Journal of the Intensive Care Society最新文献

{"title":"Corticosteroid therapy in cardiogenic shock: A systematic review and meta-analysis.","authors":"Clarence Zwengunde, Luke White, Donovan Campbell, Assad Lahlou, Marie Buckel, Peter J McGuigan, Alastair Proudfoot, Alex Warren","doi":"10.1177/17511437261483562","DOIUrl":"10.1177/17511437261483562","url":null,"abstract":"<p><strong>Introduction: </strong>Relative adrenal insufficiency and inflammation are associated with increased mortality in cardiogenic shock. In other shock states such as sepsis, guidelines recommend the administration of corticosteroids.</p><p><strong>Methods: </strong>We conducted a pre-registered (CRD420251042819) systematic review and meta-analysis, searching MEDLINE, Embase and Cochrane Central on 21 June 2025. We included randomised controlled trials and observational studies of adult patients with cardiogenic shock which compared corticosteroids to placebo or usual care. The primary outcome was acute mortality.</p><p><strong>Results: </strong>Of 3242 studies screened, eight studies (four randomised controlled trials and four observational cohort studies) were included with three observational studies of clearly-defined cardiogenic shock included in the primary analysis. There was substantial clinical heterogeneity across included studies of populations, interventions and observed mortality. Observational studies suggested between 7% and 29% of patients with cardiogenic shock received systemic corticosteroids. There was no evidence of an effect on acute mortality in unadjusted analysis (Risk Ratio = 1.05, 95% CI 0.98-1.13, <i>p</i> = 0.17), but there was high risk of residual confounding and a very low certainty of evidence. There was weak evidence of increased rates of hyperglycaemia and hospital-acquired infection, but this was defined heterogeneously and the certainty of evidence was very low.</p><p><strong>Conclusion: </strong>Our conclusions are limited by low study numbers, heterogeneity and uncertainty. There is insufficient evidence to determine the effect of corticosteroid use on acute mortality in cardiogenic shock. Further high-quality research is needed to assess the effect of corticosteroids on mortality in patients with cardiogenic shock.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261483562"},"PeriodicalIF":1.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying research priorities in adult intensive care in the United Kingdom: Results from a James Lind Alliance priority setting partnership.","authors":"Louise Rose, Sarah Wallace, Asha Abdillahi, Burcu Borysik, James Bruce, Sarah Burgess, Allan Crawford, Toto Gronlund, Joy Jarvis, John Jones, Lauren Lacorcia, Sarah Leighton, Georgina Linstead, Marie Mach, Miles Negus-Fancey, Simon Newton-Smith, Sophy Norman, Marlies Ostermann, Yangyang Peng, Pam Ramsay, David Sapsford, Brigid Sharkey, Maryrose Tarpey, Dorothy Wade, Jo Watson, Charlotte Summers","doi":"10.1177/17511437261483913","DOIUrl":"10.1177/17511437261483913","url":null,"abstract":"<p><strong>Background: </strong>Given that research priorities identified by a previous James Lind Alliance (JLA) Priority Setting Partnership (PSP) for Intensive Care are over a decade old, care advances, and recognition of long-term recovery needs, we refreshed these research priorities to identify unanswered questions most important to the people who will use the research.</p><p><strong>Methods: </strong>Following JLA guidance, we formed a steering committee comprising people with lived experience of adult intensive care and healthcare professionals to define the PSP scope. A three-stage approach to establish research priorities comprised uncertainty gathering, initial prioritisation and a final consensus workshop (July 2025 to May 2026).</p><p><strong>Results: </strong>Stage 1: 542 respondents (81% healthcare professionals; 19% former patients/family members) submitted 1593 uncertainties. These were combined into 59 indicative questions. Stage 2: 441 respondents (84% healthcare professionals; 16% former patients/family members) provided ranking, with the highest-ranked 23 taken to the consensus workshop. Of these, the top three priorities are: (1) what are the best ways to prevent, lessen or treat delirium? (2) what are the best ways to promote psychological and emotional recovery after ICU discharge? and (3) how can Post Intensive Care Syndrome be prevented or if occurs, what are the best treatments, rehabilitation and support for recovery and quality of life?</p><p><strong>Conclusion: </strong>This JLA PSP refresh has prioritised 23 uncertainties for adult intensive care research in the United Kingdom. These priorities should now be used to inform the design and funding of research meaningful to people with lived experience and the healthcare professionals who support them.