Lancet Regional Health-Europe最新文献

{"title":"Cause-specific mortality in individuals with and without mental disorders according to socioeconomic position: a population-based cohort study","authors":"Danni Chen ,&nbsp;Linda Ejlskov ,&nbsp;Julie Werenberg Dreier ,&nbsp;Natalie C. Momen ,&nbsp;Lisbeth Mølgaard Laustsen ,&nbsp;Henrik Toft Sørensen ,&nbsp;Jayati Das-Munshi ,&nbsp;Oleguer Plana-Ripoll","doi":"10.1016/j.lanepe.2025.101397","DOIUrl":"10.1016/j.lanepe.2025.101397","url":null,"abstract":"<div><h3>Background</h3><div>Mental disorders are associated with elevated cause-specific mortality rates; however, the role of socioeconomic position (SEP) on these associations remains unclear. We aimed to examine cause-specific mortality associated with diverse mental disorders by SEP, on both relative and absolute scales.</div></div><div><h3>Methods</h3><div>This cohort study included all residents of Denmark on January 1, 2000, and followed them until December 31, 2020. Information on mental disorders, SEP (income percentile, further categorized into low [&lt;20%], middle [20–79%], and high [≥80%]), and cause-specific mortality was obtained from nationwide registers. We estimated mortality rate ratios (MRRs) and rate differences (MRDs) with Poisson regression models.</div></div><div><h3>Findings</h3><div>Overall, 5,316,626 individuals (50.6% females, median age 38.3 years) were followed up to 21 years. People with mental disorders (versus without) experienced higher mortality rates from all 11 specific causes of death, regardless of SEP. MRDs (per 10,000 person-years) between people with versus without mental disorders were greater in the lower than the higher SEP groups for all 11 causes of death, except suicide where MRDs were largest in the high-SEP group (9.3 [95% CI 8.6–9.9] versus 7.2 [7.0–7.5] in middle- and 6.1 [5.8–6.4] in low-SEP groups). MRRs were similar across SEP groups for most causes, with a 30–40% increase for cancer-related deaths, and more than two-fold increase for other cause-specific deaths. Conversely, relative risks of dying from alcohol misuse and suicide were higher among the high-SEP groups (MRRs: 10.9 [95% CI 9.9–12.0] and 17.7 [16.0–19.6] respectively) than the middle-SEP (8.3 [8.0–8.6] and 11.1 [10.6–11.7]) or low-SEP (4.8 [4.6–5.0] and 7.9 [7.3–8.6]) groups. All subgroup, sensitivity, and post-hoc analyses indicated similar patterns.</div></div><div><h3>Interpretation</h3><div>We provide detailed descriptions of cause-specific mortality associated with specific mental disorders by SEP and reveal potentially differential roles of SEP across causes of death.</div></div><div><h3>Funding</h3><div><span>Independent Research Fund Denmark</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"56 ","pages":"Article 101397"},"PeriodicalIF":13.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Halifax Declaration: protecting health, dignity, and human rights in an era of forced displacement","authors":"Gabriel E. Fabreau ,&nbsp;Annalee Coakley ,&nbsp;Sarah K. Clarke ,&nbsp;Nesma El-Shazly ,&nbsp;Apostolos Veizis ,&nbsp;Joanne Liu ,&nbsp;Patrick Bodenmann ,&nbsp;William M. Stauffer ,&nbsp;Anisa Ibrahim ,&nbsp;Nathan S. Bertelsen ,&nbsp;Allen Keller ,&nbsp;Karl Blanchet ,&nbsp;Bernadette Nirmal Kumar","doi":"10.1016/j.lanepe.2025.101406","DOIUrl":"10.1016/j.lanepe.2025.101406","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"56 ","pages":"Article 101406"},"PeriodicalIF":13.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resistance battle fatigue in the face of ongoing protests in Israel","authors":"Michal Mahat-Shamir ,&nbsp;Ayelet Oreg ,&nbsp;Ester Zychlinski","doi":"10.1016/j.lanepe.2025.101418","DOIUrl":"10.1016/j.lanepe.2025.101418","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"56 ","pages":"Article 101418"},"PeriodicalIF":13.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transformative collaborations in a time of change: Europe’s unique model for public-private-philanthropic partnerships","authors":"Carmen Hurtado del Pozo ,&nbsp;Niklas Blomberg","doi":"10.1016/j.lanepe.2025.101401","DOIUrl":"10.1016/j.lanepe.2025.101401","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"56 ","pages":"Article 101401"},"PeriodicalIF":13.