral strategies to reduce harmful drinking (PBS), drinking, and repeated alcohol problems (RAPs) early in the senior year, and how these constructs influenced BW, PBS, drinking, and RAPs later in the senior year.</p><p><strong>Method: </strong>The sample included randomly selected first year students from a large northeastern university that met the inclusion criterion of consuming alcohol prior to enrollment. Students were followed each semester across 4 years. The study (<i>N</i> = 1,753; 58% female) focused on the assessments in the fall (T1) and spring (T2) semesters of their senior year (mean age = 21). A longitudinal path model examined associations among BW, PBS, drinking, and RAPs at both waves.</p><p><strong>Results: </strong>BW, drinking, and PBS had direct, concurrent associations with RAPs at T1 and T2. The nature of the associations was positive for BW and drinking and negative for PBS. Prospective analyses revealed significant independent, positive associations between T1 RAPs and T2 BW, drinking, and RAPs, while a negative independent association between T1 RAPs and PBS was observed at T2.</p><p><strong>Conclusions: </strong>Findings show evidence for a cycle of alcohol use behavior between BW, drinking, and RAPs. Based on the findings, interventions targeting college seniors seem warranted to reduce developing further alcohol problems in adulthood.</p>","PeriodicalId":17159,"journal":{"name":"Journal of studies on alcohol and drugs","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Pressure Control among Primary Care Patients with Hypertension and Unhealthy Alcohol Use: The Role of Alcohol Brief Interventions.","authors":"Stacy A Sterling, Vanessa A Palzes, Yun Lu, Andrea H Kline-Simon, Thekla B Ross, Constance M Weisner, Joseph Elson, Derek D Satre, Sameer Awsare, Asma Asyyed, Jamal Rana, Cynthia I Campbell, Verena E Metz, Felicia W Chi","doi":"10.15288/jsad.24-00263","DOIUrl":"https://doi.org/10.15288/jsad.24-00263","url":null,"abstract":"<p><strong>Objective: </strong>Hypertension is highly prevalent in primary care. Unhealthy alcohol use can impact its management and associated cardiovascular disease risks. Alcohol screening and brief intervention (ASBI) in primary care is effective for early intervention for unhealthy use, yet its effectiveness in heterogeneous populations in real-world settings remains unclear. Using electronic health records, we emulated a pragmatic clinical trial to evaluate the effects of receiving ASBI on drinking and blood pressure (BP) outcomes among primary care patients with hypertension and unhealthy alcohol use.</p><p><strong>Method: </strong>This observational study identified 72,979 patients with hypertension who screened positive for unhealthy drinking between 1/1/2014 - 12/31/2017. We used a target trial framework to compare the effects of receiving ASBI (intervention) to not receiving BI (comparison) on drinking (change in heavy drinking days and drinks/week) and BP outcomes (changes in diastolic and systolic BP) from baseline to 2- and 5-year follow-ups. Treatment effect estimates were obtained using inverse probability weighted models.</p><p><strong>Results: </strong>At 2-years, the intervention condition had about 0.2 fewer heavy drinking days and about 0.1 fewer drinks/week than the comparison condition. The intervention condition had an additional -0.5 mmHg and -0.7 mmHg decline in diastolic and systolic BP, and 8% and 6% higher odds of having a ≥3mmHg reduction in diastolic and systolic BP, respectively, than the comparison condition. Between group differences in both outcomes diminished at 5-years.</p><p><strong>Conclusions: </strong>The modest changes in drinking and blood pressure we found contribute to the emerging evidence that BI may benefit broader health outcomes on population-level.</p>","PeriodicalId":17159,"journal":{"name":"Journal of studies on alcohol and drugs","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dental Screening, Counseling, and Referral to Treatment for Substance Use Disorder: Survey of the National Dental Practice-Based Research Network.","authors":"Jenna L McCauley, Phillip Crawford, Michael C Leo, Mary Ann McBurnie, Danyelle Barton, Heather A Weidner, D Brad Rindal","doi":"10.15288/jsad.24-00383","DOIUrl":"https://doi.org/10.15288/jsad.24-00383","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to conduct a national survey of practicing dentists assessing their current knowledge, attitudes, and practice behaviors related to substance use screening among their adult patients. The secondary objective was to identify practitioner- and practice-level facilitators and barriers of substance use screening.</p><p><strong>Method: </strong>This cross-sectional study consisted of an electronic survey disseminated to practicing dentists who were active members of the National Dental Practice-Based Research Network (National Dental PBRN; n=790; 61% male).</p><p><strong>Results: </strong>The majority of dentists reported some level of screening for nicotine (95.7%), alcohol (87.2%), cannabis (83.9%), and illicit drug (87.7%) use among their adult patients. More than 2 in 5 dentists reported never counseling patients regarding problematic use of alcohol, cannabis and illicit drugs. Higher screening frequency was associated with higher counseling frequency and lower endorsement of two barrier factors: beliefs regarding responsibility, relevance, and effectiveness and lack of training and/or resources. Higher frequency of counseling was associated with higher frequency of referral behavior and lower endorsement of three barrier factors: concerns regarding patient truthfulness/discomfort, beliefs regarding responsibility, relevance, and effectiveness and lack of training and/or resources.</p><p><strong>Conclusions: </strong>Results indicate a high level of willingness to screen, counsel, and refer patients for substance use among a majority of dentists, though current practice behaviors lag willingness. Findings regarding barriers and facilitators can guide efforts to develop, disseminate and implement screening, brief intervention, and referral to treatment training, initiatives, as well as tools that are inclusive of or specifically target dental providers.</p>","PeriodicalId":17159,"journal":{"name":"Journal of studies on alcohol and drugs","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Other\" Substance Use Among American Indian Reservation-Area High School Youth.","authors":"Mark A Prince, Brandon Paez, Jessica L Morse, Bethany A Gray, Hollis Karoly, Naomi M McFarland, Noah N Emery, Meghan A Crabtree, Randall C Swaim","doi":"10.15288/jsad.25-00090","DOIUrl":"https://doi.org/10.15288/jsad.25-00090","url":null,"abstract":"<p><strong>Objective: </strong>High school youth have an elevated risk of substance use. Some substances (e.g., inhalants, MDMA) used by youth are overlooked or grouped in an \"other\" category. Compared to other racial/ethnic groups, American Indian (AI) youth may be at higher risk of using these substances. The purpose of this study is to examine the prevalence and patterns of use of \"other\" substances among youth living on or near reservations.</p><p><strong>Method: </strong>This study uses data from Our Youth Our Future, a national probability sample survey of substance use among reservation-based youth (n = 14,769) to examine prevalence rates of use across sex (51% male), AI identity (61% AI), and their intersection within seven geographic regions of the United States.</p><p><strong>Results: </strong>Results indicate AI youth largely did not endorse \"other\" substance use at significantly higher rates than non-AI youth, although in two regions they held higher odds of use of any \"other\" substance compared to non-AI participants. In the Southeast and Northwest, AI youth were less likely to use prescription opioids and over-the-counter cold medicines than non-AI youth, respectively. Notable effects for sex emerged such that males in the Southwest were more likely to use inhalants, hallucinogens, and tranquilizers than female participants. Participants in the Southern Plains reported the highest prevalence of \"other\" substance use.</p><p><strong>Conclusions: </strong>While overall risk of using \"other\" substances is similar between AI and non-AI youth in many regions, differences in use patterns by AI identity and sex can help target prevention and intervention efforts.</p>","PeriodicalId":17159,"journal":{"name":"Journal of studies on alcohol and drugs","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}