Ocular Immunology and Inflammation最新文献

{"title":"Medication Refill Adherence in Patients with Chronic Inflammatory Eye Disease.","authors":"Arthi D Bharadwaj, Avisek Datta, Pooja Bhat, Ann-Marie Lobo-Chan","doi":"10.1080/09273948.2024.2427257","DOIUrl":"10.1080/09273948.2024.2427257","url":null,"abstract":"<p><strong>Purpose: </strong>To utilize pharmacy dispenses to investigate adherence rates to immunosuppressive therapy (IMT) for the treatment of noninfectious inflammatory eye disease (IED), impact of adherence on disease control, factors associated with nonadherence, and association between adherence in the medical record and pharmacy dispenses.</p><p><strong>Method: </strong>Retrospective medical chart review was conducted on patients followed for at least 2 years in the uveitis clinic. Appointment and lab attendance, and provider documentation, determined adherence through the medical record. Dispense history was obtained from pharmacies, and IMT infusion dates were noted. Disease control was determined by clinical exam findings.</p><p><strong>Results: </strong>Sixty-three patients qualified for the study. The mean age was 49 years (SD = 19.4), 76.2% were female, 36.5% were Black/African American, and 96.8% were taking 1 or 2 IMTs. Pharmacy refill data was collected from 58 patients to determine an adherence rate (AR) of 63.9%. Thirty-nine patients (67.2%) had an average AR < 85% by pharmacy refill data and were thus deemed nonadherent. The majority of patients (86.2%) achieved ocular inflammation control. Nonadherence was 4.72 times more likely in patients taking >1 medication compared to one medication alone (95% CI: 1.02-21.86, <i>p</i> = 0.047). Comparing adherence from information in the medical record to pharmacy refill data, 71.6% of IMT comparisons were congruent (<i>p</i> < 0.0001).</p><p><strong>Conclusion: </strong>Patients taking IMT for >2 years demonstrated an AR < 65% based on pharmacy data. Most patients achieved ocular quiescence. Using pharmacy information as an objective measure of adherence correlates with assessing adherence through medical record information.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"578-584"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716555","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":"Clinical Features of Varicella-Zoster Virus-Associated Anterior Uveitis with or without Ophthalmic Herpes Zoster.","authors":"Kyosuke Seki, Keisuke Yoneda, Yu Yoneda, Yuki Takenaka, Toshikatu Kaburaki, Masaru Takeuchi","doi":"10.1080/09273948.2024.2435477","DOIUrl":"10.1080/09273948.2024.2435477","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the clinical characteristics, diagnostic markers, and treatment outcomes of varicella-zoster virus-associated anterior uveitis (VZV-AU) with and without ophthalmic herpes zoster (herpes zoster ophthalmicus (HZO) and zoster sine herpete (ZSH), respectively).</p><p><strong>Methods: </strong>Clinical records of 47 VZV-AU patients (21 ZSH, 26 hZO) were retrospectively reviewed for clinical findings, medication use, and PCR using aqueous humor (AH) results.</p><p><strong>Results: </strong>There was no significant difference in age, gender, visual acuity (VA), or intraocular pressure (IOP) between the two groups. At the initial visit, small-to-medium white keratic precipitates (KPs) were significantly more observed in ZSH group than in HZO group, although there was no significant difference in the frequencies of other ocular findings between the two groups. Early antiviral medication use was significantly higher in HZO group (96.2%) than in ZSH group (19.1%). PCR was performed in 85.7% of ZSH and 53.8% of HZO patients. VZV-DNA positivity and viral load were similar between groups. Multivariate analysis revealed a positive correlation between white KPs and VZV viral load in AH. Although the ultimate use of antiviral medication was still less in ZSH group (71.4%), there were no significant differences in VA and IOP at the last visit between the two groups.</p><p><strong>Conclusion: </strong>Patients with ZSH had more white KPs and received less early antiviral medication than those with HZO. However, visual outcomes were similar between the two groups. Small-to-medium white KPs were significantly associated with the viral load of VZV in AH, suggesting that they could be an active marker.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"662-669"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786310","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":"Bilateral Involvement in Childhood Presumed Trematode Induced Granulomatous Anterior Uveitis.","authors":"Amgad El Nokrashy, Ghada H Allam, Anas Adi, Waleed Ali Abou Samra, Engy Elemry, Nashaat Shawky, Aya M Hashish","doi":"10.1080/09273948.2024.2428422","DOIUrl":"10.1080/09273948.2024.2428422","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to elucidate the clinical spectrum of trematode-induced uveitis (TIU), with a particular focus on its bilateral presentation and providing significant insights into its pathophysiology.