Journal of Cancer Policy最新文献

{"title":"Palliative care: Seduced by wishful thinking or on safe ground?","authors":"Johanna Swenne ,&nbsp;Christoffer Johansen ,&nbsp;Lars Henrik Jensen","doi":"10.1016/j.jcpo.2026.100719","DOIUrl":"10.1016/j.jcpo.2026.100719","url":null,"abstract":"<div><div>Global advocacy for early and integrated palliative care (PC) in oncology has intensified over the past two decades, frequently positioning PC as both a clinical imperative and a human right. However, the empirical foundation supporting these claims remains surprisingly fragile relative to the strength of the associated policy rhetoric. This analytic paper critically examines the disjunction between expanding normative expectations and the limited, context-bound evidence base underpinning early PC integration in contemporary cancer care. We argue that prevailing narratives risk overstating the robustness and generalizability of existing trial evidence while underestimating the structural, organizational, and clinical realities facing oncology services. Much of the evidence derives from a small number of randomized trials conducted in high-income settings, with methodological limitations that constrain transferability and policy relevance, particularly in tax-funded European health care systems. Despite this, these findings have been widely extrapolated to justify system-wide integration mandates. Against this backdrop, we situate PC within three intersecting transformations: the transformation of many cancers into prolonged, chronic illness trajectories, the growing policy–practice gap in PC provision across Europe, and the normalization of person-centered care as a foundational principle of modern healthcare. We propose a reorientation of PC away from a distinct, predominantly specialist service model, toward a shared clinical responsibility embedded across oncology and general healthcare. In this model, specialist PC expertise is repositioned toward consultation, education, and system-level leadership rather than parallel service provision.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100719"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression-free survival is strongly associated with overall survival in relapsed/refractory diffuse large B-cell lymphoma in the CAR T-cell era","authors":"Alexander M. Gorzewski ,&nbsp;Rebecca Z. Steuer ,&nbsp;Charmi Trivedi ,&nbsp;Kaavya Mandi ,&nbsp;Christina A. Raker ,&nbsp;Charles J. Milrod ,&nbsp;Ari R. Pelcovits","doi":"10.1016/j.jcpo.2025.100699","DOIUrl":"10.1016/j.jcpo.2025.100699","url":null,"abstract":"<div><h3>Introduction</h3><div>In clinical trials for diffuse large B-cell lymphoma (DLBCL), progression-free survival (PFS) has been used as a validated surrogate endpoint to help expedite drug development and regulatory approval. The advent of chimeric antigen receptor (CAR) T-cell therapies has radically changed the treatment landscape, potentially prolonging post-progression survival and weakening the correlation between PFS and overall survival (OS). This study evaluates the utility of PFS as a surrogate endpoint for OS in relapsed/refractory (R/R) DLBCL in the CAR T-cell era.</div></div><div><h3>Materials and methods</h3><div>A systematic review of Phase 3 randomized clinical trials for R/R DLBCL initiated after 2015 was conducted. A weighted linear regression analysis was performed to assess the correlation between PFS and OS.</div></div><div><h3>Results</h3><div>Six trials, comprising 1577 patients, met the inclusion criteria. Weighted linear regression demonstrated a coefficient of determination (R²) of 0.88 (p = 0.0054), indicating a strong association between PFS and OS in R/R DLBCL trials conducted since the introduction of CAR T-cell therapy.</div></div><div><h3>Discussion</h3><div>These findings provide evidence that PFS remains a valid and strong surrogate endpoint for OS in the contemporary R/R DLBCL treatment landscape. This supports the continued use of PFS as a primary endpoint in regulatory studies for new therapies for R/R DLBCL and provides important information for health policy discussions on drug approval, insurance coverage, and reimbursement decisions for aggressive lymphomas.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"47 ","pages":"Article 100699"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psycho-oncology in India","authors":"J. Deodhar ,&nbsp;P. Nayak ,&nbsp;C.S. Pramesh ,&nbsp;A. Purushotham","doi":"10.1016/j.jcpo.2025.100640","DOIUrl":"10.1016/j.jcpo.2025.100640","url":null,"abstract":"<div><div>Psychosocial care is essential for high-quality cancer care. Psycho-oncology is a developing discipline globally. A narrative review was conducted of studies published in India from 2000 to 2024 on psychosocial care in patients with cancer. Of 233 papers identified, 85 were included. Distress rates ranged from 22 % to 62 % with the highest being in head and neck and breast cancer. Seven tools for measuring distress have been validated in a few Indian languages. Cancer-related communication revealed high rates of collusion and use of euphemisms. There is a paucity of intervention studies. Few studies described psychosocial issues in children and adolescents and older adults.Therefore, future high-quality intervention and outcome studies are required. There is an urgent need for the inclusion of psycho-oncology in national cancer control policy globally.