Medical Devices-Evidence and Research最新文献

{"title":"Actual performance of mechanical ventilators in ICU: a multicentric quality control study.","authors":"Leonardo Govoni,&nbsp;Raffaele L Dellaca',&nbsp;Oscar Peñuelas,&nbsp;Giacomo Bellani,&nbsp;Antonio Artigas,&nbsp;Miquel Ferrer,&nbsp;Daniel Navajas,&nbsp;Antonio Pedotti,&nbsp;Ramon Farré","doi":"10.2147/MDER.S35864","DOIUrl":"https://doi.org/10.2147/MDER.S35864","url":null,"abstract":"<p><p>Even if the performance of a given ventilator has been evaluated in the laboratory under very well controlled conditions, inappropriate maintenance and lack of long-term stability and accuracy of the ventilator sensors may lead to ventilation errors in actual clinical practice. The aim of this study was to evaluate the actual performances of ventilators during clinical routines. A resistance (7.69 cmH(2)O/L/s) - elastance (100 mL/cmH(2)O) test lung equipped with pressure, flow, and oxygen concentration sensors was connected to the Y-piece of all the mechanical ventilators available for patients in four intensive care units (ICUs; n = 66). Ventilators were set to volume-controlled ventilation with tidal volume = 600 mL, respiratory rate = 20 breaths/minute, positive end-expiratory pressure (PEEP) = 8 cmH(2)O, and oxygen fraction = 0.5. The signals from the sensors were recorded to compute the ventilation parameters. The average ± standard deviation and range (min-max) of the ventilatory parameters were the following: inspired tidal volume = 607 ± 36 (530-723) mL, expired tidal volume = 608 ± 36 (530-728) mL, peak pressure = 20.8 ± 2.3 (17.2-25.9) cmH(2)O, respiratory rate = 20.09 ± 0.35 (19.5-21.6) breaths/minute, PEEP = 8.43 ± 0.57 (7.26-10.8) cmH(2)O, oxygen fraction = 0.49 ± 0.014 (0.41-0.53). The more error-prone parameters were the ones related to the measure of flow. In several cases, the actual delivered mechanical ventilation was considerably different from the set one, suggesting the need for improving quality control procedures for these machines.</p>","PeriodicalId":47140,"journal":{"name":"Medical Devices-Evidence and Research","volume":" ","pages":"111-9"},"PeriodicalIF":1.3,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/MDER.S35864","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40213637","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":"Evaluation of long-acting somatostatin analog injection devices by nurses: a quantitative study.","authors":"Daphne T Adelman,&nbsp;Andrea Burgess,&nbsp;Philippa R Davies","doi":"10.2147/MDER.S37831","DOIUrl":"https://doi.org/10.2147/MDER.S37831","url":null,"abstract":"<p><p>The somatostatin analogs (SSAs) lanreotide Autogel/Depot and octreotide long-acting release are used to treat acromegaly and neuroendocrine tumors. The present study evaluated opinions on SSA injection devices, including a recently approved lanreotide new device (lanreotide-ND), among nurses in Europe and the USA. Nurses injecting SSAs for at least three patients per year (n = 77) were interviewed regarding SSA devices. Device attributes were rated via questionnaire; nurses were then timed administering test injections with lanreotide-ND and octreotide long-acting release. The most important delivery system attributes were easy/convenient preparation and injection (ranked in the top five by 70% of nurses), low clogging risk (58%), and high product efficacy (55%). Compared with the octreotide long-acting release device, lanreotide-ND scored higher on 15/16 attributes, had shorter mean preparation and administration time (329 versus 66 seconds, respectively; P ≤ 0.01) and a higher overall preference score (70 versus 114, respectively; P ≤ 0.01). The five most important lanreotide-ND attributes were: prefilled device, confidence a full dose was delivered, low clogging risk, easy/convenient preparation and injection, and fast administration. These device features could lead to improvements in clinical practice and benefit patients/caregivers who administer SSAs at home.</p>","PeriodicalId":47140,"journal":{"name":"Medical Devices-Evidence and Research","volume":" ","pages":"103-9"},"PeriodicalIF":1.3,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/MDER.S37831","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40213635","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":"Sacroiliac Joint Pain","authors":"Pascal Vanelderen, Karolina Szadek, S. P. Cohen, J. Witte, Arno Lataster, J. Patijn, Nagy Mekhail, M. V. Kleef, J. V. Zundert","doi":"10.1002/9781119968375.CH13","DOIUrl":"https://doi.org/10.1002/9781119968375.CH13","url":null,"abstract":"Abstract Sacroiliac joint pain represents a frequently misdiagnosed cause of low back pain, affecting between 15% and 30% of individuals with mechanical pain below L5. Although a battery of provocation maneuvers can identify most cases of sacroiliac joint pain with reasonable specificity, the reference standard is low-volume blocks, which are associated with a false-positive rate ranging between 10% and 30%. Between 40% and 50% of cases are caused by a specific inciting event, which can include motor vehicle collisions, falls, or more insidious etiologies, such as pregnancy, spinal fusion, and leg length discrepancies. Sacroiliac joint pain may be secondary to both intraarticular and extraarticular pathology, with the latter more likely to be unilateral