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261483913"},"PeriodicalIF":1.9,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, risk factors, and microbial spectrum of external ventricular drain-related infections among adult neurocritical care patients: A systematic review and meta-analysis.","authors":"Masoud Khoshnoodi, Negin Zameni, Armin Karamian, Alexander J Villahermosa, Brooke A Lajeunesse, Brandon Lucke-Wold, James S Harrop, Ali Seifi","doi":"10.1177/17511437261481748","DOIUrl":"10.1177/17511437261481748","url":null,"abstract":"<p><p>External ventricular drains (EVDs) monitor and manage increased intracranial pressure (ICP) in neurosurgical patients. EVD-related infection (ERI) is a serious complication linked to significant morbidity and mortality. This review aims to determine the overall incidence of ERI, identify key risk factors, compare the effectiveness of different EVD types, and analyze causative organisms. A comprehensive literature search was performed on public databases (PubMed/MEDLINE, Cochrane Library, and Google Scholar) from inception to 15 July 2025. The Newcastle-Ottawa Scale (NOS) tool and Cochrane tool (RoB-2) were used to assess the quality of included studies. A random-effects model was applied for all meta-analyses. The overall incidence of ERI was 8.6% (95% CI 7.2-10.3, <i>I</i> ² = 93%). The pooled incidence was 4.3% in AI EVDs, compared with 9.4% in plain EVDs and 10.5% in SI EVDs. In subgroup analysis, the overall incidence of ERI in studies conducted in the US was notably lower than that in the non-US countries (4.1% vs 10.4%). In comparison to plain catheters, the use of AI EVDs was associated with significant reduced risk of ERI occurrence (OR = 0.43, 95% CI 0.28-0.67, <i>I</i> ² = 16%, <i>p</i> < 0.01), but there was no significant difference between AI EVDs over SI catheters (OR = 0.44, 95% CI 0.15-1.29, <i>I</i> ² = 5%, <i>p</i> = 0.13). In sensitivity analysis, compared to plain EVDs, SI EVDs were associated with a significantly reduced risk of ERI (OR = 0.58, 95% CI 0.38-0.88, <i>I</i> ² = 0%, <i>p</i> = 0.01). Placement of more than 1 EVD, CSF leakage, and extended catheter duration were significant risk factors for ERI. Our results revealed that ERI was associated with longer duration of EVD, hospital, and ICU length of stay. The majority of infections were due to Gram-positive bacteria (65%). The <i>Staphylococcus</i> (49.8%), followed by <i>Acinetobacter</i> (7.6%), and <i>Klebsiella</i> (7%) species, and at lower classifications, <i>CoNS</i> (58%) were the most common causative organisms. Our findings suggest that AI EVDs are associated with a lower risk of ERI compared with plain EVDs. In contrast, SI EVDs did not show a statistically significant reduction in ERI risk compared with plain EVDs in the primary analysis, although a significant reduction was observed in sensitivity analysis after excluding small studies. Further multicenter randomized controlled trials are necessary to validate these conclusions.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261481748"},"PeriodicalIF":1.9,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The LoVe score: Development and validation of a bedside clinical index to identify patients at risk for prolonged invasive mechanical ventilation.","authors":"Paul A Hilders, Lada Lijović, Martijn Otten, Laurens A Biesheuvel, Ameet R Jagesar, Olof Sigling, Paul W G Elbers","doi":"10.1177/17511437261479649","DOIUrl":"10.1177/17511437261479649","url":null,"abstract":"<p><strong>Background: </strong>Early management decisions after intubation, such as humidification strategy or initiation of prevention bundles for ventilator-associated pneumonia, often depend on the expected duration of invasive mechanical ventilation (IMV). However, no simple, standardised method exists to support such estimates at the bedside. We aimed to develop and validate the Length of Ventilation (LoVe) index, a score to predict prolonged IMV beyond 48 h using peri-intubation data.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using two large, publicly available ICU databases: AmsterdamUMCdb for model development and internal validation, and MIMIC-IV for external validation. The primary outcome was prolonged IMV, defined as support beyond 48 h or death within 48 h. Two LoVe variants were derived: a ventilator-inclusive version incorporating ventilator settings, and a ventilator-agnostic version without ventilator settings. Predictors identified via logistic regression were discretised into clinically interpretable ranges and summed into an additive score. Clinical utility was assessed using decision curve analysis.