Journal of Patient Safety最新文献

{"title":"Psychometric Evaluation of the Discharge Checklist.","authors":"Sophia Hu, Savanna Plombon, Harshini Malapati, Manraj Kaur, Anuj K Dalal, Maria Edelen","doi":"10.1097/PTS.0000000000001606","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001606","url":null,"abstract":"<p><strong>Objectives: </strong>Validated discharge checklists can support discharge planning by enabling patients and care teams to systematically identify issues that hinder safe transitions from the hospital. This study evaluated the psychometric properties of a discharge checklist developed for use in a major tertiary care hospital.</p><p><strong>Methods: </strong>Adult patients (>18 y) admitted to the general medicine service between February 2022 and August 2023 were eligible if discharge was anticipated within 24 to 48 hours at the time of approach. Participants completed the 15-item Discharge Checklist, PROMIS-29+2, and GLOBAL-10 questionnaires. Dimensionality was assessed using exploratory and confirmatory factor analyses. Internal consistency was evaluated using the Cronbach alpha and item-total correlations. Construct validity was examined through bivariate and multivariable analyses.</p><p><strong>Results: </strong>A total of 269 patients completed the discharge checklist: 212 (78.81%) were admitted following an emergency room visit, 87 (32.34%) had a hospital stay of 1 to 4 days, 86 (31.97%) had 4 to 5 comorbidities, and 162 (60.22%) were discharged home with self-care. The mean discharge checklist score was 11.42 (SD=3.42). Factor analyses supported a unidimensional model. Internal consistency was high (Cronbach alpha=0.85; item-total correlations 0.19-0.62). In multivariate analyses, younger age, shorter length of stay, and higher cognitive function and mental health were significantly associated with higher discharge checklist scores (ie, more prepared).</p><p><strong>Conclusions: </strong>The questions in the discharge checklist combined to produce a scale with high internal consistency and construct validity. Future work should evaluate the implementation of these checklists more readily and as part of larger research or quality improvement programs for patients transitioning home.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic and Robotic Device Malfunction: A Scoping Review.","authors":"Ayaka Tsutsumi, Shaan Bhandarkar, Fabrizio Darby, Eric Schneider, Shilpa Murthy, David Blumberg, Alexandria Brackett, Vanita Ahuja","doi":"10.1097/PTS.0000000000001569","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001569","url":null,"abstract":"<p><p>Laparoscopic and robotic surgeries have become the gold standard for many operations. Device malfunctions during these procedures represent a preventable source of patient harm; however, the trends in malfunction reporting and their implications for surveillance systems, surgical training, and reporting infrastructure have not been comprehensively reviewed. Our aim is to conduct a scoping review of device malfunctions during minimally invasive abdominopelvic surgeries. Four databases (Web of Science, Scopus, Embase, and PubMed) were searched for relevant articles published between January 1, 1974, and March, 15, 2024. Studies analyzing the Manufacturer and User Facility Device Experience (MAUDE) database for device malfunctions involving staplers or energy-based devices in laparoscopic and robotic abdominopelvic surgeries were included. Reviews, case series, animal studies, and investigations of user error or implanted device failures were excluded. Two independent reviewers screened each article. Of 770 identified articles, 15 met the inclusion criteria. Nine focused on robotic surgical instruments (7 on the da Vinci Surgical System), 5 on laparoscopic staplers (4 nephrectomy-related), and 1 on staplers across specialties. Death was the least common outcome, followed by injuries and malfunctions without patient harm. In laparoscopic nephrectomy, stapler misfiring caused 22 deaths (5.7% of complications). Robotic surgery deaths ranged from 1.2% to 2.3%, depending on the study. This first comprehensive synthesis of MAUDE-based analyses in minimally invasive surgery reveals substantial variability in reporting practices and highlights system-level gaps in surveillance, staff training, and accountability. Standardized, multicenter reporting frameworks are needed to accurately characterize the risk of malfunction and support targeted preventive interventions.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Code Surgical Emergency Team (SET) is the \"Missing Code:\" An Emerging Perioperative Hemorrhage Best Practice.","authors":"Jessica Feinleib, Makayla Wilkes, Amanda Borchers, Victoria Marrs, Christina Givey, Iris Appenrodt, Shawn Braddock, Lisa Baker","doi":"10.1097/PTS.0000000000001594","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001594","url":null,"abstract":"<p><strong>Objectives: </strong>Managing the heightened risks of hemorrhage and hematoma vital organ compression due to surgical complications is a challenge for health care systems pursuing the ultimate goal of Zero Harm. Although a certain number of surgical complications are expected, the catastrophic outcomes that ensue are often preventable. This paper aims to contribute to the understanding of processes to address perioperative hemorrhage morbidity and mortality.