Sexually Transmitted Infections最新文献

{"title":"Qualitative exploration of the barriers and facilitators to community pharmacy PrEP delivery for UK pharmacists and underserved community members using the COM-B model of behaviour change.","authors":"China Harrison, Hannah Family, Joanna Kesten, Sarah Denford, Jennifer Scott, Caroline Sabin, Joanna Copping, Lindsey Harryman, Sarah Cochrane, John Saunders, Ross Hamilton-Shaw, Jeremy Horwood","doi":"10.1136/sextrans-2024-056308","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056308","url":null,"abstract":"<p><strong>Objectives: </strong>Expanding delivery of oral pre-exposure prophylaxis (PrEP) to community pharmacies could improve access, aligning well with the UK government's goals to eliminate new HIV acquisitions by 2030. Using the Capability, Opportunity, Motivation, Behaviour (COM-B) model for behaviour change, the aim of this research was to explore the barriers and facilitators of community pharmacy PrEP delivery, for pharmacists and community members.</p><p><strong>Methods: </strong>Community members at elevated risk of acquiring HIV and community pharmacists were recruited to participate in semi-structured interviews. Interviews were recorded, transcribed, and thematically analysed within the framework of the COM-B model.</p><p><strong>Results: </strong>17 interviews with pharmacists (pharmacy owners n=7; employed pharmacists n=6; locums n=4) and 24 with community members (black African women n=6; other women n=2; young adults aged 18-25 years n=6; transgender people n=6; female sex workers n=4) were carried out. Capability barriers included suboptimal awareness and knowledge of PrEP, pharmacy facilities and pharmacist roles in delivering public health services. Opportunity barriers included a lack of staff capacity, privacy and pharmacy screening and monitoring facilities. Motivational barriers included a concern that increased access could increase sexually transmitted infections and involve a financial cost. Capability facilitators included awareness raising, HIV and PrEP training and education. Opportunity facilitators included PrEP appointments and the accessibility of pharmacies. Motivational facilitators included a preference for pharmacy delivery over other models (eg, sexual health, General Practitioner (GP)), and a belief that it would be discrete and less stigmatising.</p><p><strong>Conclusion: </strong>Pharmacy PrEP delivery is acceptable but for it to be feasible, results point to the need for the development of a behaviour change intervention focusing on education, training and awareness raising, targeting pharmacists and community members to stimulate patient activation and de-stigmatise HIV. This intervention would need to be facilitated by system and environmental changes (eg, commissioning service).</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627365","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":"Systematic review and meta-analysis of the association between naturally induced IgG, IgM and neutralising antibodies to HPV16 and newly detected cervical HPV16 infection outcomes.","authors":"Andrea Trevisan, Patricia S de Araujo-Souza, Alix Pincivy, Joseph Niyibizi, Eduardo L Franco, Helen Trottier","doi":"10.1136/sextrans-2024-056296","DOIUrl":"10.1136/sextrans-2024-056296","url":null,"abstract":"<p><strong>Background: </strong>It is unclear whether recurrent cervical human papillomavirus type 16 (HPV16) infections can be prevented by naturally induced HPV16 antibodies in unvaccinated healthy women.</p><p><strong>Methods: </strong>We systematically searched the literature for studies that prospectively evaluated the association between HPV16 naturally induced IgG, IgM, and neutralising antibodies and newly detected cervical HPV16 infection in unvaccinated women. Data were quantitatively summarised by random effect meta-analysis.</p><p><strong>Results: </strong>Naturally induced HPV16 IgG and neutralising antibodies were negatively associated with newly detected HPV16 infection (relative risk (RR) (95% confidence interval (CI))=0.71 (0.63 to 0.80) and 0.54 (0.36 to 0.73), respectively). HPV16 antibodies tend to offer protection against subsequent HPV16 DNA detection in young women (RR (95% CI)=0.65 (0.55 to 0.74)), but not in women aged over 25 years (RR (95% CI)=0.88 (0.73 to 1.04)). HPV16 IgG antibodies were also negatively associated with persistent HPV16 infection (adjusted RR=0.67 (0.56 to 0.78)). There was high heterogeneity between studies (I² statistic=63.9%; p=0.007), and most had low risk of bias. We did not find studies evaluating IgM antibodies.</p><p><strong>Conclusion: </strong>Seroreactivity to HPV16 infection seems to provide moderate protection against newly detected cervical HPV16 infection outcomes in unvaccinated women. However, protection seems to be affected by age. These findings should be considered when evaluating public health interventions against HPV.