</p><p><strong>Results: </strong>In the cardiac surgery and non-cardiac surgery cohorts, the ventilator-inclusive LoVe index achieved AUROC scores of 0.82 and 0.75, respectively. The ventilator-agnostic version reached 0.72 in the non-cardiac surgery cohort. Validation in MIMIC-IV yielded 0.71 and 0.68 for the ventilator-inclusive version, and 0.71 and 0.65 for the ventilator-agnostic index. Decision curve analysis demonstrated that both LoVe indices provided meaningful clinical utility.</p><p><strong>Conclusions: </strong>The LoVe index provides a simple, interpretable bedside tool to estimate the likelihood of prolonged IMV early after intubation, showing consistent external validity and potential to support early ICU decision-making.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261479649"},"PeriodicalIF":1.9,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interhospital transport of patients with time-critical cardiac emergencies by an adult critical care transfer team.","authors":"Alex Warren, Simon McElligott, Daisy Riddle, Daniel Bradshaw, Alice Gravelle, Callum Gray, Thomas Guy, Letticia Irvine, James Lambert, Colum McGrady, Lorenzo Tiraboschi, Stephen Shepherd","doi":"10.1177/17511437261477679","DOIUrl":"10.1177/17511437261477679","url":null,"abstract":"<p><strong>Introduction: </strong>Due to centralisation of cardiac care, patients with acute cardiac conditions commonly require interhospital transfer. We aimed to describe the epidemiology and management of patients with time-critical cardiac emergencies by one UK Adult Critical Care Transfer Service (ACCTS) and identify potentially modifiable factors associated with prolonged packaging and transfer time.</p><p><strong>Methods: </strong>We conducted an observational cohort study of all patients referred to the ACCESS London ACCTS between 1 April 2023 and 1 April 2025 where the reason for transfer was escalation of care for specialist cardiac services. Patients with acute aortic syndromes and thoracic surgery were excluded. We assessed outcomes of transfer mortality, mortality at 72 h and packaging time. We conducted multivariable linear regression to identify exposures associated with prolonged packaging time as a potentially modifiable factor.</p><p><strong>Results: </strong>Of 466 patients meeting criteria who were referred for transfer, 406 were transferred by our ACCTS. The commonest primary diagnoses were acute myocardial ischaemia (136/406, 33%) and unstable arrhythmia (112/406, 28%). Non-invasive or invasive ventilatory support was used in 193/406 patients (48%) and vasopressor/inotrope support in 256/406 (63%). Death in transfer occurred in two patients, and of 401 patients with follow-up at 72h, 372 (93%) were alive. The median (interquartile range) packaging time was 44 (33, 60) min and median transit time 29 (21, 38) min. Factors associated with prolonged packaging time included use of invasive ventilation (<i>ß</i> = 12.8 (7.4, 18.3) min, <i>p</i> < 0.001), non-invasive ventilation (<i>ß</i> = 23.7 (10.6, 36.8) min, <i>p</i> < 0.001), increasing number of vasoactive infusions (<i>ß</i> = 7.7 (4.1, 11.2) minutes per additional infusion, <i>p</i> < 0.001) and consultant-led transfer (<i>ß</i> = 19.4 (10.1, 28.8) min, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Adult critical care transfer services can provide safe and efficient transfer of patients with cardiac emergencies.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261477679"},"PeriodicalIF":1.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are we training enough critical care specialists for Pakistan's future needs?","authors":"Manahil Rashid, Reewa Alvi, Syeda Shamyl Zehra","doi":"10.1177/17511437261477655","DOIUrl":"10.1177/17511437261477655","url":null,"abstract":"","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261477655"},"PeriodicalIF":1.9,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for a feasibility randomised controlled trial of administering daytime only enteral feeding compared to standard continuous enteral feeding, to reduce delirium in mechanically ventilated, critically ill adults, with qualitative and circadian mechanistic sub-studies.","authors":"Jessie Welbourne, Helen Neilens, Liesl Wandrag, Rachel Clarke, Helen McKenna, Liana Stapleton, Ahilanandan Dushianthan, Kat Tapson, Tim Macdonald, Elis Wilson, Helen Hambly, Sree Aroori, Paigan Aspinall, Chris Rollinson, Victoria Allgar, Daniel Martin","doi":"10.1177/17511437261470606","DOIUrl":"10.1177/17511437261470606","url":null,"abstract":"<p><strong>Background: </strong>Survivors of critical illness describe delirium as a significant problem. Delirium is multi-factorial in origin and known to be associated with disrupted circadian rhythms. The timing of enteral feeding contributes to circadian rhythms. We hypothesised that the normal practice of providing continuous enteral nutrition during critical illness may contribute to delirium, due to the adverse effects on circadian rhythms.