Disability and Health Journal最新文献

{"title":"The impact of a 12-month randomized exercise intervention on cognitive function and brain volume in adults with down syndrome.","authors":"Lauren T Ptomey, Andrew J Aschenbrenner, Brian Helsel, Amy Bodde, Julianne G Clina, Jessica C Danon, Rebecca Lepping, Laura E Martin, Morgan Brucks, Joseph R Sherman, Daniel E Forsha, Richard A Washburn, Joseph E Donnelly","doi":"10.1016/j.dhjo.2026.102134","DOIUrl":"10.1016/j.dhjo.2026.102134","url":null,"abstract":"<p><strong>Background: </strong>Adults with Down syndrome (DS) have a high risk for Alzheimer's disease (AD). While exercise improves cognition and brain health in the general population, few long-term studies have evaluated its effects in DS.</p><p><strong>Objective: </strong>We examined the impact of a 12-month remotely delivered exercise program on cognitive function and brain volume in adults with DS.</p><p><strong>Methods: </strong>81 adults with DS (mean age = 27 years) were randomized to high-frequency remote exercise (3 sessions/week, RH), low-frequency remote exercise (1 session/week, RL), or a support and education control (SE). Cognitive function was assessed using the DS-adapted Cambridge Neuropsychological Test Automated Battery (CANTAB), and brain volumes were measured via MRI at baseline and 12 months.</p><p><strong>Results: </strong>There were no significant changes in any group in executive function or episodic memory (all p > 0.05), but the RH arm significantly improved processing speed across the 12-month intervention (EMM change: 0.17; p = 0.04). No between-group differences were observed for changes in overall cognitive scores. The RL group showed a decrease in total grey matter volume (EMM change -0.82; p = 0.02) and the RH group had no change (EMM change: 0.08; p = 0.72), yielding a significant group effect across time (EMM: 0.90; p = 0.04). Additionally, the RH arm had an increase in right hippocampal volume over 12 months (EMM change: 0.004; p = 0.04).</p><p><strong>Conclusion: </strong>The improvements in reaction time, right hippocampal volume, and grey matter preservation suggest that structured exercise may influence cognition and brain health in adults with DS.</p><p><strong>Clinical trials registration: </strong>NCT04048759.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"102134"},"PeriodicalIF":3.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accessibility of day-night emergency alert systems for Deaf and hard-of-hearing adults during armed conflict.","authors":"Carolina Tannenbaum-Baruchi, Barak Kandell, Nadav Davidovitch, Stav Shapira","doi":"10.1016/j.dhjo.2026.102136","DOIUrl":"https://doi.org/10.1016/j.dhjo.2026.102136","url":null,"abstract":"<p><strong>Background: </strong>People with disabilities, including Deaf and hard-of-hearing (DHH) individuals, face disproportionate disaster risks due to communication barriers. Emergency alert systems are predominantly auditory-based, limiting their effectiveness for DHH populations. This gap is especially critical during armed conflict, where timely alerts can be life-saving.</p><p><strong>Objective: </strong>This study examined emergency alert system accessibility and associated psychological distress among DHH adults during active armed conflict.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted in Israel (October-November 2023) during the early phase of the Israel-Hamas War among DHH adults (N = 167), assessing daytime and nighttime alert accessibility and psychological distress. Analyses included McNemar's test, repeated-measures ANOVA with Bonferroni correction, independent-samples t-tests, and one- and two-way ANOVA. Effect sizes were reported throughout.</p><p><strong>Results: </strong>Participants included 87 Deaf (52.1%), 73 hard-of-hearing (43.7%), and 7 (4.2%) identifying as \"other,\" with a mean age of 55.3 years (SD = 16.4). While 69.5% received alerts via the national application during daytime, only 32.3% did so at night, indicating a substantial nighttime accessibility gap. Alert accessibility was only partially associated with psychological distress. Women reported significantly higher distress than men (p < .019). No significant differences emerged between Deaf and hard-of-hearing participants in alert use or distress levels. Education level did not predict alert accessibility, suggesting structural rather than user-dependent barriers.</p><p><strong>Conclusions: </strong>DHH individuals face systematic barriers to accessing emergency alerts, particularly at night. Equitable disaster preparedness requires multimodal systems incorporating visual, vibration, and text-based channels. Culturally accessible mental health support should be integrated into emergency response protocols.