</p><p><strong>Prospero registration number: </strong>CRD42022339579.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627368","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":"Correction: Self-start HIV postexposure prophylaxis (PEPSE), to reduce time to first dose and increase efficacy.","authors":"","doi":"10.1136/sextrans-2022-055622corr1","DOIUrl":"https://doi.org/10.1136/sextrans-2022-055622corr1","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627348","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":"High prevalence of STIs among men engaged in transactional sex and alcohol use in western Kenya: important implications for STI prevention interventions.","authors":"Sue Napierala, Elizabeth F Bair, Ouma Dan Omollo, Teniola I Egbe, Julius Oduor Wesonga, Anisha Rajaratnam, Connie Celum, Harsha Thirumurthy, Kawango Agot","doi":"10.1136/sextrans-2024-056266","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056266","url":null,"abstract":"<p><strong>Objectives: </strong>Better data on aetiological prevalence of sexually transmitted infections (STIs) among African men could greatly strengthen STI prevention efforts and convey benefits to women as well. In an ongoing study among men in Kenya, we analysed baseline STI prevalence and individual characteristics associated with STI.</p><p><strong>Methods: </strong>In Siaya County, Kenya, we recruited men aged 18-39 years who self-reported engagement in transactional sex and alcohol use. We administered a baseline questionnaire to participants and conducted testing for HIV, herpes simplex virus type 2 (HSV-2), <i>Chlamydia trachomatis</i> (CT) and <i>Neisseria gonorrhoeae</i> (NG) infection. Characteristics associated with bacterial STIs were analysed using logistic regression and we estimated the positive and negative predictive values (PPV/NPV) of syndromic management of these infections.</p><p><strong>Results: </strong>We enrolled 1500 participants from July 2022 to March 2023. Participant mean age was 27.9 years, 62.2% were married/cohabitating and 53.5% were heavy alcohol users (Alcohol Use Disorders Identification Test-Consumption≥4). Participants reported a mean of 4.2 sexual partners and 3.5 transactional sex partners in the past 3 months. HIV prevalence was 9.5%, HSV-2 was 38.7%, CT was 14.3% and NG was 2.5%. Combined CT and/or NG infection was detected in 16.1% of participants.Compared with participants uninfected, those testing positive for CT and/or NG were younger (p=0.001), had more sexual partners (p=0.027) and transactional sex partners (p=0.039), were less likely to have used a condom at last sex (p=0.015) and were more likely to self-report having an STI besides HIV in the past 12 months (p=0.002). The PPV and NPV for currently experiencing CT and/or NG symptoms were 33.3% and 84.4%, respectively.</p><p><strong>Conclusions: </strong>Among Kenyan men engaged in transactional sex and alcohol use, STI prevalence was high. These data fill an important gap about STI prevalence and risk factors in African men highlighting the risk of ongoing transmission and the need for targeted prevention programmes and expanded access to testing and treatment.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627351","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 of sexually transmitted infections and associated risk factors among female sex workers in Guinea-Bissau.","authors":"Jacob Lindman, Mamadu Aliu Djalo, Ansu Biai, Fredrik Månsson, Daniel Golparian, Joakim Esbjörnsson, Marianne Jansson, Patrik Medstrand, Magnus Unemo, Hans Norrgren","doi":"10.1136/sextrans-2023-056015","DOIUrl":"10.1136/sextrans-2023-056015","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the prevalence of the curable sexually transmitted infections (STIs) <i>Chlamydia trachomatis</i>, <i>Neisseria gonorrhoeae</i>, <i>Mycoplasma genitalium</i>, <i>Trichomonas vaginalis</i> and <i>Treponema pallidum</i>, to identify associated risk factors and to assess ciprofloxacin resistance in <i>N. gonorrhoeae</i>-positive specimens among female sex workers (FSWs) in Guinea-Bissau.</p><p><strong>Methods: </strong>For this cross-sectional study, FSWs were recruited from October 2014 to May 2019. A questionnaire on STI risk factors was completed by the study participants, and the women were asked to provide a vaginal swab for nucleic acid amplification tests for <i>C. trachomatis</i>, <i>N. gonorrhoeae</i>, <i>M. genitalium</i>, <i>T. vaginalis</i> (Aptima, Hologica), as well as a blood sample for <i>T. pallidum</i> serological testing and discriminatory HIV-testing. The prevalence of STIs was determined, and multivariate logistic regression was used to identify STI risk factors.