Lung India最新文献

{"title":"Bronchodilator reversibility and eosinophilic biomarkers in chronic obstructive pulmonary disease patients.","authors":"H Ameet, Deependra K Rai, Saurabh Karmakar, Somesh Thakur, Mala Mahto, Priya Sharma, Rajesh Yadav, Vatsal Gupta","doi":"10.4103/lungindia.lungindia_261_24","DOIUrl":"10.4103/lungindia.lungindia_261_24","url":null,"abstract":"<p><strong>Background and objectives: </strong>Chronic Obstructive Pulmonary Disease (COPD) is now one of the top three causes of death worldwide. Recently, increased focus has been on COPD patients displaying eosinophilic inflammation and asthma-like features of bronchial hyperreactivity and bronchodilator responsiveness. The objective of the study was to measure the proportion of chronic obstructive pulmonary disease patients with bronchodilator reversibility and to compare the eosinophilic biomarkers between the bronchodilator non-reversible and reversible groups.</p><p><strong>Materials and methods: </strong>This hospital-based cross-sectional study included COPD patients who visited the Pulmonary Medicine OPD at the All-India Institute of Medical Sciences, Patna. Spirometry and eosinophilic biomarkers such as blood eosinophil, sputum eosinophil, FeNO, and serum IL-5 were measured. All statistical calculations were conducted using SPSS (Statistical Package for the Social Science 22 version (SPSS, Chicago, IL, United States).</p><p><strong>Results: </strong>A total of 160 COPD patients were included in the study. The mean age of the study population was 61 (±10) years. Males (68.1%) and non-smokers (55%) respectively were predominant. The prevalence of bronchodilator reversibility was found to be 32%. There was a significant difference in eosinophil biomarker levels, of sputum eosinophil count, peripheral eosinophil count, and FeNO levels between the bronchodilator non-reversible and bronchodilator reversible groups. Serum IL-5 levels were higher and more significant in GOLD group D patients.</p><p><strong>Conclusion: </strong>Eosinophils are crucial to the underlying inflammatory response in this subset of COPD patients, as evidenced by the observation that eosinophil biomarkers were significantly higher in COPD patients with bronchodilator reversibility. Also, sputum eosinophil levels had a better correlation in comparison to peripheral eosinophil level in this subset.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 2","pages":"128-133"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516990","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":"Radiological resolution of community-acquired pneumonia in hospitalised patients in North India.","authors":"Sayar Ahmad Pandit, Hazique P Koul, Saniya Saif","doi":"10.4103/lungindia.lungindia_526_24","DOIUrl":"10.4103/lungindia.lungindia_526_24","url":null,"abstract":"<p><strong>Background: </strong>Community-acquired pneumonia (CAP) is the most common infectious cause of death, and radiology is a corner stone of its management. No data are available from India regarding the radiological resolution of CAP in the current antibiotic era. We set out to study determine the radiological resolution of CAP.</p><p><strong>Methods: </strong>The study was conducted in a 1250-bedded North Indian hospital. Consecutive consenting adults admitted with CAP over a period of 2 years from July 2019 were enrolled for the study. The patients were subjected to routine investigations and radiological imaging and treated with standard antibiotic/antiviral therapy as per standard protocols and followed daily till clinical resolution and discharge from the hospital. Serial chest radiographs were taken at 2, 4, 8, and 12 weeks after admission, and the follow-up terminated at either complete clinical or radiological resolution.</p><p><strong>Results: </strong>176 patients (age 20 to 90 years, median 60 years; 109 (61.9%) male) participated. Eighty-nine (50.6%) patients were current smokers. Chest radiographs revealed lobar consolidation as the most common finding (n = 97, 55.1%), followed by pulmonary infiltrates (n = 73, 41.5%) and pleural effusion (n = 6, 3.1%); 44 (25%) patients had multi-lobar consolidation The rates of radiological resolution at 2, 4, 8, and 12 weeks follow-up were 30%, 38.5% (cumulative 68.5%), 25.7% (cumulative 94.2%), and 5.9% (cumulative 100%) of patients, respectively. The average time taken for radiological resolution was 31.49 (±20.2) days in 70 cases, where documented. On multi-variate analysis, smoking was an independent factor for delayed radiological resolution (P = 0.007).</p><p><strong>Conclusion: </strong>Radiological resolution of CAP occurs in the majority (68.5%) of the patients at 4 weeks from the time of clinical presentation, with smoking as an independent risk factor for delayed (>4 week) radiological resolution. Clinicians can wait for 4 weeks to document radiological recovery unless clinical features suggest otherwise.