</p><p><strong>Methods: </strong>The authors first identified a broad opportunity to optimize surgical safety in the Veterans Health Administration through perioperative hemorrhage Root Cause Analysis studies from 2022 to 2023. In 2023, we verified and defined risk pain points through task analysis and identified and optimized a solution through iterative rounds of simulation from 2023 to 2024.</p><p><strong>Results: </strong>Code Surgical Emergency Team (Code SET), a hospital-wide activation of existing personnel, resources, and services to implement emergency clauses in perioperative safety protocols, was designed to address gaps in quality and safety through 7 process steps: (1) activation; (2) code announcement; (3) kit mobilization; (4) activation of emergency clauses; (5) anesthetic and surgical care; (6) poststability pause; and (7) debrief and review.</p><p><strong>Conclusion: </strong>In this paper, we describe the implementation of a comprehensive surgical safety package to reduce perioperative morbidity and mortality. Preliminary pilot findings suggest that the Code SET process may reduce surgical patient morbidity and mortality and improve outcomes. This process demonstrates how institutions can use existing resources in a standardized approach to improving patient safety.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Statutory Duty of Candor Implementation in Victoria, Australia.","authors":"Justine Atherton, Corey Adams, Nicole Youngs, Jennifer Morris, Ashfaq Chauhan, Elizabeth Manias, Peter Hibbert, Ramesh Walpola, Jeffrey Braithwaite, Reema Harrison","doi":"10.1097/PTS.0000000000001602","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001602","url":null,"abstract":"<p><strong>Background: </strong>Globally, candor-type legislations, which encourage transparency following a serious adverse patient safety event (SAPSE), exist in various countries, or jurisdictions within them, including the United Kingdom, Canada, Germany, Ireland, and Australia. However, an evidence gap exists in the barriers and facilitators to the legislation's implementation. This study explores key influencers on Statutory Duty of Candor (SDC) implementation in the Australian state of Victoria from the perspectives of health care managers, patients, and families.</p><p><strong>Methods: </strong>A thematic secondary analysis of 20 interview transcripts: 10 with health care managers experienced in SDC; and 10 with patients and family members who had experienced a SAPSE. Indicative themes were established inductively, and then overlaid and analyzed deductively to evaluate relevance using the Consolidated Framework for Implementation Research (CFIR).</p><p><strong>Results: </strong>Participants reported that SDC improved visibility and accountability regarding patient safety and incident management. However, findings also indicated misalignment, between the legislation's intent and its interpretation, and between health services' objective to meet the legislated requirements and patients' and families' objective to access support for recovery. The study also identified barriers, including clinician apprehension about SDC's impact (eg, blame and/or scrutiny) and concerns about the practicalities of legislated requirements (eg, flexibility of timelines and consistent interpretation of definitions).</p><p><strong>Conclusion: </strong>The findings indicate support for the intent and principles of SDC, but also highlight barriers which constrain the legislation's implementation and effectiveness in practice. These barriers may be addressed by extending SDC's focus to encompass restorative approaches (eg, by offering individualized support), while also assisting health system learning and quality improvement.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design for Safety and Resilience: Looking Underneath the Safety-I and II Labels.","authors":"Perla J Marang-van de Mheen, Patricia Trbovich, Charles A Vincent","doi":"10.1097/PTS.0000000000001601","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001601","url":null,"abstract":"<p><p>Ten years ago, Safety-II was introduced as a new approach to safety and contrasted with the existing approach (Safety-I), which emphasized learning from work as done in practice and the adaptive capacity of professionals who manage to deliver safe care in challenging circumstances. While Safety-II was presented as a complementary view of safety, it remained unclear how the 2 approaches would complement each other in daily practice. The aim of this paper is to reexamine the Safety-I and II distinction, look beneath the 2 labels to understand what complementary safety approaches can be distilled and how and when each safety approach might be used in practice. The Safety-I and II labels do not clearly convey the critical distinction between safety approaches, which may be part of why implementation in practice has been challenging. We suggest that the critical distinction is between \"designing hazards out of the system\" versus \"relying on adaptability and resilience of the system,\" which does not equate to Safety-I and II. This distinction makes it clearer when each approach should be used in practice, that is, in normal circumstances or when dealing with unexpected disruptions, and how well-known safety strategies fit either approach. We should focus on designing systems that support human work while also enabling any necessary adaptations to enhance care. Resilience should not be a crutch for poor system design, but a deliberate response when systems are stretched.