Journal of the American Heart Association最新文献

{"title":"Machine Learning-Based Models for Intracerebral Hemorrhage In-Hospital Mortality Prediction.","authors":"Abdulaziz T Bako, Farhaan S Vahidy","doi":"10.1161/JAHA.124.039398","DOIUrl":"https://doi.org/10.1161/JAHA.124.039398","url":null,"abstract":"","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e039398"},"PeriodicalIF":5.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Outcome of Patients With Myocardial Infarction With Nonobstructive Coronary Arteries in Japan: Insights From the Miyagi Acute Myocardial Infarction Registry Study.","authors":"Kiyotaka Hao, Jun Takahashi, Koichi Sato, Kento Fukui, Tomohiko Shindo, Kazuma Oyama, Kensuke Nishimiya, Shigeo Godo, Takashi Shiroto, Hiroaki Shimokawa, Satoshi Yasuda","doi":"10.1161/JAHA.124.036802","DOIUrl":"https://doi.org/10.1161/JAHA.124.036802","url":null,"abstract":"<p><strong>Background: </strong>Clinical characteristics and outcomes of patients with myocardial infarction (MI) with nonobstructive coronary arteries (MINOCA) are not fully understood, particularly in Japan.</p><p><strong>Methods and results: </strong>We enrolled a total of 8881 patients with acute MI from the Miyagi Acute Myocardial Infarction Registry Study (2012-2020), with a median age of 69 years. Among them, 239 patients (2.7%) were diagnosed with MINOCA. Compared with those with MI with obstructive coronary artery disease (MI-CAD), patients with MINOCA were more often women, had a higher incidence of non-ST-segment-elevation MI and a lower prevalence of dyslipidemia. Compared with patients with MI-CAD, patients with MINOCA in all age groups (<59, 60-69, 70-79, >80 years of age) had a higher incidence of non-ST-segment-elevation MI. Additionally, those ≤59 years of age were more often women and had a lower prevalence of diabetes and dyslipidemia. In-hospital mortality increased with age in patients with MI-CAD (3.9% for <59 years of age, 5.6% for 60-69 years of age, 8.3% for 70-79 years of age, and 15.2% for >80 years of age; <i>P</i><0.01), but not in patients with MINOCA (4.5%, 7.4%, 6.0%, and 9.6%, respectively; <i>P</i>=0.36). Compared with patients with MI-CAD, patients with MINOCA had lower in-hospital mortality for Killip class IV (40.7% versus 20.0%; adjusted odds ratio [OR], 0.31 [95% CI, 0.10-0.94]; <i>P</i>=0.04) and renal dysfunction (20.0% versus 7.1%; adjusted OR, 0.29 [95% CI, 0.09-0.96]; <i>P</i>=0.04).</p><p><strong>Conclusions: </strong>Patients with MINOCA exhibit distinct clinical characteristics and outcomes compared with those with MI-CAD, particularly in terms of age, sex, prevalence of comorbidities, and in-hospital mortality. These findings underscore the importance of tailored clinical approaches for patients with MINOCA.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e036802"},"PeriodicalIF":5.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of a Composite Stress Measurement Tool With Cardiovascular Risk Factors and Outcomes: Findings From the Dallas Heart Study.","authors":"Ijeoma Eleazu, Colby Ayers, Ann Marie Navar, Karim Salhadar, Michelle Albert, Mercedes Carnethon, E Sherwood Brown, Lucy Ogbu Nwobodo, Spencer Carter, Courtney Bess, Tiffany M Powell-Wiley, James A de Lemos","doi":"10.1161/JAHA.123.033752","DOIUrl":"10.1161/JAHA.123.033752","url":null,"abstract":"<p><strong>Background: </strong>Most data linking chronic stress with cardiovascular disease (CVD) risk factors and outcomes have focused on single-domain stress measurements. We evaluated the association between a novel composite measure of chronic perceived stress and CVD risk factors and outcomes in a diverse population.</p><p><strong>Methods and results: </strong>Individual chronic stress subcomponents (generalized stress, psychosocial, financial, and neighborhood stress) were standardized and integrated to create a novel composite stress score (CSS). Participants from the DHS (Dallas Heart Study) phase 2 (2007-2009) visit without prevalent CVD who completed chronic stress questionnaires were included (n=2685). Associations between CSS and demographics, cardiac risk factors, and health behaviors were assessed in multivariable analyses. Cox proportional hazards models adjusting for traditional risk factors were used to determine associations of the CSS with adjudicated atherosclerotic CVD and global CVD (atherosclerotic CVD, heart failure, and atrial fibrillation) outcomes. CSS was higher among participants who were younger, women, and Black or Hispanic individuals, with lower income and educational attainment (<i>P</i><0.0001 for each). In multivariable regression models adjusting for age, sex, race and ethnicity, income and education, higher CSS associated with hypertension, smoking, higher body mass index, hemoglobin A_1C, high-sensitivity C-reactive protein, and sedentary time (<i>P</i><0.01 for each). Over a median follow-up of 12.4 years, higher CSS associated with atherosclerotic CVD (adjusted hazard ratio [HR]. 