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"102136"},"PeriodicalIF":3.0,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of alcohol use among people with and without disabilities: a secondary analysis of 29 Multiple Indicator Cluster Surveys from Low- and Middle-Income Countries.","authors":"Rodrigo Vargas-Fernández, Hannah Kuper, Sara Rotenberg","doi":"10.1016/j.dhjo.2026.102133","DOIUrl":"https://doi.org/10.1016/j.dhjo.2026.102133","url":null,"abstract":"<p><strong>Background: </strong>Limited disability-disaggregated alcohol data in low- and middle-income countries (LMICs) hinders progress towards Sustainable Development Goal (SDG) 3.5, which focuses on strengthening the prevention and treatment of substance abuse, including narcotic drug abuse and harmful alcohol use.</p><p><strong>Objectives: </strong>To compare patterns of alcohol use between people with and without disabilities, while also examining variation across functional domains associated with disability and adjusting for socio-economic and environmental determinants of drinking behaviour.</p><p><strong>Methods: </strong>We analysed Multiple Indicator Cluster Surveys from 29 LMICs. We estimated the adjusted prevalence ratios (aPR) for alcohol-related outcomes comparing adults with and without disabilities by sex and for each country, using modified Poisson regression. Meta-analyses were performed to pool country-specific estimates for each outcome.</p><p><strong>Results: </strong>Our analyses included 353,305 adults, including 18,532 adults with disabilities. Women with disabilities had a higher prevalence of lifetime alcohol use (aPR: 1.12; 95% confidence interval [CI]: 1.05-1.19), current alcohol use (aPR: 1.11; 95% CI: 1.01-1.22), and alcohol use before age 15 (aPR: 1.31; 95% CI: 1.16-1.48) compared with women without disabilities. Men with disabilities experienced only a higher prevalence of lifetime alcohol use (aPR: 1.07; 95% CI: 1.05-1.19). People with difficulty in vision, self-care, walking, or remembering or concentrating domains experienced greater inequities in alcohol-related outcomes compared with people without disabilities.</p><p><strong>Conclusions: </strong>Women with disabilities were more likely to report alcohol use. Among men, alcohol use was high and frequent regardless of disability status. These findings highlight the need to develop health policies that explicitly incorporate a disability component to advance progress toward the SDGs in LMICs.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"102133"},"PeriodicalIF":3.0,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Providing \"ADEPT-CARE\" to patients with disabilities: Implementing a health system-wide workforce education module.","authors":"Lydia Smeltz, Caanen Churukha, Erik Lehman, Tonya King, Nora Newcomb, Ami DeWaters","doi":"10.1016/j.dhjo.2026.102132","DOIUrl":"10.1016/j.dhjo.2026.102132","url":null,"abstract":"<p><strong>Background: </strong>Disability-specific workforce education modules (WEM) are lacking in healthcare. ADEPT-CARE, a tool for approaching clinical encounters with patients with disabilities, has been an efficacious module for health professions students.</p><p><strong>Objectives: </strong>ADEPT-CARE was adapted into a WEM with the overall goal of assessing the generalizability of pilot findings among health professions students to healthcare professionals and patient-facing employees. The specific aims of this study were to (1) explore health system staff's willingness to participate in the ADEPT-CARE WEM; (2) evaluate the efficacy of ADEPT-CARE among participants; and (3) assess self-reported changes in confidence and attitudes towards patients with disabilities by key participant demographics.</p><p><strong>Methods: </strong>All healthcare professionals and patient-facing employees at an academic medical center were invited to voluntarily participate in the WEM. Demographic data from matched pre/post-survey responses were summarized. Pre/post comparisons were analyzed using a generalized estimating equations model approach to binomial logistic regression and odds ratios.</p><p><strong>Results: </strong>13,164 of 14,410 eligible employees participated in the WEM (91% completion rate). 1542 participants completed both the pre- and post-surveys. After completion, participants reported increased confidence in their ability to assess a disabled patient (OR = 12.84 (9.04, 18.24), p < 0.001) and provide the same quality of care to patients with and without disabilities (OR = 5.99 (4.40, 8.14), p < 0.001).</p><p><strong>Conclusions: </strong>ADEPT-CARE improved participants' self-reported confidence and attitudes towards patients with disabilities. Building upon prior work, these findings support ADEPT-CARE's potential value as a scalable intervention and its generalizability to a broad healthcare workforce.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"102132"},"PeriodicalIF":3.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Falls and related injury among middle-aged people aging with long-term disability are common and associated with disability symptoms.","authors":"Melissa J Krauss, Michelle Putnam, Maya Samih, Holly Hollingsworth, Susan L Stark","doi":"10.1016/j.dhjo.2026.102129","DOIUrl":"10.1016/j.dhjo.2026.102129","url":null,"abstract":"<p><strong>Background: </strong>Falls and related injury are understudied among people aging with long-term physical disabilities (PAwLTPD).