Journal of Developmental and Behavioral Pediatrics最新文献

{"title":"The Prospective Relationship Between Childhood Self-control and Adult Parenting Behaviors: A Thirty-year Follow-up Study.","authors":"Molly Kuehn, Sara B Johnson, Radhika Raghunathan, Kristin M Voegtline, Tracey Chambers Thomas, Nicholas S Ialongo, Rashelle J Musci","doi":"10.1097/DBP.0000000000001447","DOIUrl":"10.1097/DBP.0000000000001447","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether self-control in first grade predicts later parenting.</p><p><strong>Method: </strong>Participants were first graders enrolled in a universal preventive intervention trial in 1993 to improve behavior and school achievement. By 2023, n = 221 participants were parents of children aged 4 to 15 years. Pre-intervention, self-control was assessed using the Teacher Observation of Classroom Adaptation-Revised. Latent profile analysis identified 3 profiles of childhood self-control: high (n = 101, 45.7%), inattentive (n = 87, 39.4%), and inattentive/hyperactive (n = 33, 14.9%). The association between self-control profiles and later parent-rated discipline consistency and enjoyment of parenting from the Structured Interview of Parent Management Skills and Practices was evaluated using latent profile regression. The association between self-control and observed parent sensitivity, intrusiveness, and positive/negative regard for the child was explored in a subset (n = 81).</p><p><strong>Results: </strong>The high and inattentive childhood self-control profiles were more likely to discipline consistently versus the inattentive/hyperactive profile (Wald(2) = 8.55, p = 0.01). Self-control did not predict enjoyment of parenting (Wald(2) = 3.30, p = 0.19). Compared with the high profile, the inattentive/hyperactive and inattentive profiles exhibited greater positive regard for the child (Wald(2) = 11.03, p = 0.004).</p><p><strong>Conclusion: </strong>Childhood self-control may provide a foundation for discipline consistency as a parent. Individual differences in regulatory functioning that pose challenges in childhood might confer unexpected parenting benefits, underscoring the need for a life course perspective.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e169-e175"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Often do Youth ask Their Providers the Questions They Checked on an Attention-Deficit Hyperactivity Disorder Question Prompt List?","authors":"Abena A Adjei, Delesha M Carpenter, Kathleen C Thomas, Robyn Sayner, Izabela E Annis, Gail Tudor, Nacire Garcia, Laurel K Leslie, Imelda Coyne, Betsy Sleath","doi":"10.1097/DBP.0000000000001448","DOIUrl":"10.1097/DBP.0000000000001448","url":null,"abstract":"<p><strong>Objective: </strong>To describe the questions youth with attention-deficit hyperactivity disorder (ADHD) checked on a question prompt list and evaluate the extent to which youth asked these questions during medical visits.</p><p><strong>Methods: </strong>English-speaking adolescents (N = 102) aged 11 to 17 years with ADHD were enrolled from 2 pediatric primary care clinics in North Carolina; this work focuses on the 52 adolescents in the intervention group. Adolescents who received the intervention watched an educational video and completed a prompt list before visits. Medical visits were recorded, transcribed, and coded for questions asked during visits. The questions adolescents checked on the prompt list were compared with the questions they asked during visits.</p><p><strong>Results: </strong>Adolescents checked an average of 5.6 questions on the prompt list. Forty percent of adolescents who checked a question asked at least 1 question they checked during visits. The most common questions adolescents checked and asked about ADHD were, \"Should I reduce my screen time to help with ADHD?\" (50.0%) and \"Will I grow out of ADHD?\" (34.4%). The most common questions adolescents checked and asked about ADHD treatment were, \"Should I take my ADHD medicine before I play sports?\" (33.3%), \"Should I take my ADHD medicine while I am at school?\" (28.6%), and \"Would talking to a counselor help my ADHD?\" (28.6%).</p><p><strong>Conclusion: </strong>Adolescents with ADHD have many questions about ADHD; however, about 60% (n = 31) did not ask any of the questions they checked on the prompt list. Future research should examine how to encourage youth who receive a question prompt list intervention to ask questions during visits.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e192-e198"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133353","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":"Challenging Case: Health Care Professionals as Cultural Brokers for a Boy From Central America With Attention-Deficit Hyperactivity Disorder and Trauma and Stressor-related Disorder.","authors":"Natalie Cerda, Jeffrey D Shahidullah, Courtney Kates, Anahi Marquez, Elizabeth A Diekroger, Jason Fogler","doi":"10.1097/DBP.0000000000001472","DOIUrl":"10.1097/DBP.0000000000001472","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Case: &lt;/strong&gt;\"Javier\" is an 8-year-old boy with a complex psychosocial history presenting for a developmental-behavioral pediatrics consultation because of concerns regarding hyperactivity (affecting safety) and developmental delays, including \"lack of independence.