Bmj Military Health最新文献

{"title":"Emergency burr hole craniostomy for traumatic brain injury in austere environments: a practical guide for non-neurosurgeons.","authors":"Eftikhar Akam, Rafael Dib Possiedi, Husna Irfan Thalib, Lucas Fontenelle Vieira, Abhishek Thapa, David Milzman, Marcelo A Fontenelle Ribeiro","doi":"10.1136/military-2026-003287","DOIUrl":"https://doi.org/10.1136/military-2026-003287","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) is a leading cause of mortality and morbidity, particularly in austere environments where neurosurgical expertise is scarce. TBI causing extra-axial haemorrhage can lead to intracranial hypertension and herniation. Emergency burr hole craniostomy is a critical intervention for managing extra-axial haematomas in patients with deteriorating neurological status. The need for non-neurosurgeons to be capable of this procedure has been reinforced by experience from the Russo-Ukrainian war and by planning assumptions for Large-Scale Combat Operations, in which contested airspace, prolonged casualty care and a finite NATO military neurosurgical workforce make timely transfer to neurosurgical care unreliable. This article provides a detailed practical guide for non-neurosurgeons, such as general surgeons and emergency physicians, to perform these procedures in resource-constrained settings without imaging or electric power. It is explicitly aligned with the US Joint Trauma System Clinical Practice Guideline 'Emergency Life-Saving Cranial Procedures by Non-Neurosurgeons in Deployed Setting', the Brain Trauma Foundation Guidelines and the NATO Committee of the Chiefs of Military Medical Services (COMEDS) Medical Action Plan. Drawing on extensive experience in austere surgical environments, we describe the clinical assessment, step-by-step technique and the structured training pathway required to ensure safe and effective intervention. The objective is to empower non-specialist surgeons to act decisively, stabilising patients and bridging them to definitive care, thereby improving outcomes in settings with limited resources.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological human augmentation, fatigue management and spatial disorientation training during distant air operations: lessons learned from the wars in Iran.","authors":"Ivan Gur, Sharon Itzchakov, Idan Nakdimon","doi":"10.1136/military-2026-003430","DOIUrl":"https://doi.org/10.1136/military-2026-003430","url":null,"abstract":"<p><strong>Background: </strong>Military aviation in distant operations increases aircrew fatigue and the risk of human-factor-related safety incidents. This study evaluated the impact of different fatigue management and pharmacological human augmentation approaches on flight safety and, in a separate analysis, the effect of prior spatial disorientation (SD) simulator training on in-flight SD severity.</p><p><strong>Methods: </strong>We retrospectively reviewed human-factor-related safety incidents in the Israeli Air Force across three operational periods: Operation 'Iron Swords' (short-range, lower-tempo), 'Rising Lion' (12-day long-range, high-tempo) and 'Epic Fury' (42-day extended-duration, high-tempo). The primary outcome was the normalised rate of safety incidents per flight hour. Secondary outcomes included the normalised utilisation of caffeine and modafinil and the severity of SD events among trained versus untrained aircrew.</p><p><strong>Results: </strong>Across the three periods, 949 incidents were reported. Normalised incident rates and severity distributions remained stable between 'Rising Lion' and 'Epic Fury', despite the latter's significantly greater flight volume. The fighter fleet, the only platform to fully implement preplanned, individualised flight-and-rest scheduling and personalised stimulant prescriptions, was also the only platform to demonstrate a decrease in normalised incident rates (r=-0.82, p=0.004). Aircrew who had never undergone SD simulator training sustained significantly more severe SD events than previously trained aircrew (p=0.015).</p><p><strong>Conclusions: </strong>Implementing individualised physiological envelopes-combining personalised pharmacological augmentation with structured rest-was associated with stable or reduced in-flight safety incident rates during sustained, high-tempo operations. Additionally, prior SD simulator training was associated with a decreased level of severity of SD events.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From cockpit to convalescence: the forgotten RAF operational patient care pathway of World War 2.","authors":"Owen David Williams, Oliver Hawksley, Oliver Brown","doi":"10.1136/military-2026-003497","DOIUrl":"https://doi.org/10.1136/military-2026-003497","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical conditions leading to medical discharge among Danish conscripts: a population-based study.","authors":"Niels Frederich Rose Holm, Frank Dyrehauge Thøgersen, Karsten Lindgaard","doi":"10.1136/military-2026-003393","DOIUrl":"https://doi.org/10.1136/military-2026-003393","url":null,"abstract":"<p><strong>Introduction: </strong>Medical discharge during basic military training reduces readiness and training efficiency. In Denmark, diagnosis-specific evidence is limited, including differentiation between pre-existing conditions, overuse-related disorders and acute injuries. This study aimed to provide an International Classification of Diseases, 10th Revision (ICD-10)-informed profile of physical conditions leading to medical discharge in Danish conscripts and describe time to discharge.