1.22 per SD [95% CI, 1.01-1.47]) and global CVD (adjusted HR, 1.20 [95% CI, 1.03-1.40]). No interactions were seen between CSS, demographic factors, and outcomes.</p><p><strong>Conclusions: </strong>Composite measures of chronic stress are higher in vulnerable populations and may help identify individuals at risk for CVD who may benefit from enhanced prevention strategies.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e033752"},"PeriodicalIF":5.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Providing Optimal ST-Segment-Elevation Myocardial Infarction Care: How Do We Overcome Barriers?","authors":"Fathima Aaysha Cader, Alexander E Sullivan, Angela Lowenstern","doi":"10.1161/JAHA.124.040169","DOIUrl":"https://doi.org/10.1161/JAHA.124.040169","url":null,"abstract":"","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e040169"},"PeriodicalIF":5.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-Hospital or Out-of-Hospital Initiation of Sacubitril/Valsartan Versus Valsartan in Patients With Mildly Reduced or Preserved Ejection Fraction After A Worsening Heart Failure Event: The PARAGLIDE-HF Trial.","authors":"Nina Nouhravesh, Derek Cyr, Adrian F Hernandez, David A Morrow, Eric J Velazquez, Jonathan Ward, Samiha Sarwat, Kavita Sharma, Kristin Williamson, Randall C Starling, Serge Lepage, Shelley Zieroth, Scott D Solomon, Robert J Mentz","doi":"10.1161/JAHA.124.037899","DOIUrl":"https://doi.org/10.1161/JAHA.124.037899","url":null,"abstract":"<p><strong>Background: </strong>Efficacy and tolerability of sacubitril/valsartan (Sac/Val) is not well characterized in heart failure (HF) with ejection fraction >40% initiated in-hospital. Thus, this prespecified PARAGLIDE-HF (Prospective Comparison of ARNI With ARB Given Following Stabilization In Decompensated HFpEF) analysis assessed the effects of Sac/Val versus valsartan (Val) by location of initiation in HF with ejection fraction >40% and recent worsening HF.</p><p><strong>Methods and results: </strong>This analysis of the double-blind, randomized controlled trial assessed patients by in-hospital and out-of-hospital (≤30 days of worsening HF) initiation. The primary end point was time-averaged proportional change in NT-proBNP (N-terminal pro-B-type natriuretic peptide) from baseline through weeks 4 and 8. A secondary hierarchical outcome consisted of cardiovascular death, HF hospitalizations, urgent HF visits, and NT-proBNP change. Safety end points were symptomatic hypotension, hyperkalemia, and worsening renal function. Overall, 324 (70%, 162 Sac/Val, 162 Val) were initiated in-hospital and 142 (71 Sac/Val, 71 Val) out-of-hospital. There was no evidence of a statistically significant differential treatment benefit of Sac/Val versus Val on NT-proBNP change by location of initiation (in-hospital, 0.86 [95% CI, 0.70-1.05] and out-of-hospital, 0.87 [95% CI, 0.70-1.09]; <i>P</i>_interaction=0.99). The win ratio for the hierarchical outcome was 1.09 (95% CI, 0.82-1.45; <i>P</i>=0.57) for in-hospital and 1.43 (95% CI, 0.91-2.26; <i>P</i>=0.12) for out-of-hospital. For the safety end points of symptomatic hypotension, hyperkalemia, and worsening renal function, no statistically significant differences in tolerability were seen between in-hospital and out-hospital initiation (<i>P</i>_interaction>0.1).</p><p><strong>Conclusions: </strong>Sac/Val provided consistent benefit compared with Val, whether initiated in-hospital or out-of-hospital in HF with ejection fraction >40% with a recent worsening HF event, demonstrating an opportunity to improve postdischarge outcomes by initiating Sac/Val during hospitalization.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e037899"},"PeriodicalIF":5.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Mortality of Heart Failure Stages in a Free-Living Older Adult Population: Data From the Brazilian Longitudinal Study of Adult Health.","authors":"Altair I Heidemann, Angela B S Santos, Marcio S Bittencourt, Antonio L P Ribeiro, Luis E Rohde, Paulo A Lotufo, Bruce B Duncan, Murilo Foppa","doi":"10.1161/JAHA.124.038993","DOIUrl":"https://doi.org/10.1161/JAHA.124.038993","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) has a major impact on public health. HF staging helps capture preclinical disease and its progression to advanced stages. There are scarce data on HF staging from longitudinal studies in Latin America. This study aimed to determine the prevalence and mortality of HF stages in a Brazilian adult cohort of participants 60 years old and over.