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clarifying the Concept of \"Unanticipated Transfer to the ICU\": A Scoping Review.","authors":"Rachel Y Lee, Brian Douthit, Sachleen Tuteja, Patricia C Dykes, Catherine Ivory, Po-Yin Yen, Kenrick D Cato, Sarah C Rossetti","doi":"10.1097/PTS.0000000000001597","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001597","url":null,"abstract":"<p><p>Unanticipated transfer to the intensive care unit (ICU), typically defined as an unscheduled escalation of care from inpatient general wards, is widely used in clinical research as a marker of adverse events, clinical deterioration, and system failure. However, its conceptual meaning, definition, and operationalization vary substantially across the literature, complicating interpretation and cross-study comparison. We conducted a scoping review following PRISMA-ScR guidelines to map how unanticipated ICU transfers are defined, framed, and used in empirical research. Searches of PubMed, CINAHL, and Web of Science identified 4,019 studies through August 7, 2025. After removing duplicates, 2,092 studies were screened for title and abstract, 565 underwent full-text review, and 219 studies met the inclusion criteria. Most studies were observational studies and terminology varied widely, with \"unplanned admission to ICU\" being the most common. Definitions were heterogeneous but generally focused on unscheduled ICU admission from inpatient wards, often excluding transfers from the emergency department or operating room and sometimes incorporating triggers such as rapid response activation or time-based thresholds. Unanticipated ICU transfer was predominantly used as a dependent variable and was overwhelmingly framed as a negative outcome or proxy for clinical deterioration. However, a smaller body of literature conceptualized these transfers as appropriate or beneficial escalations of care, particularly when occurring early in the course of deterioration. Our findings highlight definitional and conceptual inconsistency and suggest that unanticipated ICU transfer is a context-dependent process measure influenced by both patient condition and institutional factors. Greater standardization and a reframing toward appropriateness and timing of escalation may improve its utility in research and practice.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse Events due to Surgical Procedures Among Pediatric Inpatients: The Japan Adverse Event Study.","authors":"Yasunobu Miki, Mio Sakuma, Yoshinori Ohta, Jiro Takeuchi, Mari Nezu, Yuki Yuza, Hiroyuki Ida, Takeshi Morimoto","doi":"10.1097/PTS.0000000000001599","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001599","url":null,"abstract":"<p><strong>Objectives: </strong>Adverse events (AEs) and medical errors (MEs) related to surgery in pediatric inpatients are critical concerns. However, comprehensive epidemiological data across pediatric surgeries remain limited. We aimed to examine the detailed epidemiology of AEs and MEs related to surgery.</p><p><strong>Methods: </strong>We analyzed data from the Japan Adverse Events Study, a retrospective cohort study conducted at 2 tertiary care teaching hospitals in Japan. We included patients who underwent surgery, classified as major or minor. Major surgeries involved access to major body cavities or deep structures with anatomic modification, whereas minor surgeries involved only superficial approaches.</p><p><strong>Results: </strong>Of 328 surgical patients [4261 patient-days], 87 had major and 241 had minor surgeries. The median age was 1 year (interquartile range: 0-8) in the major surgery group and 4 years (interquartile range: 1-7) in the minor surgery group (P = 0.03). A total of 292 AEs were identified: 156 in the major and 136 in the minor surgery group (83 versus 57 per 1000 patient-days, P = 0.001). Life-threatening AEs occurred numerically more frequently in the major surgery group (5% versus 2%, P = 0.53). The incidence of MEs was similar (33 versus 37 per 1000 patient-days), but MEs were more likely to result in AEs in the major surgery group [22/61 (36%) versus 14/88 (16%), P = 0.005].</p><p><strong>Conclusions: </strong>AEs occurred more frequently, and MEs were more likely to result in AEs in the major than in the minor surgery group. These findings suggest that perioperative patient safety strategies should be tailored according to surgical invasiveness.