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"46 ","pages":"Article 100640"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic distribution of CAR T-cell therapy clinical trials for childhood cancer: Scientific coherence and persistent needs","authors":"Fabriccio J. Visconti-Lopez ,&nbsp;Johana Galvan-Barrios ,&nbsp;Oscar Andrés Alzate Mejía ,&nbsp;Foday Tejan Mansaray","doi":"10.1016/j.jcpo.2025.100668","DOIUrl":"10.1016/j.jcpo.2025.100668","url":null,"abstract":"<div><div>This study aimed to evaluate the geographic distribution of Chimeric Antigen Receptor (CAR) T-cell therapy clinical trials for childhood cancer and assess their alignment with global health needs. Using a quantitative approach, we analyzed data on 317 clinical trials from the WHO’s Global Observatory on Health Research and Development (2007–2022) alongside global health metrics, stratified by WHO region. Our results show a profound geographic imbalance: 56.7 % of trials occurred in the Western Pacific and 27.7 % in the Americas, while regions like Africa, the Eastern Mediterranean, and South-East Asia hosted almost none. Academic institutions were the primary sponsors (69.2 %). Correlational analysis revealed no statistically significant link between trial frequency and childhood cancer mortality rates. The only significant correlation found was between the number of trials and alcohol-related deaths in children aged 5–14 (r² = 0.67; p = 0.04). These findings indicate a stark misalignment between scientific research and the regions with the greatest pediatric oncology burden, highlighting significant scientific inequity. We conclude that structural barriers and misaligned funding prevent vulnerable populations from accessing these transformative therapies, necessitating a strategic shift in global policy to ensure equitable research distribution.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"46 ","pages":"Article 100668"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"US pharmaceutical tariffs and European oncology: Policy risks, openings, and clinical implications","authors":"Javier-David Benitez-Fuentes","doi":"10.1016/j.jcpo.2025.100665","DOIUrl":"10.1016/j.jcpo.2025.100665","url":null,"abstract":"","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"46 ","pages":"Article 100665"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Central and Eastern Europe: A crucible for clinical cancer innovation?","authors":"Mark Lawler ,&nbsp;Susan Bhatti ,&nbsp;Pawel Przewiezlikowski ,&nbsp;Birgit Wolf ,&nbsp;Joanna Frątczak-Kazana ,&nbsp;Piotr Rutkowski ,&nbsp;Peter Šišovský ,&nbsp;Lidia Zielińska ,&nbsp;Axel Glasmacher","doi":"10.1016/j.jcpo.2025.100647","DOIUrl":"10.1016/j.jcpo.2025.100647","url":null,"abstract":"<div><div>Clinical research in oncology is essential for improving patient outcomes; however, cancer care provision and access to novel therapies remains highly heterogeneous across Europe, particularly between Western and Eastern EU27 regions. This has been further compounded by the Russian invasion of Ukraine, severely disrupting regional cancer treatment, research infrastructures and clinical trials activity. Challenges to clinical research in the Central and Eastern regions of the European Union (EU27-CEE) are multifactorial, relating to patient access, local implementation and conduct of trials, education, infrastructure and regulatory procedures. Nevertheless, EU27-CEE comprises a very active clinical trial landscape with its specialist workforce, high productivity and quality of data, empowering a growing regional pharmaceutical industry and establishing itself as an important clinical cancer research hub for conducting global trials. Consequently, patients recruited in EU27-CEE exercise an important impact on global cancer drug development. Poland has proven to be a model for biomedical innovation, serving as the region’s blueprint for a productive clinical trials ecosystem. Multi-stakeholder collaboration and patient-centric approaches are required to streamline procedures for quicker trial initiation, simpler trial conduct, and better cross-border access. Recognizing these challenges and opportunities, we have developed, through a consultative approach, a Call to Action that, if implemented, would enhance the cancer clinical trials landscape in EU27-CEE countries and empower patient access to the latest advances and therapies in cancer drug development.