</p><p><strong>Methods: </strong>The ELSA-Brasil (Brazilian Longitudinal Study of Adult Health) multicentric cohort comprises 15 105 adults. From 2008 to 2010, ELSA carried out interviews and clinical, laboratory, and cardiovascular tests. In this analysis, we included participants 60 years old and over who had an echocardiogram performed at baseline visit and additional information regarding risk factors and functional capacity.</p><p><strong>Results: </strong>There were 2356 participants (65±4 years; 53% women) with baseline echocardiogram. Of these, 504 (21%) participants were considered at low risk for developing HF (stage 0). Prevalence of HF was 1026 (44%) for stage A (at risk for HF), 557 (24%) for stage B (pre-HF), and 269 (11%) for stage C (symptomatic HF), with different distribution between sexes (<i>P</i><0.001). Multivariable risk-adjusted model for all-cause mortality over a median follow-up of 12 years, found 6%, 12%, 18%, and 27% for stages 0, A, B, and C, respectively, with hazard ratios of 1.82 [95% CI, 1.2-2.7], 2.52 [95% CI, 1.7-3.8], and 4.29 [95% CI, 2.8-6.6], using as reference stage 0.</p><p><strong>Conclusions: </strong>The high prevalence of symptomatic, and preclinical HF in older adults and the increased mortality with disease progression may be responsible for an elevated public health burden. This information is critical for understanding and planning health policies for older adults in middle-income countries.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e038993"},"PeriodicalIF":5.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Racial Residential Segregation and Survival After Out-of-Hospital Cardiac Arrest in the United States.","authors":"Ethan E Abbott, David G Buckler, Aditya C Shekhar, Elizabeth Landry, Benjamin S Abella, Lynne D Richardson, Alexis M Zebrowski","doi":"10.1161/JAHA.124.038940","DOIUrl":"10.1161/JAHA.124.038940","url":null,"abstract":"<p><strong>Background: </strong>Social determinants of health such as residential segregation have been identified as drivers of disparities in health outcomes; however, this has been understudied for out-of-hospital cardiac arrest (OHCA). We sought to examine whether there were differences in survival to discharge and survival with good neurological outcome, as well as likelihood of bystander cardiopulmonary resuscitation, using validated measures of racial, ethnic, and economic segregation.</p><p><strong>Methods: </strong>We conducted a retrospective observational study using data from the Cardiac Arrest Registry to Enhance Survival data set. The primary predictor for this study was the Index of Concentration at the Extremes. The primary outcomes were survival to discharge and survival with good neurological status.</p><p><strong>Results: </strong>During the study period, 626 264 had an out-of-hospital cardiac arrest, and patients had a mean age of 62 years (SD 17.2 years). In multivariable models, we observed an increased likelihood of survival to discharge and survival with good neurological outcome for those patients residing in more highly segregated predominately White population and higher-income census tracts as compared with more highly segregated and lower-income Black and Hispanic/Latinx population census tracts. We found that the magnitude of this disparity was 24% for the outcome of survival to discharge as compared with reference (relative risk,1.24 [95% CI, 1.20-1.28]).</p><p><strong>Conclusions: </strong>This research suggests that areas impacted by residential and economic segregation are important targets for both public policy interventions as well as addressing disparities in care across the chain of survival for out-of-hospital cardiac arrest.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e038940"},"PeriodicalIF":5.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Latest in Resuscitation Research: Highlights From the 2023 American Heart Association's Resuscitation Science Symposium.","authors":"Aarthi Kaviyarasu, Sarah Perman, Rithvik Balakrishnan, Ryan W Morgan, Eugene Yuriditsky, Luke Andrea, Anne V Grossestreuer, Sachin Agarwal, Clark G Owyang, William Reis, Betty Y Yang, Audrey L Blewer, Nicholas J Johnson, Catherine R Counts, Benjamin S Abella, Felipe Teran","doi":"10.1161/JAHA.124.037295","DOIUrl":"https://doi.org/10.1161/JAHA.124.037295","url":null,"abstract":"","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e037295"},"PeriodicalIF":5.