</p><p><strong>Methods: </strong>Population-based registry study of male conscripts initiating compulsory service in Denmark (January 2019-December 2023). The primary reason for discharge was grouped into clinically meaningful categories informed by ICD-10. Musculoskeletal conditions were classified as pre-existing, acute traumatic or overuse-related; trauma prior to service/leave was recorded separately. Analyses were descriptive.</p><p><strong>Results: </strong>Among 17 579 conscripts, 1499 (8.5%) were medically discharged. Of these, 827 (55.2%) were discharged due to physical conditions. Median age at enlistment was 20.4 years (IQR 19.7-21.8), and median service duration before discharge was 5.4 weeks (IQR 2.4-10.0). Musculoskeletal conditions accounted for 661 (79.9%) medical discharges for physical conditions, and other physical diagnoses for 166 (20.1%). Knee pain (n=229), back pain (n=166) and shoulder pain (n=49) were most frequent. Within musculoskeletal discharges, 33.9% were classified as pre-existing, 36.5% as overuse-related, 23.9% as acute traumatic and 5.8% as trauma prior to service/leave. Concussion was the most frequent non-musculoskeletal diagnosis (n=26). Mental health-related comorbidity was recorded in 4.4% of medical discharges for physical conditions, mainly alongside pre-existing or overuse-related musculoskeletal conditions.</p><p><strong>Conclusions: </strong>Medical discharge for physical conditions in Danish conscripts was dominated by musculoskeletal conditions, most often classified as pre-existing or overuse-related rather than acute traumatic. An ICD-10-informed, discharge-focused classification may support baseline risk identification, earlier clinical recognition and selective modification of cumulative military load during the initial weeks of service as conscript intake increases.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DMS CHECK: a cross-sectional study of the mental health of the UK defence medical services, focusing on factors associated with probable common mental disorder.","authors":"Amos Simms, Kate King, Toby James Holland, Di Lamb, Danielle Lamb, Neil Greenberg, Sharon A M Stevelink, Simon Wessely, Daniel Leightley","doi":"10.1136/military-2026-003488","DOIUrl":"https://doi.org/10.1136/military-2026-003488","url":null,"abstract":"<p><strong>Introduction: </strong>During the COVID-19 pandemic, adverse mental health indicators were widely reported among healthcare workers, but evidence relating specifically to UK Defence Medical Services (DMS) personnel is limited. DMS personnel work across military and civilian healthcare settings and supported the UK pandemic response while maintaining operational commitments. This study examined the prevalence of adverse mental health indicators among DMS personnel and factors associated with probable common mental disorder (CMD).</p><p><strong>Methods: </strong>An anonymous cross-sectional survey was distributed to DMS personnel between October 2021 and February 2022. The questionnaire assessed probable CMD, probable post-traumatic stress disorder (PTSD), alcohol misuse and suicidal ideation using validated measures, together with perceptions of morale, leadership and cohesion. Factors associated with probable CMD were examined using logistic regression.</p><p><strong>Results: </strong>Of approximately 5000 accessible personnel, 1531 responded (estimated response rate: 30.6%); 1276 contributed to the primary fully adjusted model. Probable CMD was identified in 43.6% of respondents, probable PTSD in 12.1%, alcohol misuse in 16.9% and suicidal ideation within the previous 2 months in 8.9%. After full adjustment, personnel under 40 had higher odds of probable CMD than those aged 40 or over. Nurses and medics/paramedics had higher odds than non-clinical personnel. Less favourable perceptions of morale, leadership and cohesion showed the strongest associations with probable CMD. Alcohol misuse was also associated with higher odds of probable CMD.</p><p><strong>Conclusions: </strong>Although probable CMD and probable PTSD were less prevalent than reported in the initial UK National Health Service (NHS) CHECK study, a substantial proportion of DMS respondents screened positive for adverse mental health indicators. Probable CMD was associated with younger age, selected clinical roles, alcohol misuse and less favourable perceptions of morale, leadership and cohesion. These findings support continued DMS mental health surveillance and greater attention to organisational factors alongside individual support and clinical care.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health and well-being among military remotely piloted aircraft systems personnel: a systematic review.","authors":"Amos Simms, Neil Greenberg, Daniel Leightley, Nicola T Fear","doi":"10.1136/military-2026-003419","DOIUrl":"https://doi.org/10.1136/military-2026-003419","url":null,"abstract":"<p><strong>Introduction: </strong>Remotely piloted aircraft systems (RPAS) are integral to military operations. Although geographically removed from the battlefield, RPAS personnel are exposed to operational, organisational and moral stressors. This review synthesises evidence on the mental health and well-being of military RPAS personnel.