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in epilepsy mortality of three incidence cohorts across 2006–2023 in Sweden: a matched register-based study","authors":"Johan Zelano ,&nbsp;André Idegård ,&nbsp;David Larsson","doi":"10.1016/j.lanepe.2025.101388","DOIUrl":"10.1016/j.lanepe.2025.101388","url":null,"abstract":"<div><h3>Background</h3><div>Idiopathic epilepsy alone accounts for a large health burden as shown in the Global Burden of Diseases Study. In countries with ageing populations, secondary epilepsies are now even more common. Altered clinical practice and reduced use of older enzyme-inducing drugs may be beneficial, but understanding of trends in the prognosis of all epilepsy is needed. Our objective was to determine and study trends in mortality in persons with epilepsy in Sweden through 2006–2023.</div></div><div><h3>Methods</h3><div>We performed a matched cohort study by cross-referencing National Patient, Drug, and Cause of Death Registers. We included all persons with a diagnosis of epilepsy and antiseizure medication (ASM) after 2006 (n = 61,375) and three age-/sex-matched comparators/case. Mortality was assessed for three incidence cohorts; 2006–2010, 2011–2015, and 2016–2020, totally and in four subgroups: age &gt;50, vascular disease, generalized epilepsy, and age &lt;20. Risk of death was assessed by Cox regression.</div></div><div><h3>Findings</h3><div>Carbamazepine and valproic acid were common first ASMs in 2006–2010, but replaced by levetiracetam by 2016–2020. Valproate became less common in generalized epilepsy. The adjusted hazard ratio [HR] for death was 1.99 (95% confidence interval [CI]:1.90–2.08) in 2006–2010 and 1.90 (95% CI: 1.82–1.99) in 2016–2020. The adjusted HR for death was 1.59 (95% CI: 1.50–1.68) for persons with cardiovascular disease versus comparators during 2016–2020. A sensitivity analysis showed that the excces risk of cardiovascular death had decreased between our cohorts. Young persons with epilepsy had a 30–50 fold increased HR of death. Dementia and vascular disease were important risk factors for death in persons with epilepsy.</div></div><div><h3>Interpretation</h3><div>Mortality in epilepsy has remained largely unchanged relative to age- and sex matched comparators. The increased use of non-inducing ASMs may have reduced vascular risk slightly. Efforts should be targeted to specific patient groups, particularly regarding epilepsy management in the young and vascular and neurodegenerative comorbidities in older persons with epilepsy.</div></div><div><h3>Funding</h3><div><span>Swedish Research Council</span>, Swedish State through the <span>ALF agreement</span>, <span>Knut and Ragnvi Jacobsson foundation</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"56 ","pages":"Article 101388"},"PeriodicalIF":13.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144685763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing oral health in the Balkans: promoting selective caries removal for underserved populations","authors":"Rasa Mladenovic","doi":"10.1016/j.lanepe.2025.101399","DOIUrl":"10.1016/j.lanepe.2025.101399","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"56 ","pages":"Article 101399"},"PeriodicalIF":13.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Out-of-home care placement, psychiatric disorders, and risk of homelessness: a population-based cohort study","authors":"Sandra Feodor Nilsson ,&nbsp;Thomas Munk Laursen ,&nbsp;Anne Ranning ,&nbsp;Anne A.E. Thorup ,&nbsp;Merete Nordentoft ,&nbsp;Seena Fazel","doi":"10.1016/j.lanepe.2025.101381","DOIUrl":"10.1016/j.lanepe.2025.101381","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Family adversity and childhood abuse have been associated with an increased risk of homelessness in adulthood. However, to our knowledge, no population-based longitudinal studies have examined the association between out-of-home placement and subsequent homelessness, while accounting for psychiatric disorders and parental background. Thus, we aimed to investigate the association between out-of-home placement and psychiatric disorders during childhood or adolescence and homelessness later in life.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We used data from a nationwide, register-based birth cohort in Denmark from 1 January 1983 to 31 December 2003, who were alive at any point from 1 January 2001 to 31 December 2021. Children and adolescents (aged 0–17) were followed up from their 18th birthday for risk of homelessness. We investigated associations using national registers with information on homelessness and psychiatric disorders. We examined individuals with any out-of-home placement history with and without psychiatric disorders diagnosed up to age 18 according to the first episode of homelessness after age 18, defined as first contact with a shelter. We estimated the cumulative incidence function using an Aalen-Johansen estimator. Hazard ratios (HRs) for the association between out-of-home placement, psychiatric disorder, and homelessness were estimated by sex using Cox proportional-hazard regression analyses, adjusted for birth year, parental sociodemographic factors and psychiatric disorders. Additionally, we employed a stratified Cox model (stratified by mother) to examine the contribution of within-family covariates.