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 2","pages":"134-139"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517039","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":"Improvement in radiologic findings over time is associated with increased survival in patients with viral ARDS requiring extracorporeal membrane oxygenation.","authors":"Laura DiChiacchio, Ikeoluwapo Ibrahim, Alison Grazioli, Neda Bionghi, Kiran Batra, Sameer Chabbra, Nicholas Ladikos, Vaidehi Kaza, Srinivas Bollineni, Manish R Mohanka, Adrian Lawrence, Fernando Torres, Aldo Iacono, Daniel Herr, Irina Timofte","doi":"10.4103/lungindia.lungindia_501_24","DOIUrl":"10.4103/lungindia.lungindia_501_24","url":null,"abstract":"<p><strong>Introduction: </strong>Acute respiratory distress syndrome (ARDS) requiring venovenous extracorporeal membrane oxygenation (VV ECMO) support is associated with chest radiograph changes commonly referred to as \"drowning ECMO lung\" ECMO lung presents as white-out of both lung fields, involving all lobes of the bilateral lungs. While the clinical significance of chest radiograph findings over time has been described in the general ARDS population, it has not been evaluated specifically in VV ECMO patients. This subpopulation suffers the most severe disease as well as the confounding effects of ECMO support.</p><p><strong>Materials and methods: </strong>We identified 28 patients requiring VV ECMO cannulation for influenza-related ARDS between September 2009 and January 2018. Interpretation of chest X-ray images was divided into zones that correspond to anatomical lobes on computed tomography. Progression of radiologic injury was assessed by analysing the number of zones involved on the chest radiograph (X-ray) at days 1, 3, 7, 14, and 21 from cannulation and discharge. The primary endpoint was survival to hospital discharge.</p><p><strong>Results: </strong>The majority of patients had complete opacification on days 1, 3, and 7 after VV ECMO cannulation. Patients with persistent complete opacification on chest X-ray infiltrate by day 14, following cannulation had an increased mortality. Survival to hospital discharge was increased in patients demonstrating improvement in radiological findings at day 19 compared to patients without significant radiologic improvement (100% vs 53%, log-rank P = 0.003).</p><p><strong>Conclusion: </strong>The evolution and recovery of lung injury reflected by serial chest X-ray imaging studies after influenza-related ARDS requiring VV ECMO support is associated with improved survival in this single centre, retrospective cohort.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 2","pages":"91-96"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517052","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":"Utility of stool Xpert MTB/Rif assay in the diagnosis of pulmonary and abdominal tuberculosis in children - A study from Western India.","authors":"Ira Shah, Dhruv N Gandhi, Dhruv Mamtora, Meenakshi Dey, Suhani Jain, Sonal Patil, Maneesha D'souza, Sanjay Mattoo, Daksha Shah, Varsha Puri, Minnie Bodhanwala","doi":"10.4103/lungindia.lungindia_528_24","DOIUrl":"10.4103/lungindia.lungindia_528_24","url":null,"abstract":"<p><strong>Background: </strong>Microbiological diagnosis of pediatric pulmonary and intestinal tuberculosis remains difficult due to difficulty in specimen collection such as with sputum, gastric aspirates or intestinal biopsies. Stool Xpert MTB/Rif may be useful as specimen collection is non-invasive.</p><p><strong>Objectives: </strong>To determine the sensitivity and specificity of Stool Xpert for the diagnosis of pulmonary or intestinal tuberculosis in Indian children.</p><p><strong>Methods: </strong>We retrospectively compared the performance of stool Xpert, pulmonary sample Xpert (gastric lavage, sputum, bronchoalveolar lavage), and Mycobacteria Growth Indicator Tube (MGIT) for 52 children with pulmonary, intestinal or disseminated tuberculosis.</p><p><strong>Results: </strong>Thirty (57.7%) children had positive pulmonary Xpert results, while 17(32.7%) had positive stool Xpert results. The sensitivity and specificity of stool Xpert compared to pulmonary Xpert was 43.3% and 81.8%, respectively. On using MGIT as a reference, pulmonary Xpert had a higher sensitivity compared to stool Xpert (81.8% vs. 63.6%, respectively) but lower specificity (48.8%vs.75.6%, respectively). Kappa analysis showed fair agreement between stool and pulmonary Xpert results (0.23), and moderate agreement between stool and gastric lavage Xpert results (0.43). Stool Xpert was found to be equivalent to pulmonary Xpert in detecting tuberculosis in children younger than 5 years (36.4% in both; 4 children each tested positive out of 11). No patients with isolated intestinal tuberculosis had positive stool Xpert.