</p><p><strong>Methods: </strong>This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Cochrane methodology. The protocol was preregistered on PROSPERO. Searches were conducted in MEDLINE, EMBASE, PsycINFO, CINAHL, Web of Science, ScienceDirect and PILOTS for studies from January 2002 to June 2025. Peer-reviewed studies examining mental health outcomes among military RPAS personnel were included while grey literature and technical repositories were screened for context. Study quality was assessed using NICE (National Institute for Health and Care Excellence) public health guidance checklists. Given variation in study designs and outcome measures, findings were synthesised narratively.</p><p><strong>Results: </strong>Fourteen studies met the inclusion criteria, comprising nine cross-sectional surveys, two retrospective record analyses, one cohort study, one physiological experiment and one qualitative study. The prevalence of probable post-traumatic stress disorder (PTSD) ranged from 3.3% to 6.7%, which is broadly comparable to other military populations. Psychological distress was reported in 13.0%-16.0% of personnel, and high emotional exhaustion in 25.0%-37.0%. Suicidal ideation ranged from 4.4% to 8.0%. Subthreshold PTSD symptoms, sleep disturbance and functional impairment were frequently reported. The identified risk factors were predominantly organisational rather than combat-related, including long working hours, shift instability, understaffing, role conflict and sleep disruption. Protective factors included leadership support, team cohesion, adequate sleep and positive help-seeking attitudes.</p><p><strong>Conclusions: </strong>RPAS personnel do not show significantly higher rates of diagnosable mental disorder than other military groups. However, they do experience considerable occupational strain. Across the literature, adverse outcomes were more often linked to chronic organisational stressors than to direct battlefield exposure. Future research should prioritise longitudinal designs, comparative cohorts and the evaluation of targeted occupational interventions.</p><p><strong>Prospero registration number: </strong>CRD42022329937.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrition and dietary pattern in relation to blood status and physical work capacity among Swedish conscripts during basic combat training.","authors":"Fabian Taube, Mats Navrén, Örjan Ekblom, Ingrid Larsson","doi":"10.1136/military-2026-003436","DOIUrl":"https://doi.org/10.1136/military-2026-003436","url":null,"abstract":"<p><strong>Introduction: </strong>Adequate nutrition and regular meal patterns are essential for maintaining metabolic health as well as optimal physical and cognitive function. Military conscripts represent a particularly vulnerable population due to the high physical and cognitive demands placed on them during basic combat training (BCT). We sought to identify the relationship between nutrition and dietary patterns before and during BCT and health-related variables.</p><p><strong>Methods: </strong>A total of 96 female and 129 male conscripts completed questionnaires at baseline and after 5 months, assessing dietary habits and general health. Haemoglobin and ferritin were measured both at baseline and after 5 months of BCT. Physical work capacity was assessed at baseline, including an incremental multistage shuttle run test and a neuromuscular multitest.</p><p><strong>Results: </strong>Vegetarian dietary patterns were associated with lower baseline ferritin (β=-20.5, p=0.011) but a greater increase in haemoglobin during BCT (β=4.50, p=0.026). Less frequent breakfast consumption was associated with lower baseline physical work capacity (β=-0.32, p=0.015). Over a 5-month period, conscripts reporting less frequent consumption of full meal portions had lower baseline physical work capacity (β=-0.33, p=0.019) and higher odds of injury or overuse symptoms (OR 2.33, p=0.015) and missed training (OR 1.85, p=0.047). Not eating enough in relation to individual needs was associated with a smaller increase in haemoglobin (β=-7.38, p<0.001). Poor self-rated physical health was associated with higher odds of injury or overuse symptoms (OR 1.80, p=0.035).</p><p><strong>Conclusions: </strong>Irregular meal patterns and insufficient food intake were associated with lower physical work capacity and increased risk of adverse outcomes during BCT. Dietary behaviours may represent modifiable factors relevant to performance, health and resilience in military training.