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"46 ","pages":"Article 100647"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurse-enabled survivorship in early-stage breast cancer (1970–2024): A critical bibliometric review of models, outcomes, and PRO-driven workflows","authors":"Alex S. Borromeo ,&nbsp;Russell John Catalig ,&nbsp;Abigail Ramos ,&nbsp;Catherine Atud ,&nbsp;Josefina Reyes ,&nbsp;Walton Wider","doi":"10.1016/j.jcpo.2025.100664","DOIUrl":"10.1016/j.jcpo.2025.100664","url":null,"abstract":"<div><h3>Background</h3><div>Survivorship has become a central component of early-stage breast cancer care, yet implementation of evidence-based models remains inconsistent across settings. Nurses now serve as the backbone of follow-up, psychosocial support, and patient-reported outcome (PRO) monitoring, linking hospital and community-based care.</div></div><div><h3>Objectives</h3><div>To map nursing’s scholarly contributions to survivorship, identify dominant research clusters and intellectual anchors, and explain why proven nurse-enabled and PRO-driven models remain underutilized in clinical practice.</div></div><div><h3>Interventions/Methods</h3><div>A critical bibliometric review was conducted using the Web of Science Core Collection (1970–2024). Descriptive metrics and VOSviewer co-citation and co-word analyses were used to examine publication trends, thematic clusters, and intellectual linkages.</div></div><div><h3>Results</h3><div>A total of 196 peer-reviewed articles (5,361 citations; H-index = 39) were identified. Four key clusters emerged: (1) risk-stratified nurse-led follow-up, (2) psychosocial well-being and rehabilitation, (3) shared decision-making and communication, and (4) PRO and quality-of-life infrastructure. Evidence supports streamlined, nurse-enabled care as safe and effective, with PRO-integrated triage reducing emergency visits and improving outcomes. Persistent gaps relate to limited reimbursement, workforce constraints, and PRO collection without actionable triage protocols.</div></div><div><h3>Conclusions</h3><div>Nursing constitutes the operational core of survivorship. Embedding PROs as clinical triggers, integrating psychosocial and rehabilitation services, and aligning funding with nurse-led, equity-focused pathways can transform survivorship delivery.</div></div><div><h3>Implications for Oncology Nursing Practice</h3><div>Oncology nurses should lead risk-stratified follow-up, normalize distress and exercise screening, and operationalize PRO triage with defined response times. Institutions should reimburse nurse-led encounters, report survivorship quality indicators, and scale culturally responsive models to achieve equitable survivorship care.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"46 ","pages":"Article 100664"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring experiences of reasonable adjustments in cancer care among patients with disabilities and their carers: A focus group study in South West England","authors":"Selin Siviş ,&nbsp;Andrew Turner ,&nbsp;Hannah Little ,&nbsp;Shamim Kholwadia ,&nbsp;Ruth Hendy ,&nbsp;Fiona Spence ,&nbsp;Gifty Markey ,&nbsp;Jon Banks","doi":"10.1016/j.jcpo.2025.100641","DOIUrl":"10.1016/j.jcpo.2025.100641","url":null,"abstract":"<div><h3>Background</h3><div>The UK Equality Act 2010 mandates equal access to healthcare for people with disabilities. For those with disabilities who have also been diagnosed with cancer, addressing these needs is complex and multifaceted. Whilst existing research has primarily focused on reasonable adjustments for individuals with learning disabilities or autism, this study broadens the scope to include physical disabilities, cognitive or sensory impairments, and mental health conditions.</div></div><div><h3>Aim</h3><div>This study aimed qualitatively explore and understand the experiences of individuals with disabilities requiring reasonable adjustments, who have direct or indirect exposure to cancer treatment within the cancer care setting, as well as the experiences of their carers.</div></div><div><h3>Methods</h3><div>Qualitative study based on seven focus groups with 44 participants who have direct or indirect experience of cancer treatment and experience of one or more of a range of conditions that may require reasonable adjustments. Thematic analysis was used inductively to explore patterns.</div></div><div><h3>Results</h3><div>Participants described various care pathway adjustments but also noted their limited effectiveness. The main concern was a lack of alignment with individual needs. Three key areas for improvement emerged: (1) communication and coordination (e.g., clearer signposting, longer appointments, better understanding of needs); (2) support for family and carers (e.g., tailored adjustments for caregivers, clearer explanations); and (3) adherence to compassion and empathy (e.g., avoiding jargon, using accessible language, and ensuring patients feel heard).</div></div><div><h3>Conclusion</h3><div>Reasonable adjustments are necessary but not sufficient for equitable care. Participants emphasised the need for an integrated approach to individual needs to ensure adjustments are both accessible and effective.</div></div><div><h3>Policy summary</h3><div>An integrated understanding of individuals’ and their family carers’ needs should underpin approaches to reasonable adjustments by healthcare providers. A first step to achieving this is to develop training for healthcare professionals to encompass a broader understanding of reasonable adjustments beyond legal categories.