\" He is not yet toilet trained and in his mother's words, \"he has the mindset of a child that is much younger than his actual age.\" Javier's family emigrated to the United States from Central America a year ago to seek asylum. During his family's journey to the United States, Javier and his mother were kidnapped and sexually assaulted. On settling into the United States, Javier was evaluated by his local school district and qualified for specialized services. His mother is not aware of what support he receives at school and is concerned that he is not making sufficient progress. He has not previously received developmental therapies or psychosocial interventions.Javier has demonstrated developmental delays, including reduced reciprocal social communication skills, since birth. His mother shared that he was not able to attend school in Central America as \"no schools had the resources to educate him.\" He began speaking around age 5 years and currently communicates using phrased speech. There have been long-standing safety concerns related to his impulsivity, including wandering, which first emerged in his early toddler years. His hyperactivity predates his history of trauma and sexual abuse. Currently, he demonstrates intermittent physical aggression toward family members. He is interested in fire and has set objects on fire in the home. He is also drawn to placing items in electrical outlets, which has resulted in multiple self-electrocutions.Javier does not have medical insurance but receives limited health coverage through a program for uninsured residents with low income. He was evaluated by a psychiatrist and prescribed 2 medications, although his mother does not know the names of the medications prescribed. Review of psychiatry records indicated that he was prescribed guanfacine extended-release and amphetamine and dextroamphetamine salts extended release. These medications led to improvements in his behavior regulation, although he was not able to take these medications consistently because of cost.Javier's developmental evaluation included assessment of his cognitive, adaptive, and social communication skills in his native language. His diagnostic evaluation yielded provisional diagnoses of autism spectrum disorder with accompanying speech and intellectual impairment. Psychiatric diagnostic impressions included complex attention-deficit/hyperactivity disorder in the context of his significant trauma history. His mother did not have prior conceptualization of developmental or psychiatric diagnoses, and psychoeducation through a cultural lens was provided. What are your next steps in partnering with Javier's family as they navigate medical and educational systems follo","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e267-e269"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Interplay Between Screen Time and Outdoor Play on Preschool Children's Cognitive and Social-emotional Development.","authors":"Ramiah Moldenhauer, Madison Boyd, Yeongho Hwang, Sandra Wiebe, Yao Zheng, Christina M Rinaldi, Morgan Potter, Joshua Li, Kyla Dorn, Valerie Carson","doi":"10.1097/DBP.0000000000001444","DOIUrl":"10.1097/DBP.0000000000001444","url":null,"abstract":"<p><strong>Objective: </strong>To (1) identify distinct profiles (i.e., subgroups) of screen time (ST) and outdoor play (OP) in a sample of preschool children, and (2) examine the mean differences in specific domains of cognitive and social-emotional development between these profiles.</p><p><strong>Method: </strong>Baseline data from the Technology and Development in Early Childhood study were used. Participants were 352 preschool children (3-4 years) and their parents living in Western Canada. ST (television [TV]/video viewing and video/computer games) and OP for both weekdays and weekend days were parent-reported. Social-emotional development outcomes (emotional, cognitive, and behavioral self-regulation) and demographic covariates were assessed by questionnaire. Cognitive development outcomes (language, response inhibition, working memory, and self-control) was assessed by 4 short games played during a recorded virtual meeting. Latent profile analysis was conducted.</p><p><strong>Results: </strong>Four profiles were identified: (1) low ST/medium-high OP, (2) high TV/high OP, (3) medium ST/low OP, and (4) high ST/medium-high OP. Profile 1 was selected as the reference group. For response inhibition, the medium ST/low OP ( M = 10.3, SE = 2.0; p = 0.03) and high ST/medium-high OP ( M = 2.8, SE = 3.7; p < 0.01) profiles scored significantly lower than the reference group ( M = 15.3, SE = 1.0). For self-control, the high TV/high OP ( M = 65.5, SE = 3.2; p = 0.03) and medium ST/low OP ( M = 63.8, SE = 4.8; p < 0.05) profiles scored significantly lower than the reference group ( M = 74.2, SE = 2.1). For behavioral self-regulation, the high TV/high OP ( M = 3.6, SE = 0.1; p < 0.01) profile scored significantly lower than the reference group ( M = 3.9, SE = 0.04).