</p><p><strong>Methods: </strong>A prospective cross-sectional observational study was conducted at the uveitis outpatient clinic of Mansoura University Ophthalmic Center. The study involved children diagnosed with presumed TIU. Comprehensive clinical evaluations were performed, including detailed history taking and thorough ophthalmological examinations of both the anterior and posterior segments, emphasizing the unaffected fellow eye.</p><p><strong>Results: </strong>The cohort consisted of 80 children, with a male predominance of 98.75%. The proportion of bilateral involvement was observed in 12 out of 80 (15%). The involvement of the fellow eye was observed as follows: conjunctival hyperemia (3/80), conjunctival phlycten-like lesions (3/80), ciliary injection (10/80), corneal immune infiltration (4/80), retro-corneal membrane (5/80), anterior chamber granuloma (5/80), peripheral anterior synechiae (3/80), complicated cataract (2/80), diffuse cyclitis and choroid thickening (12/80), and intermediate uveitis (11/80).</p><p><strong>Conclusion: </strong>This study demonstrates that TIU is not confined to the initially affected eye; the fellow eye may also be affected in a significant number of cases. Therefore, it is crucial to conduct thorough examinations of both eyes in patients diagnosed with TIU to ensure comprehensive clinical management.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"596-602"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676392","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":"Epidemiology of Intermediate Uveitis.","authors":"Sonya Besagar, Alejandra de-la-Torre, Jennifer Thorne, Jyotirmay Biswas, Rupesh Agrawal, Eric B Suhler, John H Kempen, Sapna Gangaputra","doi":"10.1080/09273948.2024.2408411","DOIUrl":"10.1080/09273948.2024.2408411","url":null,"abstract":"<p><p>Intermediate uveitis is defined as inflammation of the vitreous and pars planitis. Etiology can be infectious, associated with a systemic disease, neoplastic or idiopathic. Pars planitis is the term used for idiopathic intermediate uveitis that presents with snowballs and snowbanks. While relatively rare, intermediate uveitis is present globally and typically affects adult females. Awareness of the presentation and a dilated fundus examination in patients presenting with floaters is essential to the diagnosis. PCR testing has enhanced the ability to diagnose infectious and neoplastic conditions that masquerade as intermediate uveitis. A structured review of systems and focused imaging, and laboratory testing will assist with early diagnosis and initiation of treatment.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"503-511"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365966","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":"Vitamin D Supplementation and Remission from Chronic Anterior Uveitis.","authors":"Hueyjong Shih, Yineng Chen, Katie Huynh, Eric B Suhler, Jennifer E Thorne, Nirali P Bhatt, C Stephen Foster, Douglas A Jabs, Grace A Levy-Clarke, Robert B Nussenblatt, James T Rosenbaum, H Nida Sen, Sapna S Gangaputra, Abhishek R Payal, Hosne Begum, Naira Khachatryan, Sherri-Ann M Burnett-Bowie, Gui-Shuang Ying, John H Kempen, Lucia Sobrin","doi":"10.1080/09273948.2024.2427857","DOIUrl":"10.1080/09273948.2024.2427857","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic anterior uveitis (CAU) often requires suppressive therapy, which has potential side effects including cataract, ocular hypertension, and increased risk of infection. No remittive therapy is currently available; however, several studies have demonstrated an association between low 25-hydroxy Vitamin D (25OHD) levels and either uveitis incidence or uveitis disease activity. This study investigates the potential of Vitamin D supplementation as a remittive treatment for CAU.</p><p><strong>Methods: </strong>We conducted a retrospective analysis using data from the Systemic Immunosuppressive Therapy for Eye Disease (SITE) cohort study, which included patients with ocular inflammatory disease seen at U.S. tertiary centers between 1979 and 2010. Vitamin D supplementation data was analyzed for patients with CAU. Eyes were considered in remission if they remained quiet for at least 90 days off all anti-inflammatory treatment for eye disease.</p><p><strong>Results: </strong>Among 2688 patients who never used Vitamin D, the cumulative adjusted CAU remission incidence was 13.5% at the 16-month follow-up. In contrast, among 75 patients who used Vitamin D for a duration of ≤1 year, the cumulative adjusted CAU remission incidence was 28% at 16 months. The use of Vitamin D was associated with a crude hazard ratio for remission of 2.14 [95% confidence interval (CI) 1.23-3.71, <i>p</i> = 0.0071], and an adjusted hazard ratio for remission of 2.43 [95% CI: 1.36-4.33, <i>p</i> = 0.0027].