</p><p><strong>Objectives: </strong>This study examined the prevalence of falling and injury among PAwLTPD over three years and explored associations of disability-related symptoms with these outcomes.</p><p><strong>Methods: </strong>A longitudinal survey (annual, three years: T0, T1, T2) was conducted among PAwLTPD (45-65 years). Participants were queried about whether they fell in the past year and fall-related injury. PROMIS measures were used to assess depression, fatigue, and pain.</p><p><strong>Results: </strong>323 PAwLTPD (69% women, 63% White, average age 56 years, average 19 years with disability) completed the three annual surveys. Over 65% fell in the past year at T0. Participants had lower odds of falling at T1 (odds ratio [OR] 0.55, 95% confidence interval [CI] 0.36-0.85) and at T2 (OR 0.55, CI 0.36-0.85). Approximately 40% fell in all three years. At T0, 15% fell with major injury. The odds of falling with major injury were lower at T1 (OR 0.15, CI 0.06-0.37) and T2 (OR 0.17, CI 0.07-0.40). In multivariable models, increasing fatigue T-score was associated with increased odds of falling (adjusted OR [aOR] 1.08, CI 1.05-1.12), falling all three years (aOR 1.12, CI 1.06-1.18), and minor injury (aOR 1.09, CI 1.05-1.13).</p><p><strong>Conclusion: </strong>Falls across multiple years and related injury are common among PAwLTPD and associated with disability symptoms. Regular screening and interventions to manage these conditions, including fatigue, should be researched as possible methods to decrease falls and injury among this understudied population.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"102129"},"PeriodicalIF":3.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescent learning disability and premature mortality: A 30-year prospective study of gender differences.","authors":"NaKyung Nam, Jinho Kim","doi":"10.1016/j.dhjo.2026.102131","DOIUrl":"https://doi.org/10.1016/j.dhjo.2026.102131","url":null,"abstract":"<p><strong>Background: </strong>Learning disabilities (LD)-defined in the U.S. as specific learning disorders (e.g., dyslexia, attention-related difficulties) and distinct from intellectual disability-are associated with educational disadvantage, psychosocial stress, and constrained healthcare access. Evidence on whether adolescent LD predicts premature mortality in adulthood remains limited.</p><p><strong>Objective: </strong>To examine the association between adolescent LD and premature mortality through early to mid-adulthood and assess whether these associations differ by gender.</p><p><strong>Methods: </strong>Data were drawn from 17,478 U S. adolescents in Wave I (1994-1995) of the National Longitudinal Study of Adolescent to Adult Health, linked to National Death Index records through 2023. Cox proportional hazards models with school-clustered robust standard errors estimated hazard ratios (HR) for all-cause and cause-specific (disease, external, suicide) mortality. Sex-stratified models and LD × sex interactions assessed sex differences.</p><p><strong>Results: </strong>Adolescents with LD had significantly elevated all-cause premature mortality (adjusted HR = 1.79 [1.47-2.18]). Associations were strongest for disease-related mortality (HR = 2.14 [1.61-2.85]) and elevated for external causes (HR = 1.57 [1.13-2.18]); suicide was non-significant. Sex-stratified analyses revealed substantially stronger effects among females than males (all-cause HR = 2.29 vs 1.58; disease-related HR = 2.87 vs 1.72); the LD × male interaction was statistically significant (p < 0.01).</p><p><strong>Conclusions: </strong>Adolescents with LD experience markedly elevated mortality through mid-adulthood, particularly from disease-related causes and especially among females. The findings position LD as a marker of cumulative social disadvantage shaped by stigma, exclusion, and unmet healthcare needs, calling for sustained, gender-sensitive support across educational, healthcare, and social systems.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"102131"},"PeriodicalIF":3.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological considerations in a recent meta-analysis of physical health among caregivers of children with disabilities.","authors":"Rhushvi Thakkar, Deepika Raina, Chandana Maji, Vaseem Anjum","doi":"10.1016/j.dhjo.2026.102127","DOIUrl":"https://doi.org/10.1016/j.dhjo.2026.102127","url":null,"abstract":"","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"102127"},"PeriodicalIF":3.0,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Cognitive impairments are the worst\": Staff perspectives on challenges in buprenorphine care for people with cognitive and mental health disabilities who inject drugs.","authors":"Roberto Abadie","doi":"10.1016/j.dhjo.2026.102130","DOIUrl":"https://doi.org/10.1016/j.dhjo.2026.102130","url":null,"abstract":"<p><strong>Background: </strong>Opioid use disorder (OUD) is highly prevalent among people with disabilities, who often experience cognitive and mental health impairments. These disabilities can complicate treatment and contribute to disparities in access and outcomes.