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nighttime Interruptions and Clinical Risk: A Systematized Review of After-hours Paging and Error-related Outcomes.","authors":"Connor D Yost, Hannah D'Cunha, Noel Balli, Ron Tang, Keshav Nandakumar, Claudia J Garcia, Evan Jacobs, Paul Tran, Laura Mercer, Tamlyn Tarzia, Jad Dandashi, Hanh Soe-Lin, Christina Weaver, Joanna Kowalik, McKenna Yost, Jaya Raj, Daniel Maas, Mateen Khokhar, Sai-Sridhar Boddupalli, Heather Walker, Cassie Eno, Christine Firth","doi":"10.1097/PTS.0000000000001598","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001598","url":null,"abstract":"<p><p>Nighttime inpatient cross-cover combines fatigue, reduced staffing, limited patient familiarity, and frequent paging interruptions, with resident physicians carrying much of this workload in teaching hospitals. We conducted a systematized PubMed review (search executed January 2026; publications from January 2021 to January 2026) using a 4-concept search covering night or after-hours work, inpatient settings, interruptions (pages, alerts, secure messages), and medical errors or patient-safety outcomes. Each of 112 records was independently screened by all 5 reviewers against a priori eligibility criteria, with disagreements resolved by consensus. Of these, 45 were excluded at title/abstract and 48 at full text; 19 studies met the inclusion criteria. Designs were quality improvement [n=8 (42%)], interview or survey [n=6 (32%)], and observational or retrospective [n=5 (26%)]; most were academic teaching hospitals in North America. Overnight interruptions most often involved medication questions, plan-of-care clarifications, handoff-related communication, diagnostic workflow disruptions, or electronic alerts. Most outcomes were process measures or error surrogates rather than direct clinical endpoints. Interventions that standardized communication or restructured notification workflows consistently reduced interruption burden, improved handoff efficiency, or increased capture of clinically significant overnight events. Combined with fatigue, reduced staffing, and limited continuity, nighttime interruptions amplify cognitive load and increase vulnerability to delays, omissions, and unsafe cross-cover. The most consistent benefits came from structured handoffs, clearer escalation expectations, and strategies that reduce deferrable or ambiguous overnight communication. Multicenter studies linking paging events to downstream EHR actions and patient-centered outcomes are needed.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic Surgery Needs a Cybersecurity Time-out: Integrating Cyber Readiness Into the Surgical Safety Checklist.","authors":"Malik Muhammad Nasr Fayyaz, Abdullah Mughal, Inshal Uddin Khattak","doi":"10.1097/PTS.0000000000001596","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001596","url":null,"abstract":"","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Insulin Self-Administration Errors in Adults With Diabetes: A Quasi-Experimental Study of a Structured Intervention.","authors":"Hudson C de Oliveira, Juliana F Campos, Cristiana D Silveira, Fernanda F E Silva, Patrícia S de Souza, Bruna G R Araujo, Carla de A Vianna, Sérgio A de Jesus, Rebecca O L B Barber","doi":"10.1097/PTS.0000000000001595","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001595","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of a structured intervention based on Rapid-Cycle Deliberate Practice (RCDP) in reducing insulin self-administration errors in adults with diabetes.</p><p><strong>Methods: </strong>A quasi-experimental single-group pretest-post-test study was conducted in 2 public outpatient clinics in Rio de Janeiro, Brazil, between March 2020 and June 2023. Participants performed insulin self-administration using procedure-specific structured checklists. The intervention consisted of a structured, feedback-driven approach based on RCDP, involving real-time error correction and repeated practice cycles, using a low-fidelity simulation pad. Outcomes included the error rate, participant satisfaction, and self-confidence. Statistical analyses included the McNemar test, a generalized mixed-effects model, and effect size estimation.</p><p><strong>Results: </strong>A total of 103 participants were included. The error rate of insulin self-administration decreased from 47.2% at baseline to 5.7% after the intervention (P<0.001), representing a substantial reduction in unsafe practices. The intervention demonstrated a large effect size (Cohen d=1.55), indicating a marked improvement in procedural performance. Participants also reported high levels of satisfaction and self-confidence.</p><p><strong>Conclusions: </strong>A structured RCDP-based intervention significantly reduced insulin self-administration errors, addressing a critical gap in medication safety in outpatient care. By enabling patients to perform a high-risk procedure more safely, this approach represents a practical and scalable strategy to reduce preventable harm and improve the safety of diabetes self-management.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}