</p><p><strong>Results: </strong>The study included 467 women. The prevalence of current infection with any curable STI was 46.7%, and the most common pathogen was <i>T. vaginalis</i> (26.3%), followed by <i>M. genitalium</i> (21.9%), <i>C. trachomatis</i> (11.8%), <i>N. gonorrhoeae</i> (10.1%) and <i>T. pallidum</i> (2.8%). The proportion of asymptomatic infections among the diagnosed STIs was 61.8%, 61.5%, 55.3%, 55.3% and 52.2% for <i>C. trachomatis, T. pallidum, N. gonorrhoeae, T. vaginalis and M. genitalium, respectively</i>. The prevalence of the <i>gyrA</i> S91F mutation conferring ciprofloxacin resistance in <i>N. gonorrhoeae</i>-positive specimens was 84.0%. Significant risk factors for having a curable STI were age and HIV-1 infection, while use of female condoms was a protective factor.</p><p><strong>Conclusion: </strong>This study demonstrated that the prevalence of curable STIs was high among FSWs in Guinea-Bissau during the study period, indicating an unmet need for STI services. Moreover, the results indicated that symptomatic treatment might be insufficient, highlighting a need for periodic aetiological testing to facilitate detection of asymptomatic as well as symptomatic STIs to stop ongoing transmission.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"411-417"},"PeriodicalIF":3.6,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976546","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":"Mpox prevalence among samples sent for HSV and syphilis testing in the West of Scotland.","authors":"Neil McInnes, Alasdair MacLean, Rory N Gunson","doi":"10.1136/sextrans-2024-056211","DOIUrl":"10.1136/sextrans-2024-056211","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"469"},"PeriodicalIF":3.6,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318209","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":"Validation of self-reported male circumcision status and genital ulcer disease among Ugandan men.","authors":"Ronald Moses Galiwango, Godfrey Kigozi, Xinyi Feng, Steven Reynolds, Thomas Quinn, Stephen Dalton Kiboneka, Josephine Mpagazi, John Baptist Kereba, Annet Nakayijja, Robert Ssekubugu, Larry Chang, Joseph Kagayi, Aaron Tobian, Mary K Grabowski","doi":"10.1136/sextrans-2023-056096","DOIUrl":"10.1136/sextrans-2023-056096","url":null,"abstract":"<p><strong>Objective: </strong>Voluntary medical male circumcision (MC) is a critical tool in combination HIV prevention programmes in Africa. Self-reported MC (SrMC) status is used in HIV epidemiological surveys to assess MC coverage but is subject to response bias with limited validation. This study evaluated the utility of SrMC status as a marker of MC as well as self-reported genital lesions for genital ulcer disease (GUD) among Ugandan men.</p><p><strong>Methods: </strong>Male participants aged 18-49 years in the cross-sectional Sexually Transmitted Infection Prevalence study, conducted between May and October 2019, responded to a questionnaire capturing SrMC status and current genital ulcer symptoms followed by clinical assessment to verify MC and presence of GUD.Sensitivity, specificity, positive predictive value, negative predictive value and corresponding CIs (95% CI) for SrMC status and GUD were estimated.</p><p><strong>Results: </strong>There were 853 male participants, of whom 470 (55.1%) self-reported being circumcised and 23 (2.7%) self-reported GUD (SrGUD). MC was clinically confirmed in 50.2% (n=428) of participants with sensitivity of SrMC status at 99% (95% CI: 98% to 100%) and specificity 89% (95% CI: 86% to 92%). Specificity of SrMC was lowest among persons living with HIV and viremic (>1000 copies/mL) at 72% (95% CI: 46% to 90%). 18 participants had clinically confirmed GUD, but only 12 SrGUD symptoms, corresponding to a sensitivity and specificity of 67% (95% CI: 41% to 87%) and 99% (95% CI: 98% to 99%), respectively.</p><p><strong>Conclusions: </strong>SrMC status is a robust proxy for clinically confirmed MC status and may reliably be used to assess MC coverage in this setting. Conversely, GUD symptoms were under-reported, which may impact effective syndromic management of sexually transmitted infections and warrants further examination.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"457-459"},"PeriodicalIF":3.6,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535130","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":"Emergency department attendances and inpatient admissions due to mpox infection, England, 2022.","authors":"Hannah Taylor, Clare Humphreys, Neville Q Verlander, Alex Bhattacharya, Roberto Vivancos, Karthik Paranthaman","doi":"10.1136/sextrans-2024-056200","DOIUrl":"10.1136/sextrans-2024-056200","url":null,"abstract":"<p><strong>Objectives: </strong>In 2022, a global outbreak of mpox was reported. In the UK, it predominantly affected gay, bisexual and men who have sex with men (GBMSM). The study objectives were to describe the impact of the mpox outbreak on healthcare service usage in England in 2022, particularly emergency department (ED) attendance, inpatient admission and a number of bed days. Additionally, we wanted to explore whether pre-exposure prophylaxis (PrEP) usage, as a marker of condomless anal intercourse, which increases the risk of sexually transmitted infections associated with compromised skin integrity, was associated with higher ED attendance or hospital attendance.