</p><p><strong>Conclusion: </strong>Stool Xpert may serve as a supplementary diagnostic tool in paediatric tuberculosis, particularly in young children where specimen collection is difficult. However, its lower sensitivity compared to pulmonary samples limits its potential as a standalone test.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 2","pages":"115-119"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517078","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":"Small airway disease (SAD) in asthma in pregnancy evaluated by impulse oscillometry: A cross-sectional study.","authors":"Mita Mandal, Indranil Halder, Subhankar Sarkar, Arman Haque, Manidip Pal","doi":"10.4103/lungindia.lungindia_413_24","DOIUrl":"10.4103/lungindia.lungindia_413_24","url":null,"abstract":"<p><strong>Background and objective: </strong>Asthma is a common respiratory disease in pregnancy, with approximately 18% of cases worsening. Small airway disease (SAD) with a reported prevalence of up to 70% is now recognised as a principal indicator of poor asthma control. Impulse oscillometry (IOS) is a non-invasive, technically easier, and patient-friendly tool for detecting SAD. We aimed to assess the prevalence of SAD in pregnant women with asthma and the acceptance of the IOS across different trimesters of pregnancy.</p><p><strong>Methods: </strong>This cross-sectional study was conducted among pregnant women aged ≥18 years with clinically diagnosed asthma. All patients underwent IOS following manufacturer and European Respiratory Society guidelines. A questionnaire was used to assess their satisfaction with the technique.</p><p><strong>Results: </strong>Out of 78 patients who underwent IOS, SAD was present in 55.1% (95% CI = 43.4 to 66.4%). Post-bronchodilator reversibility was observed in 37.2% of patients. Abnormal total (R5) and larger (R20) airway resistance were found in 79.5% and 64.1% of patients, respectively. Other IOS parameters (Fres, AX, and X5) were abnormal in 58.9%, 30.7%, and 39.7% of patients, respectively. Bivariate and multivariate logistic regression analyses indicated longer duration of asthma (OR = 1.1; 95% CI = 1.05-1.18; P < 0.001) and passive smoking (OR = 4.2; 95% CI = 1.58-11.1; P = 0.004) were significantly associated with SAD. All participants tolerated the IOS well, with a satisfaction score of 4.75 ± 0.72.</p><p><strong>Conclusion: </strong>The IOS is a helpful tool for the evaluation of SAD, a significant comorbidity in pregnant women with asthma. Factors such as longer disease duration and exposure to passive smoking, akin to risk factors for chronic airflow obstruction, are significantly associated with SAD. Future research should explore SAD's impact on clinical management and overall asthma outcomes.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 2","pages":"87-90"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517041","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":"Low occurrence of pulmonary lophomoniasis among cigarette smokers: An analysis of risk factors based on registry data.","authors":"Mahdi Fakhar, Zahra Hosseininejad, Ali Sharifpour, Fatemeh Z Hosseini, Zakaria Zakariaei","doi":"10.4103/lungindia.lungindia_518_24","DOIUrl":"10.4103/lungindia.lungindia_518_24","url":null,"abstract":"<p><strong>Background and objectives: </strong>Lophomonas blattarum is an emerging protozoan agent that mainly causes pulmonary lophomoniasis. Given that cigarette smokers are predisposed to various diseases while some conditions are less common among them, the current study aimed to compare the relationship between smoking status and the prevalence of pulmonary lophomoniasis in patients registered at the Iranian National Registry Center for Lophomoniasis (INRCL). Additionally, we examined common risk factors associated with Lophomonas infection among these registered subjects.</p><p><strong>Materials and methods: </strong>This descriptive-analytical cross-sectional registry-based study was conducted on 600 registered subjects through microscopic examination (wet mount smears) and conventional polymerase chain reaction assay between 2021 and 2023. We analysed the smoking status and smoking intensity of 135 Lophomonas-positive patients and 465 Lophomonas-negative patients who were referred to the INRCL. Baseline data were collected from participants using a questionnaire.</p><p><strong>Results: </strong>Our results showed the prevalence of Lophomonas infection among enrolled subjects was estimated to be 22.5% (135/600). Also, we studied 135 Lophomonas positive patients (male = 92, female = 43). Furthermore, most patients testing positive for Lophomonas (74.8%; 101/135) also had at least one comorbidity condition. Our findings showed a statistically significant occurrence of Lophomonas infection among non-smokers (70.4%; n = 95), in contrast to smokers (29.6%; n = 40) (P = 0.001). Correspondingly, among the 40 Lophomonas-positive smokers, the majority (62.5%) were classified as light smokers. Moreover, based on the multiple logistic regressions, Lophomonas infection was 2.123, 3.142, and 2.353 times higher in men compared to women, patients aged 51-70 years compared to other age groups, and non-smokers compared to cigarette smokers, respectively (P = 0.001).