and affect younger individuals. Both intraarticular and extraarticular steroid blocks have been shown to provide short- to intermediate-term and are sometimes used to select patients for radiofrequency denervation or fusion. Since the lateral branches targeted during denervation innervate the ligaments, those with extraarticular pathology are more likely to benefit. Minimally invasive fusion should be reserved for individuals with dislocation or degeneration with instability who have failed more conservative therapies.","PeriodicalId":47140,"journal":{"name":"Medical Devices-Evidence and Research","volume":"57 6","pages":"96-102"},"PeriodicalIF":1.3,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50781006","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":"High molecular weight hyaluronan for treatment of chronic shoulder pain associated with glenohumeral arthritis.","authors":"Arnold J Weil","doi":"10.2147/MDER.S22423","DOIUrl":"https://doi.org/10.2147/MDER.S22423","url":null,"abstract":"<p><strong>Background: </strong>There is insufficient evidence to determine whether intra-articular injections may be effective for treatment of glenohumeral osteoarthritis. Euflexxa(®) (high molecular weight hyaluronate), a bioengineered high molecular weight hyaluronan, has been shown to be a safe and effective treatment for patients with knee osteoarthritis. There is also support for the use of hyaluronate injection for the treatment of chronic shoulder pain associated with osteoarthritis or rotator cuff damage. This small-scale exploratory study was conducted to evaluate the safety and efficacy of high molecular weight hyaluronate for the treatment of chronic shoulder pain associated with osteoarthritis.</p><p><strong>Methods: </strong>Subjects with glenohumeral osteoarthritis and chronic pain (n = 27) received one injection per week for 3 weeks of high molecular weight hyaluronate and were assessed for changes in pain (100 mm visual analog scale [VAS]), range of motion, and the subject's and physician's global assessment over 26 weeks. Subjects were also assessed for pain, stiffness, and physical functioning using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Finally, responses were evaluated using modified Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT)-Osteoarthritis Research Society International (OARSI) Proposition D criteria. Safety was assessed by recording adverse events.</p><p><strong>Results: </strong>High molecular weight hyaluronate significantly improved pain (VAS, WOMAC), range of motion, stiffness, and physical functioning scores; 77.8% of subjects were rated as having an OMERACT-OARSI Proposition D high response. There were no serious adverse events, and none were considered to be related to treatment.</p><p><strong>Conclusion: </strong>Treatment with high molecular weight hyaluronate improves pain, stiffness, and range of motion, and may have an acceptable safety and tolerability profile. A randomized, double-blind, placebo-controlled clinical trial may be warranted to investigate further the efficacy and safety of intra-articular high molecular weight hyaluronate for treatment of chronic shoulder pain in patients with glenohumeral osteoarthritis.</p>","PeriodicalId":47140,"journal":{"name":"Medical Devices-Evidence and Research","volume":" ","pages":"99-105"},"PeriodicalIF":1.3,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/MDER.S22423","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30853706","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":"Tobramycin administered by the TOBI(®) Podhaler(®) for persons with cystic fibrosis: a review.","authors":"Donald R Vandevanter,&nbsp;David E Geller","doi":"10.2147/MDER.S16360","DOIUrl":"https://doi.org/10.2147/MDER.S16360","url":null,"abstract":"<p><p>From its introduction, the antibiotic tobramycin has been an important tool in the management of persons with cystic fibrosis (CF) and chronic Pseudomonas aeruginosa lung infections. Initially an intravenous rescue treatment for pulmonary exacerbations, tobramycin delivered by inhalation has become a mainstay of chronic suppressive CF infection management. Platforms for tobramycin aerosol delivery have steadily improved, with increased lung deposition complimented by decreased device complexities, loaded tobramycin doses, delivery times, and treatment burdens. Most recently, a unique tobramycin inhalation powder (TIP) formulation with a portable delivery system, the TOBI(®) Podhaler(®) (Novartis AG, Basel, Switzerland) has been developed and approved in Europe, Canada, and Chile. Four capsules, each containing 28 mg of TIP are successively pierced and inhaled via the T-326 Dry Powder Inhaler Device (Novartis AG, Basel, Switzerland). No external power source is required to deliver an efficacious tobramycin dose in minutes. By comparison, tobramycin inhalation solution (TIS) (TOBI(®); Novartis), is delivered by LC(®) Plus (PARI Respiratory Equipment Inc, Midlothian, VA) jet nebulizer powered by an air compressor over 15-20 minutes. Comparative pharmacokinetics, safety, and efficacy studies of TIS and TIP in CF subjects with P. aeruginosa ≥ 6 years old demonstrate that: tobramycin lung deposition with 112 mg TIP is comparable to that attained with 300 mg TIS, TIP is more effective than placebo and not inferior to TIS with respect to pulmonary function benefit, and TIP has significantly faster treatment times and achieves higher patient satisfaction than TIS. TIP is associated with an increased frequency of mild to moderate local adverse events (cough, dysphonia, and dysgeusia) compared with TIS, however, these become less frequent as subjects gain TIP experience. These results suggest that the TOBI Podhaler may better meet the needs of many CF patients and families by reducing treatment time and complexity and improving patient satisfaction compared with TIS.