</p><p><strong>Objective: </strong>To explore staff perspectives on cognitive and mental health impairments among people who inject drugs (PWID) receiving buprenorphine treatment, and how these challenges affect care delivery.</p><p><strong>Methods: </strong>From March 2025 to January 2026, 29 staff members from two buprenorphine clinics in the San Juan metropolitan area of Puerto Rico participated in semi-structured interviews. Data were analyzed using inductive and deductive coding to identify themes related to cognitive and mental health disabilities, treatment barriers, and management strategies.</p><p><strong>Results: </strong>Staff encountered a wide range of cognitive and mental health challenges. Stigmatized severe mental health conditions, such as schizophrenia or bipolar disorder, tended to be hidden by patients, affecting treatment outcomes. Staff viewed severe intellectual disabilities as a barrier to treatment due to the perception that patients with such disabilities could not adhere to the requirements of the cognitive therapy employed by the clinics. Often patients exhibited both cognitive and mental health impairments simultaneously, adding complexity to buprenorphine treatment and erecting new barriers.</p><p><strong>Conclusion: </strong>This study identifies cognitive and mental health impairments among PWID in buprenorphine treatment and highlights the challenges they pose for staff. The findings underscore the need for integrated, disability-informed approaches, including systematic screening, continuous assessment, culturally sensitive training, and community engagement and peer support, as well as further research on prevalence, barriers, and treatment outcomes.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"102130"},"PeriodicalIF":3.0,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in physical health between caregivers of children with and without disabilities: A systematic review and meta-analysis.","authors":"Byungmo Ku, Hyeondon Moon, Hajin Lee, Bumcheol Kim, Seoungmo Lee","doi":"10.1016/j.dhjo.2026.102128","DOIUrl":"https://doi.org/10.1016/j.dhjo.2026.102128","url":null,"abstract":"","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"102128"},"PeriodicalIF":3.0,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of weight loss on cardiovascular function in adolescents and young adults with overweight/ obesity and intellectual and developmental disabilities.","authors":"Geetha Haligheri, Tyler Johnson, Melanie Kathol, Laura Kuzava, Natalie Goth, David A White, Vincent S Staggs, Joseph E Donnelly, Lauren T Ptomey, Daniel Forsha","doi":"10.1016/j.dhjo.2026.102126","DOIUrl":"10.1016/j.dhjo.2026.102126","url":null,"abstract":"<p><strong>Background: </strong>Overweight and obesity affect over 60% of adolescents and young adults with intellectual and developmental disabilities (IDD) and are associated with impairments in cardiovascular (CV) function.</p><p><strong>Objective: </strong>This study aims to evaluate the impact of weight loss on cardiac strain and other measures of CV function in adolescents and young adults with IDD and obesity, addressing a current literature gap.</p><p><strong>Methods: </strong>Adolescents and young adults with IDD and obesity entering a weight loss parent trial (NCT02561754) were voluntarily co-enrolled in this observational ancillary study (49 participants representing 45% of those enrolled in the parent trial). The ancillary study CV testing was performed at baseline and 6 months including echocardiograms optimized for strain, pulse wave velocity, and treadmill stress testing. Changes in CV parameters were compared to changes in body mass index (BMI). Statistical analyses included medians (interquartile range), Spearman correlation with bootstrapping, and regression modeling (adjusting for IDD diagnosis), p < 0.05 significant.</p><p><strong>Results: </strong>The ancillary study cohort consisted of 21 females (42%), 23 participants with Down syndrome (47%), and 26 with autism (53%); the mean age was 16.5 ± 2.4 years (range 13-21 years). Average weight loss through the parent trial intervention was 6.5% (BMI decreased 6.0%) over 6 months, with 9/49 (18%) losing >10% body weight. The decrease in BMI correlated with increases in left ventricular (LV) global longitudinal strain (p < 0.01), tricuspid annular plane systolic excursion (TAPSE) (p = 0.02), LV lateral E/e' (p = 0.007), LV global circumferential strain (p = 0.01), and LV end-diastolic strain rate (p = 0.005). Modest changes in LV global longitudinal strain (p < 0.001) and TAPSE (p = 0.003) remained significant on multivariant modeling.</p><p><strong>Conclusions: </strong>Weight loss in adolescents and young adults with IDD and overweight/obesity relates to improvements in certain parameters of ventricular function.</p>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":" ","pages":"102126"},"PeriodicalIF":3.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}