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"46 ","pages":"Article 100641"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing multidisciplinary oncology care: Feasibility of structured tools for Belgian multidisciplinary oncological consultation meetings","authors":"Nadine Boesten ,&nbsp;Melissa De Regge ,&nbsp;Hannes Vanpoecke ,&nbsp;Mark Leys ,&nbsp;Kristof Eeckloo ,&nbsp;Paul Gemmel","doi":"10.1016/j.jcpo.2025.100656","DOIUrl":"10.1016/j.jcpo.2025.100656","url":null,"abstract":"<div><h3>Background</h3><div>Multidisciplinary team meetings (MDTMs) are considered a cornerstone of oncology care, yet questions remain about their efficiency and patient-centeredness. While tools exist to guide and structure MDTMs, their integration into hospital settings is often inconsistent.</div></div><div><h3>Methods</h3><div>This feasibility study examined the use of two validated tools—the MDT-QuIC checklist and the MDT-MeDiC complexity tool—across ten Multidisciplinary Oncological Consultations (MOCs) in five Belgian hospitals. Baseline assessments were conducted using the validated MDT-MODe observational instrument. Implementation feasibility was evaluated through repeated observations at the MOCs and interviews with MOC chairs.</div></div><div><h3>Results</h3><div>Baseline data showed limited discussion of psychosocial information and patient preferences, and minimal nurse contribution. The MDT-QuIC was generally accepted as helpful for structure and role clarity, though not consistently applied due to time pressures. The MDT-MeDiC tool was considered too resource-intensive for routine use. Implementation success varied by existing structure, leadership style, and administrative support.</div></div><div><h3>Conclusion</h3><div>Structured tools can improve the organization of MOCs, but feasibility is dependent on local context. Broader uptake across health systems requires attention to team composition, preparatory workflows, and integration into supportive policy and digital frameworks.</div></div><div><h3>Policy summary</h3><div>Embedding structured MDTM tools into oncology policy, through digital integration, case complexity triaging, and incentives for psychosocial and nursing input enables efficient use of expert time while safeguarding patient-centredness.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"46 ","pages":"Article 100656"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indirect economic burden of cancer in populations in China, 2021: A measurement based on a human capital approach","authors":"Xin-Yi Zhou ,&nbsp;Xin Wang ,&nbsp;Sen-Yao Cai ,&nbsp;Yan-Jie Li ,&nbsp;Jie-Bin Lew ,&nbsp;Wanqing Chen ,&nbsp;Ju-Fang Shi","doi":"10.1016/j.jcpo.2025.100648","DOIUrl":"10.1016/j.jcpo.2025.100648","url":null,"abstract":"<div><h3>Objectives</h3><div>Cancer imposes an enormous burden. In China, research on cancer economic burden has primarily focused on the direct economic burden while the indirect economic burden of cancer (IEBC) has been overlooked. Therefore, we aimed to conduct a systematic quantification of IEBC in populations in China.</div></div><div><h3>Methods</h3><div>A human capital approach was used to estimate the IEBC. The loss of productivity time was approximated based on disability-adjusted life years (DALYs) from the GBD 2021. The labour force participation rate and per capita economic parameters were sourced from various datasets, and subgroup and sensitivity analyses were conducted. The indirect-to-direct economic burden ratio was estimated partially based on results from a literature review.</div></div><div><h3>Results</h3><div>The overall IEBC in populations in China was estimated to be CNY1014.4 billion in 2021, representing 0.89 % of the gross domestic product (GDP). Among this total, CNY990.3 billion (97.6 %) was attributed to premature death and CNY24.1 billion to disability; CNY822.3 billion (81.1 %) to males and CNY853.8 billion (84.2 %) to populations under the age of 60 years. Region heterogeneity was observed to be CNY26.5 billion for the Northwest and CNY263.7 billion for the East. Of the overall IEBC, 58.8 % (CNY596.9 billion) could be attributed to a range of modifiable risk factors (tobacco was the leading one at CNY304.6 billion); 76.0 % (CNY770.8 billion) was attributed to screening-targeted cancers, mainly gastrointestinal cancers (CNY458.2 billion), lung cancer (CNY232.9 billion), breast and cervical cancer (CNY57.2 billion). The by-cancer median value of the indirect-to-direct economic burden ratio was 2.56 (range 0.83–4.76).</div></div><div><h3>Conclusions</h3><div>The previously underestimated IEBC was roughly 3 times the reported direct economic burden in populations in China. Systematic quantification of the IEBC from \"preventable\" and \"screenable\" cancer types suggests there to be a potential extent of future economic benefit of implementing more effective and scaled-up population-based primary and secondary interventions.</div></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"46 ","pages":"Article 100648"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}