</p><p><strong>Conclusion: </strong>In the SITE Cohort, Vitamin D supplementation is associated with a significantly increased incidence of remission. Vitamin D supplementation should be explored in a prospective trial as the next step of evaluation.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"585-588"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716667","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":"Review on the Use of Difluprednate in Inflammatory Eye Disorders: The Topical Steroid That Goes the Distance.","authors":"Radgonde Amer, Shani Pillar","doi":"10.1080/09273948.2024.2423869","DOIUrl":"10.1080/09273948.2024.2423869","url":null,"abstract":"<p><p>Difluprednate (DFP) (difluoroprednisolone butyrate acetate, or DFBA) ophthalmic emulsion 0.05% (Durezol®) was the first potent corticosteroid to be approved for both postoperative pain and inflammation in 2008. In June 2012, it was approved for the treatment of endogenous anterior uveitis. It is a synthetic difluorinated prednisolone derivative that was originally developed in Japan as a dermatologic ointment. The glucocorticoid binding affinity of its active metabolite was demonstrated to be 56 times stronger than prednisolone. Experimental models showed that it reached the anterior and posterior segments of the eye quickly, via both transcorneal and noncorneal (conjunctiva and sclera) absorption routes. Its clinical applications have been expanded to treat patients with uveitic macular edema and anterior scleritis. Case reports and case series also describe its use in some forms of posterior uveitis and in non-uveitic entities. Elevated intraocular pressure and acceleration of cataract formation are the main concerns with DFP as with all corticosteroids. Because IOP elevation is particularly pronounced in the pediatric age group, IOP is to be closely monitored at every visit in children. High incidence of cataract formation and progression was also documented in children, thus necessitating vigilant follow-up of children on chronic treatment. This review aims to give a comprehensive and up-to-date overview of difluprednate's pharmacological properties, clinical applications, safety profiles, and alternative delivery methods.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"670-682"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591328","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":"Comprehensive Update on Multiple Sclerosis-Associated Uveitis and New Epidemiological Insights from the United Kingdom.","authors":"Cara Heppell, Anuradhaa Subramanian, Nicola J Adderley, Krishnarajah Nirantharakumar, Alastair K Denniston, Carlos Pavesio, Tasanee Braithwaite","doi":"10.1080/09273948.2025.2491567","DOIUrl":"https://doi.org/10.1080/09273948.2025.2491567","url":null,"abstract":"<p><p>Multiple sclerosis (MS)-associated uveitis is characterised most frequently by bilateral intermediate uveitis with peripheral vascular leakage or panuveitis. The interesting association between these autoimmune diseases, which develop in two immune-privileged sites, places some undifferentiated uveitis patients at heightened risk of demyelination and clinical MS precipitation from the use of licensed anti-tumour necrosis factor α (TNFα) biologic therapy. However, their association may also open novel treatment avenues, considering the rapidly expanding arsenal of highly effective MS disease-modifying therapies. Here, we offer new data on MS-uveitis from the first national population-representative matched case-control and cohort study, using IQVIA medical research data (IMRD-UK), a primary care database of 11 million people. Amongst 25 thousand uveitis cases, patients with (any) uveitis are nearly three times more likely than matched controls to develop MS by 15 years follow-up (adjusted Hazard 2.7 (95% CI 2.1-3.6, <i>p</i> < 0.001)), but the proportion of MS-uveitis is low overall (0.72%, 180/24,895 uveitis cases). What tools might enhance MS risk stratification in uveitis patients in the future? In this comprehensive narrative review, we summarise primary observational data informing our epidemiological understanding of the association between MS and uveitis, and its variable clinical presentations, to highlight the state of play, and the important questions that remain in MS-uveitis.