</p><p><strong>Methods: </strong>Data on adult males with laboratory-confirmed mpox were linked with hospital records and described. Using routinely collected data and self-reported exposure data (including PrEP usage) from surveillance questionnaires, multinomial regression was used to estimate adjusted relative risk ratios (aRRRs) with 95% CIs for ED attendance and hospital admission compared with those not admitted.</p><p><strong>Results: </strong>Among 3542 adult males with mpox during May to December 2022, 544 (15.4%) attended ED and 202 (5.7%) were admitted to the hospital. London had the most cases (2393, 68.7%), ED attendances (391, 71.9%) and hospital admissions (121, 59.9%). In multinomial regression, we found strong evidence that compared with people living with HIV, the aRRR for hospital admissions was higher in those not using PrEP (6.9 (95% CI 2.3 to 20.6) vs 4.9 (95% CI 1.7 to 14.1)). The aRRR for ED attendance was 0.63 (95% CI 0.36 to 1.1) for those not using PrEP versus 0.49 (95% CI 0.31 to 0.79).</p><p><strong>Conclusions: </strong>This outbreak had a considerable impact on health services, particularly in high-incidence areas. Commissioners of sexual and healthcare services should review plans for healthcare provision for similar sexually transmitted infection or novel outbreaks among GBMSM or naïve populations in the future. Further studies are needed to confirm and identify reasons for the higher likelihood of hospital admission seen for GBMSM without HIV infection.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"423-429"},"PeriodicalIF":3.6,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288575","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":"Quality, acceptability and usability of self-sampling kits used by non-healthcare professionals for STI diagnosis in Spain: a single-blind study.","authors":"Javier Gómez-Castellá, Marta Cobos Briz, Néstor Nuño, Asuncion Diaz, Francisco Javier Bru-Gorraiz, Alejandro Martín-Gorgojo, Maria Concepción Almonacid-Garrido, Anna Mir, Mario Muñoz, Julia Del Amo","doi":"10.1136/sextrans-2024-056124","DOIUrl":"10.1136/sextrans-2024-056124","url":null,"abstract":"<p><strong>Objectives: </strong>Sexually transmitted infections (STIs) have markedly increased over the last decade in Spain, calling for prevention and control innovative approaches. While there is evidence indicating the effectiveness of self-sampling for STI diagnosis, no kits for this purpose have been authorised in Spain.</p><p><strong>Methods: </strong>A prospective single-blind cross-sectional study carried out between November and December 2022 in an STI clinic in Madrid, Spain, to determine the validity, feasibility and acceptability of self-sampling kits used by non-healthcare professionals from vagina, pharynx, rectum and urethra to diagnose <i>Chlamydia trachomatis</i> (CT) and <i>Neisseria gonorrhoeae</i> (NG). Self-samples were compared with samples collected by healthcare professional (HC samples) and analysed by PCR. Frequency of CT and NG diagnosis by sample type was compared using McNemar's test for paired data. Sensitivity and specificity of self-samples for CT and NG diagnosis were also calculated.</p><p><strong>Results: </strong>306 self-samples from 51 participants were analysed. 80% were men with median age of 33 (IQR: 28-38) years. Self-samples and HC samples showed no significant statistical differences in CT and NG diagnosis. Self-samples had a sensitivity of 81% for CT and 93% for NG, with a specificity of 97% for CT and 95% for NG. More than 90% of participants had no difficulty understanding the kit instructions and 71% expressed high levels of satisfaction with the self-sampling kit.</p><p><strong>Conclusion: </strong>Self-sampling kits for CT and NG diagnosis can be safely and effectively used by non-healthcare professionals in Spain. National strategies for STI prevention and control should prioritise self-sampling strategies.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"405-410"},"PeriodicalIF":3.6,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535113","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":"Research news in clinical context.","authors":"Rachel Herbert, Marina Daskalopoulou, Rayner Kay Jin Tan","doi":"10.1136/sextrans-2023-056077","DOIUrl":"https://doi.org/10.1136/sextrans-2023-056077","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":"100 7","pages":"475-476"},"PeriodicalIF":3.6,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473880","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}