</p>","PeriodicalId":47140,"journal":{"name":"Medical Devices-Evidence and Research","volume":" ","pages":"179-88"},"PeriodicalIF":1.3,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/MDER.S16360","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30852073","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":"A better effect of cilostazol for reducing in-stent restenosis after femoropopliteal artery stent placement in comparison with ticlopidine.","authors":"Ichiro Ikushima,&nbsp;Kazuchika Yonenaga,&nbsp;Hironao Iwakiri,&nbsp;Hideki Nagoshi,&nbsp;Haruhito Kumagai,&nbsp;Yasuyuki Yamashita","doi":"10.2147/MDER.S21629","DOIUrl":"https://doi.org/10.2147/MDER.S21629","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to assess the preventive effect of cilostazol on in-stent restenosis in patients after superficial femoral artery (SFA) stent placement.</p><p><strong>Materials and methods: </strong>Of 28 patients with peripheral arterial disease, who had successfully undergone stent implantation, 15 received cilostazol and 13 received ticlopidine. Primary patency rates were retrospectively analyzed by means of Kaplan-Meier survival curves, with differences between the two medication groups compared by log-rank test. A multivariate Cox proportional hazards model was applied to assess the effect of cilostazol versus ticlopidine on primary patency.</p><p><strong>Results: </strong>The cilostazol group had significantly better primary patency rates than the ticlopidine group. Cumulative primary patency rates at 12 and 24 months after stent placement were, respectively, 100% and 75% in the cilostazol group versus 39% and 30% in the ticlopidine group (P = 0.0073, log-rank test). In a multivariate Cox proportional hazards model with adjustment for potentially confounding factors, including history of diabetes, cumulative stent length, and poor runoff, patients receiving cilostazol had significantly reduced risk of restenosis (hazard ratio 5.4; P = 0.042).</p><p><strong>Conclusion: </strong>This retrospective study showed that cilostazol significantly reduces in-stent stenosis after SFA stent placement compared with ticlopidine.</p>","PeriodicalId":47140,"journal":{"name":"Medical Devices-Evidence and Research","volume":" ","pages":"83-9"},"PeriodicalIF":1.3,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/MDER.S21629","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30853314","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":"Therapeutic hypertension system based on a microbreathing pressure sensor system.","authors":"Ziji Diao,&nbsp;Hongying Liu,&nbsp;Lan Zhu,&nbsp;Xiaoqiang Gao,&nbsp;Suwen Zhao,&nbsp;Xitian Pi,&nbsp;Xiaolin Zheng","doi":"10.2147/MDER.S19971","DOIUrl":"https://doi.org/10.2147/MDER.S19971","url":null,"abstract":"<p><strong>Background and methods: </strong>A novel therapeutic system for the treatment of hypertension was developed on the basis of a slow-breath training mechanism, using a microbreathing pressure sensor device for the detection of human respiratory signals attached to the abdomen. The system utilizes a single-chip AT89C51 microcomputer as a core processor, programmed by Microsoft Visual C++6.0 to communicate with a PC via a full-speed PDIUSBD12 interface chip. The programming is based on a slow-breath guided algorithm in which the respiratory signal serves as a physiological feedback parameter. Inhalation and exhalation by the subject is guided by music signals.</p><p><strong>Results and conclusion: </strong>Our study indicates that this microbreathing sensor system may assist in slow-breath training and may help to decrease blood pressure.</p>","PeriodicalId":47140,"journal":{"name":"Medical Devices-Evidence and Research","volume":" ","pages":"51-7"},"PeriodicalIF":1.3,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/MDER.S19971","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30853310","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":"Assessment of the added value of the Twente Photoacoustic Mammoscope in breast cancer diagnosis.","authors":"Marjolein P Hilgerink,&nbsp;Marjan Jm Hummel,&nbsp;Srirang Manohar,&nbsp;Simon R Vaartjes,&nbsp;Maarten J Ijzerman","doi":"10.2147/MDER.S20169","DOIUrl":"https://doi.org/10.2147/MDER.S20169","url":null,"abstract":"<p><strong>Purpose: </strong>Photoacoustic (PA) imaging is a recently developed breast cancer imaging technique. In order to enhance successful clinical implementation, we quantified the potential clinical value of different scenarios incorporating PA imaging by means of multi-criteria analysis. From this analysis, the most promising area of application for PA imaging in breast cancer diagnosis is determined, and recommendations are provided to optimize the design of PA imaging.