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":"33 4","pages":"535-547"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038142","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":"Candidate Tear-Based Uveitis Biomarkers in Children with JIA Based on Arthritis Activity and Topical Corticosteroid Use.","authors":"Ilaria Maccora, Mekibib Altaye, Kenneth D Greis, Hermine I Brunner, Alexandra Duell, Wendy D Haffey, Tiffany Nguyen, Megan Quinlan-Waters, Grant S Schulert, Alyssa Sproles, Virginia Miraldi Utz, Sherry Thornton, Sheila T Angeles-Han","doi":"10.1080/09273948.2024.2428846","DOIUrl":"10.1080/09273948.2024.2428846","url":null,"abstract":"<p><strong>Background: </strong>Uveitis is an inflammatory ocular disease secondary to disruption of the retinal pigmented epithelium (RPE) and blood retinal barrier (BRB). Known clinical factors do not accurately predict uveitis risk in Juvenile Idiopathic Arthritis (JIA). Tear fluid is easily obtained for biomarker study. We aim to identify tear-based markers associated with the presence of uveitis in children with JIA.</p><p><strong>Methods: </strong>In a cross-sectional comparative cohort study, tears were collected by Schirmer strips from children with oligoarticular JIA-associated uveitis (JIA-U) and JIA without uveitis (JIA-no-U). A tandem isotope tagging (iTRAQ and TMT) strategy was used for relative quantitation via nanoLC-MS/MS to quantify proteins in the affected eye. Log transformed relative protein abundance of protein levels was compared between groups using Wilcoxon exact test. We explored the influence of arthritis activity and topical corticosteroids (CS) use on protein levels. STRING analysis was performed.</p><p><strong>Results: </strong>Tear samples of 14 JIA-U and 14 JIA-no-U patients were analyzed. Thirteen proteins were differentially expressed between both groups. Stratified analysis based on arthritis activity (inactive arthritis) and topical CS (off CS) showed that alpha-2-macroglobulin (<i>p</i> = 0.012), apolipoprotein A1 (<i>p</i> = 0.036), S100A9 (<i>p</i> = 0.05), haptoglobin (<i>p</i> = 0.066), and transthyretin (<i>p</i> = 0.066) consistently differentiated between both groups. On STRING analysis, these proteins were associated with the RPE, BRB, and inflammation.</p><p><strong>Conclusion: </strong>Importantly, we identified proteins involved in the RPE, BRB, and immune response that were differentially abundant in the tears of children with JIA-U compared to JIA-no-U, regardless of arthritis activity or topical CS. Candidate tear-based biomarkers may represent a non-invasive means to detect uveitis.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"603-612"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716605","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":"Intermediate Uveitis: An Updated Review of the Differential Diagnosis and Relevant Special Investigations.","authors":"Jacob Biju Mark, Derrick P Smit, Rajashree E, Rathinam Sr","doi":"10.1080/09273948.2025.2450473","DOIUrl":"10.1080/09273948.2025.2450473","url":null,"abstract":"<p><p>The aim of this review is to provide an update on both the differential diagnosis of intermediate uveitis (IU) and the special investigations that may be required to determine the underlying etiology of this condition. The authors describe how they identified the relevant publications included in this review and then proceed to outline the possible causes of IU by classifying them into the following categories: Idiopathic, infectious, systemic, genetic/hereditary, drug-induced and masquerades. Thereafter, the special investigations relevant to each cause are discussed individually.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"522-534"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984403","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":"Patterns and Outcomes of Pediatric Uveitis in a University-Based Tertiary Referral Center in Riyadh, Saudi Arabia.","authors":"Abdulrahman F AlBloushi, Sulaiman M AlTariqi, Ruba Saleh Alghofaili, Priscilla W Gikandi, Ahmed M Abu El-Asrar","doi":"10.1080/09273948.2024.2435470","DOIUrl":"10.1080/09273948.2024.2435470","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the patterns and outcomes of pediatric uveitis.</p><p><strong>Methods: </strong>Retrospective review of patients with uveitis in pediatric age group.</p><p><strong>Results: </strong>A total of 184 patients (335 eyes) were included. There were 96 (52.2%) boys and 88 (47.8%) girls, with a mean age of 12.8 ± 3.4 years at presentation. Panuveitis was most common (55.2%), followed by anterior uveitis (29.6%), intermediate uveitis (12.2%) and posterior uveitis (3%). Uveitis was non-granulomatous in 71% and non-infectious in 94.6% of the eyes. The most identifiable specific diagnoses were Vogt-Koyanagi-Harada (VKH) disease (21.2%), juvenile idiopathic arthritis (6.5%), sarcoidosis (4.3%), and presumed tuberculous uveitis (3.3%). After 1-year follow-up, 85.4% of the eyes achieved visual acuity of 20/40 or better.</p><p><strong>Conclusions: </strong>The most common anatomic diagnosis was panuveitis. VKH disease was the most frequently diagnosed entity.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"654-661"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786258","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}