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Daily Avocado Intake on Cardiovascular Health Assessed by Life's Essential 8: An Ancillary Study of HAT, a Randomized Controlled Trial.","authors":"Janhavi J Damani, Penny M Kris-Etherton, Alice H Lichtenstein, Nirupa R Matthan, Joan Sabaté, Zhaoping Li, David Reboussin, Kristina S Petersen","doi":"10.1161/JAHA.124.039130","DOIUrl":"https://doi.org/10.1161/JAHA.124.039130","url":null,"abstract":"<p><strong>Background: </strong>The effect of single food-based dietary interventions on the American Heart Association's cardiovascular health score, Life's Essential 8 (LE8), is unclear. The aim of this study was to examine the effect of daily avocado intake for 26 weeks on LE8 in adults with abdominal obesity.</p><p><strong>Methods and results: </strong>An ancillary analysis including participants (n=969; aged 51±14 years) from the HAT (Habitual Diet and Avocado Trial), a randomized controlled trial, was conducted. The Avocado-Supplemented Diet Group was provided with 1 avocado per day, and the Habitual Diet Group was instructed to maintain their usual diet. LE8 component scores (diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure) were calculated using a modified American Heart Association algorithm. The LE8 score was calculated as the unweighted average of each component (range, 0-100 points). Between-group differences in the 26-week change in LE8 were assessed using general linear models. No significant between-group difference in the 26-week change in the LE8 score from baseline was observed (0.79 points [95% CI, -0.41 to 2.00]). However, avocado intake increased the LE8 component scores for diet (3.53 points [95% CI, 1.38-5.68]), sleep health (3.20 points [95% CI, 0.38-6.02]), and blood lipids (3.46 points [95% CI, 1.03-5.90]) compared with the Habitual Diet Group.</p><p><strong>Conclusions: </strong>Intake of 1 avocado per day for 26 weeks did not significantly affect the total cardiovascular health score in US adults with abdominal obesity. However, diet quality, sleep health, and blood lipids improved with daily avocado intake.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT03528031.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e039130"},"PeriodicalIF":5.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of RICAS (Remote Ischemic Preconditioning on Collaterals of Atherosclerosis Stroke): Rationale and Design.","authors":"Zi-Ai Zhao, Yan Lv, Hui-Sheng Chen","doi":"10.1161/JAHA.124.038570","DOIUrl":"https://doi.org/10.1161/JAHA.124.038570","url":null,"abstract":"<p><strong>Background: </strong>As a noninvasive, low-cost, nonpharmacological procedure with excellent properties of safety, remote ischemic conditioning (RIC) has been demonstrated to prevent recurrence of stroke among patients with ischemic stroke of large artery atherosclerosis origin. We hypothesized that the benefit is attributed to the improvement of collaterals by chronic RIC in this population, and we aimed to explore the influence of chronic RIC on collateral status evaluated by digital subtraction angiography in this population.</p><p><strong>Methods: </strong>The RICAS (Remote Ischemic Preconditioning on Collaterals of Atherosclerosis Stroke) study is a prospective, randomized, blind end point, multicenter study. Eligible patients with ischemic stroke of anterior circulation caused by large artery atherosclerosis, poor collateral compensation, and more than 1 month of symptom onset, are randomly assigned into experimental and control groups with a ratio of 1:1. The patients in the experiment group will receive treatment with RIC (bilateral upper limbs, for a total procedure time of 50 minutes, twice daily) for 1 year as an adjunct to guideline-based treatment, while patients in the control group only receive guideline-based treatment. A maximum of 300 patients (150 participants per group) are required to test the superiority hypothesis with 80% power (using a 2-sided <i>α</i>=0.05) to detect a 15% difference. Subgroup analyses for the primary end point will be performed on 8 prespecified subgroups by age, sex, ischemic event (acute ischemic stroke ore transient ischemic stroke), tandem lesion, history of hypertension, hypercholesterolemia, diabetes, and myocardial infarction. The primary outcome is the proportion of collateral status improvement, which is defined as an increase of ≥1 point on the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology score, as assessed by digital subtraction angiography at 12 months after randomization. The safety outcomes include RIC-related adverse events.</p><p><strong>Conclusions: </strong>This study may provide the direct evidence for the potential effect of chronic RIC treatment on the improvement of collateral status.</p><p><strong>Registration: </strong>URL: https://clinicaltrials.gov. Unique identifier: NCT06170944.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e038570"},"PeriodicalIF":5.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}