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;The study cohort included 1,226,130 Danish residents aged 18–39 years. Of these, 53,281 individuals (4·3%) had experienced out-of-home placement during childhood or adolescence. By age 39, 12·2% (95% CI 11·6–12·7) of males and 6·3% (95% CI 5·9–6·7) of females with a history of out-of-home placement experienced homelessness. This corresponds to a substantially increased risk compared to people without such a history, with adjusted HRs of 7·1 (95% CI 6·7–7·5) for males and 9·0 (8·2–9·8) for females. In sibling analyses restricted to 955,287 individuals and adjusted for birth year, out-of-home placement was associated with a 3-fold increased risk of homelessness compared to siblings without such a history (aHR 2·8 (95% CI 2·4–3·3) for males and aHR 3·2 (2·4–4·1) for females). Homelessness risk was even higher for individuals with a history of both out-of-home placement and psychiatric disorder, particularly when psychiatric diagnosis occurred after the first placement. In the full cohort, adjusted HRs were 11·8 (95% CI 10·8–13·0) for males and 19·3 (16·9–21·9) for females, compared to individuals with neither out-of-home placement nor psychiatric disorder.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Individuals with a history of out-of-home placement are at higher risk ","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"56 ","pages":"Article 101381"},"PeriodicalIF":13.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a national digital pre-implantation biopsy service for deceased-donor kidney transplantation in the UK (Pithia trial); a stepped-wedge cluster randomised registry trial","authors":"Dominic M. Summers ,&nbsp;John O.O. Ayorinde ,&nbsp;Desley A. Neil ,&nbsp;Karla Hemming ,&nbsp;Laura Smith ,&nbsp;Jennifer Mehew ,&nbsp;Helen Thomas ,&nbsp;Rosie Brown ,&nbsp;Suzie Phillips ,&nbsp;Emma Laing ,&nbsp;Anna Sidders ,&nbsp;Alison J. Deary ,&nbsp;Rachel J. Johnson ,&nbsp;Victoria Bardsley ,&nbsp;Sathia Thiru ,&nbsp;Meryl H. Griffiths ,&nbsp;Ranmith Perera ,&nbsp;Owen Cain ,&nbsp;Candice Roufosse ,&nbsp;Naomi Simmonds ,&nbsp;Gavin J. Pettigrew","doi":"10.1016/j.lanepe.2025.101390","DOIUrl":"10.1016/j.lanepe.2025.101390","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Pre-implantation biopsy may help select kidneys retrieved from elderly deceased donors for transplantation, but concerns persist that it may cause unnecessary discard of kidneys that would have provided acceptable transplant function. The PITHIA trial tested the hypothesis that introduction of a National Digital Pathology Service (NDPS) would increase the proportion of kidneys transplanted from elderly donors and/or improve their function.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A stepped-wedge cluster randomised controlled registry trial delivered the NDPS to 22 UK kidney transplant centres (clusters) in 5 sequences at four-monthly intervals, using a restricted randomisation technique to ensure similar cluster sizes in the intervention and control status. Upon access to the intervention, centres could request urgent pre-implantation biopsy on kidneys from deceased donors aged 60 years or older. Co-primary outcome measures were the proportion of kidneys transplanted upon first offer according to whether the centre had access or not to the biopsy service, and the 1-year eGFR of the kidneys that were transplanted. Analysis adjusts for clustering and underlying secular trends, with 97.5% Confidence Intervals (CI) reported to reflect the two co-primary outcomes. The trial is complete (Trial Registration Number: ISRCTN 11708741).