</p><p><strong>Conclusion: </strong>Children with the combination of lower ST and higher OP had more advanced cognitive and social-emotional development for some outcomes.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e199-e205"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031542","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":"Afterword to Exploring Complex Attention Deficit Hyperactivity Disorder Through Challenging Cases.","authors":"Elizabeth A Diekroger, Jason M Fogler","doi":"10.1097/DBP.0000000000001475","DOIUrl":"10.1097/DBP.0000000000001475","url":null,"abstract":"","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e272-e273"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rebuilding Family Relations for Children and Youth Separated From Family.","authors":"Ikpe Justice Akpan","doi":"10.1097/DBP.0000000000001473","DOIUrl":"10.1097/DBP.0000000000001473","url":null,"abstract":"","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"278"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582848","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":"Pediatric Resident Participation in Primary Care Autism Evaluations: A Novel Continuity Clinic Training Opportunity.","authors":"Brittany Perry, Julie Cooper, Ran Zhang, Meghan Harrison","doi":"10.1097/DBP.0000000000001442","DOIUrl":"10.1097/DBP.0000000000001442","url":null,"abstract":"<p><strong>Objective: </strong>There is a growing need for autism evaluations in young children. Wait times to evaluation are long due to the limited specialty workforce. Primary care autism evaluations are 1 solution, but many providers lack training and confidence in autism care. Literature highlights the need for improvement in developmental and behavioral pediatrics training among pediatric residents. This study evaluates resident confidence in autism care after participation in a novel autism evaluation pathway in a primary care pediatric resident continuity clinic.</p><p><strong>Methods: </strong>Pediatric residents led a primary care autism evaluation with a trained pediatrician in their continuity clinic. Residents were provided with enhanced autism education which included neurodiversity-affirming strategies and training on the use of an autism assessment tool. Presurveys and postsurveys were used to assess resident confidence in autism care before and after the educational intervention. Survey data were compared using Mann-Whitney U tests appropriate for ordinal, nonpaired data.</p><p><strong>Results: </strong>Thirty resident-led autism evaluations were conducted during the study period. There was statistically significant improvement in resident confidence in autism screening, use of assessment tools, evaluation, diagnosis, treatment recommendations, sharing resources, understanding of neurodiversity, and use of a strength-based approach after participation.</p><p><strong>Conclusion: </strong>Providing autism education and hands-on primary care autism evaluation training opportunities for residents in pediatric continuity clinic improves confidence in autism care. This model is 1 way to enhance autism education and training during pediatric residency which may have a positive impact on the care provided to autistic patients.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e182-e185"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12928545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Social Determinants of Health on Health Care Delivery for Children With Cerebral Palsy in the US Health Care System: A Scoping Review.","authors":"Kathryn Radulovacki, Bradley Q Fox, Christian Zirbes, Rachelle Shao, Evelyn Hunter, Summer Shabana, Muhamed Sanneh, Devika A Shenoy, Stephanie Hendren, Anthony A Catanzano","doi":"10.1097/DBP.0000000000001465","DOIUrl":"10.1097/DBP.0000000000001465","url":null,"abstract":"<p><strong>Objective: </strong>This scoping review evaluated the impact of social determinants of health (SDOH) on health care delivery and access for US children with cerebral palsy (CP).</p><p><strong>Method: </strong>A comprehensive literature search was conducted using Medline, Embase, CINAHL Complete, and Scopus. Studies lacking extractable data or published before 2010 or outside the United States were excluded. Two independent investigators screened abstracts and a third resolved disagreements. Selected manuscripts underwent full-text review and data extraction for thematic and comparative analysis. Descriptive statistics were calculated in Excel.</p><p><strong>Results: </strong>In total, 6482 articles were identified and 146 underwent full-text review. Ultimately, 9 studies were included. The 3 main themes discussed were race (n = 6), economic standing (n = 5), and insurance status (n = 3). Three articles examined multiple themes. Black and multiracial individuals had significantly higher postoperative complication rates and unmet care coordination needs, and lower rates of receiving special services (e.g., physical therapy). Higher economic status was associated with greater health care expenses and service access. Public insurance was associated with insufficient care coordination, decreased special service utilization, and increased rates of readmission and inpatient complications.