</p><p><strong>Methods: </strong>DAYDREAM is a multicentre, open-label, randomised controlled feasibility trial conducted in two UK ICUs. Forty mechanically ventilated adult patients requiring enteral nutrition will be randomised 1:1 to receive either daytime-only feeding (08:00-22:00) or standard continuous enteral feeding. The primary outcomes are feasibility metrics, including recruitment, retention, intervention fidelity, and completeness of data collection. Secondary outcomes include delirium- and coma-free days (assessed using RASS and CAM-ICU), feeding intolerance, glycaemic control, ICU length of stay, and 90-day mortality. A nested qualitative sub-study will explore staff acceptability and implementation barriers. A mechanistic sub-study will evaluate circadian rhythmicity using physiological and biochemical markers between days 3 and 5 of ICU admission.</p><p><strong>Results: </strong>Recruitment commenced in December 2025, with completion anticipated in 2027. Findings will inform the design and delivery of a subsequent definitive multicentre trial.</p><p><strong>Conclusion: </strong>This study will determine the feasibility of implementing daytime-only enteral feeding in critically ill adults and provide preliminary data on its clinical and circadian effects.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261470606"},"PeriodicalIF":1.9,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13443336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clocks on the intensive care unit: A quality improvement initiative to improve patient orientation.","authors":"Alice Worrall, Tom Cliff Lyne, Lester Sarmiento, Tamara Banerjee","doi":"10.1177/17511437261474732","DOIUrl":"10.1177/17511437261474732","url":null,"abstract":"<p><p>Prevention and management of delirium is important for patients on intensive care units (ICU). National Guidelines recommend visible 24-hour clocks for ICU patients. Multi-modal approaches including improved orientation help prevent delirium, but literature on specific impacts of clocks on orientation in ICU patients is limited. This quality improvement project in a tertiary ICU introduced clocks at each bedspace and assessed impact on patient orientation. Proportion of patients orientated to time improved from 45% initially, to 70% post-implementation, then 94% following clock repositioning. Feedback was positive. Clocks are effective in aiding re-orientation which may support delirium prevention and management in ICUs.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261474732"},"PeriodicalIF":1.9,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13443075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No rule, no accountability: Why intensive care needs a statutory triage framework.","authors":"L Mulleague","doi":"10.1177/17511437261474728","DOIUrl":"10.1177/17511437261474728","url":null,"abstract":"","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261474728"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a comprehensive haemodynamic ultrasound assessment for critical care: Rationale and methodology from the FUSIC programme.","authors":"Ashley Miller, Marcus Peck, Hannah Conway, Prashant Parulekar, Antonio Rubino, Jennie Stephens, Jonathan Wilkinson, Justin Kirk-Bayley, Manni Waraich, Michael Griksaitis","doi":"10.1177/17511437261470613","DOIUrl":"10.1177/17511437261470613","url":null,"abstract":"<p><p>Haemodynamic ultrasound is central to bedside assessment of circulatory failure in critical care. The Focused UltraSound in Intensive Care HaemoDynamics (FUSIC HD) programme was originally designed to provide a structured national framework for physiologically focused ultrasound assessment, distinct from comprehensive diagnostic echocardiography. Since publication of the original framework, experience from training cohorts, logbook review, and centralised summative assessment has shown that a broader range of haemodynamic parameters can be acquired and interpreted in routine practice. This article outlines the rationale, development process, and methodological principles underpinning the recent revision of the FUSIC HD dataset. The updated framework incorporates additional assessment of left ventricular performance, right ventricular function, and pulmonary vascular loading, together with a refined approach to estimating left atrial pressure while maintaining emphasis on physiological coherence, bedside feasibility, and avoidance of unnecessary diagnostic complexity. The aim is not to expand diagnostic echocardiography capability, but to support more integrated haemodynamic interpretation in critically ill patients within an established training and governance structure.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261470613"},"PeriodicalIF":1.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}