</p><p><strong>Methods: </strong>The added value of PA imaging was assessed in two areas of application in the diagnostic track. These areas include PA imaging as an alternative to x-ray mammography and ultrasonography in early stage diagnosis, and PA imaging as an alternative to Magnetic Resonance Imaging (MRI) in later stage diagnosis. The added value of PA imaging was assessed with respect to four main criteria (costs, diagnostic performance, patient comfort and risks). An expert panel composed of medical, technical and management experts was asked to assess the relative importance of the criteria in comparing the alternative diagnostic devices. The judgments of the experts were quantified based on the validated pairwise comparison technique of the Analytic Hierarchy Process, a technique for multi-criteria analysis. Sensitivity analysis was applied to account for the uncertainty of the outcomes.</p><p><strong>Results: </strong>Among the considered alternatives, PA imaging is the preferred technique due to its non-invasiveness, low cost and low risks. However, the experts do not expect large differences in diagnostic performance. The outcomes suggest that design changes to improve the diagnostic performance of PA imaging should focus on the quality of the reconstruction algorithm, detector sensitivity, detector bandwidth and the number of wavelengths used.</p><p><strong>Conclusion: </strong>The AHP method was useful in recommending the most promising area of application in the diagnostic track for which PA imaging can be implemented, this being early diagnosis, as a substitute for the combined use of x-ray mammography and ultrasonography.</p>","PeriodicalId":47140,"journal":{"name":"Medical Devices-Evidence and Research","volume":" ","pages":"107-15"},"PeriodicalIF":1.3,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/MDER.S20169","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30853707","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":"Everolimus-eluting stents: update on current clinical studies.","authors":"Dominic J Allocco, Anita A Joshi, Keith D Dawkins","doi":"10.2147/MDER.S22043","DOIUrl":"10.2147/MDER.S22043","url":null,"abstract":"<p><p>Everolimus-eluting stents (EES) have become the most commonly implanted coronary stents worldwide. This review describes and analyzes the clinical data supporting the use of EES, focusing primarily on published, randomized, controlled trials. Everolimus-eluting stents have been shown to have less restenosis, stent thrombosis, and periprocedural myocardial infarction compared with earlier generation paclitaxel-eluting stents (PES). Lower rates of adverse events for EES compared with PES were generally seen in all subgroups, with the notable exception of patients with diabetes mellitus. There have been fewer, randomized, clinical trials comparing EES with either sirolimus-eluting stents or zotarolimus-eluting stents, although very good results with EES have been observed in the trials that have been performed. Recent clinical trial data suggest that this excellent safety and efficacy profile is maintained in a next-generation EES designed to have improved mechanical properties and radiopacity.</p>","PeriodicalId":47140,"journal":{"name":"Medical Devices-Evidence and Research","volume":" ","pages":"91-8"},"PeriodicalIF":1.3,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3417879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30853315","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":"Long-term effectiveness and safety of sirolimus drug-eluting stents.","authors":"Mahesh Bikkina,&nbsp;Jayanth Koneru","doi":"10.2147/MDER.S11749","DOIUrl":"https://doi.org/10.2147/MDER.S11749","url":null,"abstract":"<p><p>The root cause of coronary artery disease is atherosclerosis, ie, intraluminal narrowing (stenosis) of the arteries that supply blood to tissues of the heart. The introduction of the drug-eluting stent over the past decade has revolutionized the field of interventional cardiology. It is used extensively in clinical practice for the treatment of coronary artery disease. The first drug-eluting stent to receive US Food and Drug Administration approval was the sirolimus-eluting stent. Recently, two other stent analogs of sirolimus were approved, ie, the zotarolimus-eluting stent and the everolimus-eluting stent. However, concern has arisen in recent years about the long-term safety and efficacy of drug-eluting stents, due to the occurrence of late adverse clinical events, such as stent thrombosis. This review focuses on clinical studies that have been performed with the sirolimus-eluting stent or its analogs. We discuss the pharmacology, safety, and various therapeutic options that exist when choosing stents for coronary artery disease. Our aim is to provide a thorough review of the long-term efficacy and safety of sirolimus drug-eluting stents, and also to discuss currently approved and promising investigational drug-eluting stents, in an effort to provide insight into how these stents are currently evolving and generate further investigation in this area.</p>","PeriodicalId":47140,"journal":{"name":"Medical Devices-Evidence and Research","volume":" ","pages":"117-24"},"PeriodicalIF":1.3,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/MDER.S11749","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30853708","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}