</p><p><strong>Conclusion: </strong>Included articles demonstrate that race, insurance status, and economic standing are significantly associated with unequal health care access and outcomes for US children with CP. Future efforts should prioritize standardization of reported metrics for SDOH and investigation into systemic inequalities in health care access.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":"47 2","pages":"e254-e260"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693489","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":"Positive Childhood Experiences Among Children and Youth With Special Health Care Needs.","authors":"Emma Kathryn Boswell, Maushmi Patel, Taryn Farrell, Elizabeth Crouch","doi":"10.1097/DBP.0000000000001451","DOIUrl":"10.1097/DBP.0000000000001451","url":null,"abstract":"<p><strong>Objective: </strong>Positive childhood experiences (PCEs) are protective events against the impact of childhood trauma. Previous research has found that children and youth with special health care needs (CYSHCN) are more likely to experience adverse childhood experiences, but the prevalence of PCEs among this population has not been examined. Therefore, this study seeks to evaluate the prevalence of PCEs among CYSHCN.</p><p><strong>Methods: </strong>Cross-sectional data from the 2021 to 2022 National Survey of Children's Health (n = 47,207) was used to evaluate differences in the prevalence of PCEs between CYSHCN and non-CYSHCN, and to evaluate predictors of PCE exposure among CYSHCN. Rao-Scott χ 2 test and multivariable logistic regression, using appropriate survey weights, were used.</p><p><strong>Results: </strong>Compared with non-CYSHCN, CYSHCN had lower odds of having at least one PCE (adjusted odds ratio [aOR]: 0.35, 95% Confidence Intervals [CIs]: 0.15‒0.83), and having specific types of PCEs: having constructive social engagement (aOR: 0.24, 95% CIs: 0.21‒0.27), having nurturing and supportive relationships (aOR: 0.80, 95% CIs: 0.72‒0.89), living in a safe, stable, and equitable environment (aOR: 0.75, 95% CIs: 0.68‒0.82), and creating social and emotional competency (aOR: 0.62, 95% CIs: 0.56‒0.69). Among CYSHCN, children of color, those with greater poverty, and those with more complex needs have lower odds of experiencing most PCEs.</p><p><strong>Conclusion: </strong>The results of this study indicate a need for programs aimed at fostering resilience among CYSHCN. There is also a need for additional research creating better measures of evaluating PCEs among CYSHCN and examining how PCEs mitigate the effects of adverse childhood experiences in this population.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e232-e239"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835112","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":"The Febrile Effect in Autism Spectrum Disorder: An Investigation of Behavioral Improvements During Episodes of Fever in Chinese Children.","authors":"Chunyang Li, Miao Yang, Chuanxue Tan, Yingping An, Jie Zhang","doi":"10.1097/DBP.0000000000001439","DOIUrl":"10.1097/DBP.0000000000001439","url":null,"abstract":"<p><strong>Purpose: </strong>Some individuals with autism spectrum disorder (ASD) demonstrate marked behavioral improvements during febrile episodes, which is called febrile effect. This study aimed to investigate the prevalence and characteristics of the febrile effect in children with ASD in China.</p><p><strong>Methods: </strong>One hundred fifty-seven patients diagnosed with ASD were recruited to participate in the study; the parents completed a self-compiled questionnaire regarding the febrile effect. Children who reportedly improved with fever (Improve Group) were compared with those who reportedly did not improve (No Improve Group) on the core symptoms and developmental status.</p><p><strong>Results: </strong>Parent reports of 16.56% of children exhibited behavioral improvements during fever. Improvements included reduced problem behaviors, enhanced cognitive or learning abilities, increased social interaction, and decreased stereotypical behaviors. The Improve Group scored higher in Autism Diagnostic Observation Schedule, Second Edition and Social Responsiveness Scale. There were no significant differences in the incidence of infectious diseases during pregnancy among mothers in the 2 groups; however, a marked disparity was observed in the frequency of febrile episodes within the preceding year. The duration of the febrile effect varied, with 76.92% being temporary and 23.08% showing sustained improvements postfever. Children with sustained improvements had more severe social deficits.</p><p><strong>Conclusion: </strong>The febrile effect is observed in a subset of ASD children and may be associated with more severe social deficits. The heterogeneity in the duration of the febrile effect suggests the need for further research to elucidate the underlying mechanisms and potential therapeutic applications.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e176-e181"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679271","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}