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The recovery, readjustment and reintegration programme (R3P): a guide to implementation.","authors":"Di Lamb, Joanna Jepson, Amos Simms","doi":"10.1136/military-2026-003355","DOIUrl":"https://doi.org/10.1136/military-2026-003355","url":null,"abstract":"<p><p>The Recovery, Readjustment and Reintegration Programme (R3P) is a structured, meaning-based psychological support tool that offers peers the opportunity to meet and discuss their shared experiences to enable better coping. Since its inception in 2020, the tool has been adopted nationally by the UK National Health Service and by international military partners. R3P is a leader-led, non-medical initiative, which navigates participants through group discussions focussing on five themes that are acknowledged to cause distress and to linger in a person's mind long after their occurrence. The five themes, namely morally injurious events, death and suffering, vulnerability, personal and professional challenge, and unrealistic expectations, might be experienced on military deployments but apply equally to everyday life and the occupational environment in the home nation. This paper aims to provide a simple guide of how and when to implement R3P, with considerations for providing a psychologically safe space to optimise fruitful engagement. It will also dispel the myths that have emerged since its inception.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncrewed operational medical support: a doctrinal gap in UK and NATO military medicine.","authors":"Owen David Williams, Ed Barnard","doi":"10.1136/military-2026-003432","DOIUrl":"https://doi.org/10.1136/military-2026-003432","url":null,"abstract":"<p><p>Uncrewed (Ux) systems are now central to contemporary military operations, providing reconnaissance, precision strike, logistics and persistence in environments where crewed platforms may be exposed, unavailable or unacceptable. Their use for the evacuation of operational casualties is therefore an intuitive extension of current capability, particularly in dispersed, contested and casualty-dense settings. This analysis examines current UK and NATO doctrine and future concepts relating to uncrewed air, ground and maritime systems with specific attention to their potential role in casualty evacuation. Across the UK and NATO publications, uncrewed systems are consistently presented as important to future force design, multi-domain integration and operational resilience. However, there is little practical doctrinal guidance on their use for casualty movement, and almost no detail on clinical governance, command responsibility, monitoring, escort, acceptability or the boundary between casualty evacuation and medical evacuation. The most mature doctrinal material concerns uncrewed aerial systems; ground and maritime applications are less developed and medical applications remain largely conceptual. We argue that uncrewed systems should initially be considered for medical logistics and selected casualty evacuation tasks rather than assumed to provide medical evacuation in the conventional sense. A staged model is proposed, progressing from uncrewed resupply and CASEVAC through remotely monitored evacuation towards an integrated cross-domain uncrewed medical care capability. Before operational adoption, UK Defence Medical Services should lead development and testing of clinical tactics, techniques and procedures, standard operating procedures and assurance mechanisms.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with in-flight G-induced loss of consciousness (G-LOC) in military aircrew.","authors":"Maya Harel, Idan Nakdimon, Oded Ben-Ari","doi":"10.1136/military-2026-003318","DOIUrl":"https://doi.org/10.1136/military-2026-003318","url":null,"abstract":"<p><strong>Introduction: </strong>G-induced loss of consciousness (G-LOC) remains a significant hazard in high-performance aviation. Although protective equipment and anti-G straining manoeuvres improve tolerance to high +Gz acceleration, individual physiological and operational factors may influence susceptibility to G-LOC during flight. The aim of this study was to characterise in-flight G-LOC cases and to identify potential factors associated with these events.</p><p><strong>Methods: </strong>This retrospective case-control study analysed all in-flight G-LOC events reported among Israeli Air Force cadets and fighter aircrew between 2015 and 2025. For each case, four controls matched for age and squadron were randomly selected without a history of G-LOC. Variables included anthropometric characteristics, resting blood pressure, operational role during the manoeuvre, flight training stage, G-levels at the time of G-LOC, incapacitation duration and preceding symptoms.</p><p><strong>Results: </strong>Fifteen in-flight G-LOC events occurring in 13 individuals were identified. The mean age at the time of the event was 23.4±5.6 years. The mean incapacitation duration was 19.6±9.9 s. Visual symptoms preceded loss of consciousness in 73% of events. G-LOC cases were significantly taller than matched controls (183.8±6.3 cm vs 176.8±3.3 cm, 95% CI 2.89 to 11.01, p=0.003). Within the G-LOC cohort, higher G-levels at the time of G-LOC were observed during events in which the affected pilot was directly controlling the aircraft. Among cadets, G-level at the time of G-LOC was positively correlated with training stage (Spearman ρ=0.74, p=0.014).</p><p><strong>Conclusions: </strong>These findings provide observational data suggesting that anthropometric and operational factors may influence the conditions under which G-LOC occurs during flight.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}