</p><p><strong>Conclusion: </strong>Our findings reveal that Lophomonas infection is significantly lower among cigarette smokers compared to nonsmokers. Our data shed light on a new hypothesis about lophomoniasis among smokers. Further research is needed to assess the role of smoking in the pathophysiology of lophomoniasis.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 2","pages":"109-114"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517073","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":"Chest radiology quiz in an unusual case of chronic cough.","authors":"Giacomo Ghinassi, Simone Ielo, Magda Viani, Raffaele Scala","doi":"10.4103/lungindia.lungindia_280_24","DOIUrl":"10.4103/lungindia.lungindia_280_24","url":null,"abstract":"<p><strong>Abstract: </strong>Welcome to this radiology challenge. Follow the clues to diagnose a young woman presenting with an unusual and persistent cough. Let us dive into the clinical case and see if you can figure out the cause.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 2","pages":"159-160"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516995","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":"Life after lung lobectomy: The road to recovery and well-being - A descriptive study.","authors":"Nandita Ghosh, Neena V Singh, Sukhpal Kaur, Harkant Singh","doi":"10.4103/lungindia.lungindia_349_24","DOIUrl":"10.4103/lungindia.lungindia_349_24","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary lobectomy significantly impacts the quality of life (QOL) in lung cancer patients. This study investigates QOL in lung lobectomy patients, identifying challenges and influencing factors to inform strategies for improving care and outcomes and enhancing recovery and long-term well-being.</p><p><strong>Objective: </strong>To assess the quality of life of patients who underwent lung lobectomy.</p><p><strong>Methods: </strong>Using a descriptive study design, 50 patients who had undergone lung lobectomy at least 3 months before and were attending CTVS OPD at a tertiary hospital were enrolled consecutively. Apart from collecting the clinical and socio-demographic profiles of patients, the EORTC-QLQ-C30 scale was used to assess QOL of patients.</p><p><strong>Results: </strong>The mean (standard deviation [SD]) age of the patients was 45.34 (15.19) years. Male patients outnumbered females (62%). The most common diagnosis was non-small cell lung cancer (28%). Around 18% of patients had a history of treatment for pulmonary tuberculosis. The majority (76%) of patients had a higher QOL, with a mean (SD) score of 64.50 (19.27). Age and socioeconomic status were linked to fatigue and pain, respectively. Alcohol consumption history was associated with fatigue (P = 0.02), while smoking history was linked to pain (P = 0.04) and dyspnoea (P = 0.02), revealing significant correlations between lifestyle factors and postoperative symptoms. In addition, patients in the postoperative period of 3-6 months tended to have poorer QOL.</p><p><strong>Conclusion: </strong>There is a need to plan comprehensive support, considering the age, health habits and socioeconomic status of patients to optimise recovery and QOL. Proper care and education can help patients adapt and make positive outcomes in post-surgery rehabilitation.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 2","pages":"120-127"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517070","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":"Pulmonary artery sling with total anomalous pulmonary venous return: Hitherto unreported association.","authors":"Saurabh Deshpande, Pratyaksha Rana, Megha M Sheth, Hit Jivani, Timiri Madhukaran Harishkar, Dinesh Patel","doi":"10.4103/lungindia.lungindia_465_24","DOIUrl":"10.4103/lungindia.lungindia_465_24","url":null,"abstract":"","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 2","pages":"172-173"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517037","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":"Effective initiative to beat tuberculosis from India: Revised Nikshay Mitra support policy.","authors":"Sameena Khan, Sahjid Mukhida, Rajashri Patil, Nikunja K Das","doi":"10.4103/lungindia.lungindia_522_24","DOIUrl":"10.4103/lungindia.lungindia_522_24","url":null,"abstract":"","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 2","pages":"173-174"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517034","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}