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;The trial commenced on 1st October 2018 and ended on 31st January 2022. Of the 2502 eligible kidneys offered, 1355 single and 67 dual transplants were performed. Regarding the first primary endpoint, a non-significantly lower proportion of those kidneys first offered to centres with access to the biopsy service were transplanted compared with those offered to centres without access (295 of 1241 (23.8%) vs. 377 of 1261 (29.9%): adjusted Odds Ratio (97.5% CI) 0.91 (0.60–1.39); p = 0.6083). For the second primary endpoint, the adjusted mean (SE) 1-year eGFR of the transplant kidneys was similar, irrespective of whether the implanting centre had access to the biopsy service or not (43.7 (1.3) ml/min/1.73 m&lt;sup&gt;2&lt;/sup&gt; vs. 42.2 (1.3) ml/min/1.73 m&lt;sup&gt;2&lt;/sup&gt;; adjusted mean difference (97.5% CI) 1.53 (−2.33 to 5.40); p = 0.37). Secondary outcome analysis of how the biopsy service was adopted revealed that biopsies were performed on 287 of the 1493 (19.2%) kidneys offered to at least one centre with access to the biopsy service, with marked variation between transplant centres in requests for biopsy, and in implantation rates of biopsied kidneys. Nevertheless, 191 (66.6%) of biopsied kidneys were transplanted, compared with 643 of the 1009 (63.7%) kidneys only ever offered to centres without biopsy access, and 588 of the 1206 (48.8%) kidneys that were not biopsied, despite being offered to at least one centre with biopsy access.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Implementation of the NDPS did not significantly increase transplantation rates of elderly decease","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"56 ","pages":"Article 101390"},"PeriodicalIF":13.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can predicting future pregnancies after loss personalise miscarriage care?","authors":"Lara Catherine Morley ,&nbsp;Tina Jayne Shillito","doi":"10.1016/j.lanepe.2025.101394","DOIUrl":"10.1016/j.lanepe.2025.101394","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"55 ","pages":"Article 101394"},"PeriodicalIF":13.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144657266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excess mortality and hospitalisations associated with respiratory syncytial virus, influenza, and COVID-19 among adults in Denmark (2015–2024): a modelling study","authors":"Amanda Marie Egeskov-Cavling ,&nbsp;Chelsea L. Hansen ,&nbsp;Caroline Klint Johannesen ,&nbsp;Birgitte Lindegaard ,&nbsp;Samir Bhatt ,&nbsp;Cecile Viboud ,&nbsp;Thea K. Fischer","doi":"10.1016/j.lanepe.2025.101396","DOIUrl":"10.1016/j.lanepe.2025.101396","url":null,"abstract":"<div><h3>Background</h3><div>Understanding the long-term epidemiology trends of RSV, influenza, and COVID-19 is essential for planning of vaccination strategies and healthcare system epidemic preparedness. This is the first study to provide a comprehensive estimation of both excess mortality and hospitalisations among adults for these respiratory viruses in a European setting. We aim to estimate excess mortality and excess hospitalisations for RSV, influenza, and COVID-19 among adults ≥18 years in Denmark from January 2015 to March 2024.</div></div><div><h3>Methods</h3><div>This nationwide time-trend modelling study investigates weekly mortality and hospitalisation rates surpassing the seasonal baseline for RSV, influenza, and COVID-19 among adults in Denmark. Data from the Cause of Death Register, the Danish National Patient Registry, and respiratory virus surveillance data were analysed with Generalized Additive Models (GAM) using a negative binomial likelihood function, including RSV, influenza, COVID-19 variants, and time effects to account for seasonality and trend.</div></div><div><h3>Findings</h3><div>We estimated 3944 RSV-attributed, 5675 influenza-attributed, and 5636 COVID-19-attributed deaths. Among adults aged 65 or older, the annual mortality rates were 31.2 per 100,000 for RSV, 42.9 for influenza, and 88.5 for COVID-19. Furthermore, we estimated annual admission rates for those aged 65 and older of 177.4 per 100,000 for RSV, 164.6 for influenza, and 398.7 for COVID-19.</div></div><div><h3>Interpretation</h3><div>This modelling study reveals a substantial impact of RSV on individuals aged 65 and older, with a notable increase in RSV-attributed deaths and hospitalisations in recent years likely due to expanded respiratory testing after the COVID-19 pandemic. Our findings highlight the need for increased awareness in previously considered lower-risk patients, and establish benchmarks for evaluating preventive interventions.</div></div><div><h3>Funding</h3><div>This study received funding from <span>Independent Research Fund Denmark</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"55 ","pages":"Article 101396"},"PeriodicalIF":13.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144657206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}