Journal of Vascular Access最新文献

{"title":"Endovascular management of central venous catheter induced superior vena cava syndrome.","authors":"Brigitte Anderson, Vashisht Madabhushi, Alison Flentje, Javaneh Jabbari, Mirnal Chaudhary, Joel Harding, Khanjan Nagarsheth","doi":"10.1177/11297298241303191","DOIUrl":"10.1177/11297298241303191","url":null,"abstract":"<p><p>This case series describes the endovascular management of three patients with catheter-associated superior vena cava (SVC) syndrome. SVC syndrome can result from malignant (60%) or benign (40%) etiologies. The most common causes of benign SVC syndrome are indwelling central venous catheters (CVCs) with 1%-3% and 0.2%-3.3% of patients being affected. In all cases, a mechanical thrombectomy device was used to evacuate the chronic and acute thrombus, followed by a balloon angioplasty and stenting of the SVC. Anterograde flow and rapid symptom resolution was achieved following the procedure. No peri- or postprocedural complications occurred. These cases demonstrate the feasibility of endovascular management of catheter-associated SVC syndrome.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1760-1765"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787787","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":"Clinical benefit of adding cyanoacrylate glue during PICC line insertion compared to standard procedure in outpatient cancer patients: Results from the randomized prospective trial PICCandGLUE.","authors":"Benjamin Figari, Norvène Driffort, Aymeric De Montfort, Julien Gautier, Laurie Bissuel, Hervé Rosay, David Perol, Grégoire Wallon","doi":"10.1177/11297298251369058","DOIUrl":"https://doi.org/10.1177/11297298251369058","url":null,"abstract":"<p><strong>Background: </strong>Peripherally inserted central catheters (PICCs) can be used to administer a variety of intravenous therapies to cancer patients. PICC insertion can be associated with bleeding at the puncture site requiring additional care and dressing repairs. Several studies suggest that the addition of cyanoacrylate glue (CAG) at PICC insertion reduces the risk of bleeding and the further need for compresses, as well as catheter-related complications.</p><p><strong>Methods: </strong>This monocenter, randomized, controlled, prospective study was conducted in the vascular access unit (VAU) of the French comprehensive cancer center Léon Bérard. The primary objective was to compare the efficacy of PICC insertion with CAG versus without glue in cancer patients requiring central venous access. Success was defined as the absence of compress requirement at the end of the procedure. Secondary objectives included the number of patients needing a change of dressing within 1 h, at day 8 and at day 30, and the incidence of PICC removal and PICC-related complications in the 30 days following insertion.</p><p><strong>Results: </strong>From August 2023 to July 2024, 98 outpatients were randomized (1:1) in the experimental arm (CAG, <i>n</i> = 48) or in the standard arm (without glue, <i>n</i> = 50). Success occurred in 47 (98%) patients in the CAG arm versus 39 (78%) in the standard arm (<i>p</i> = 0.001). Within the first hour 1 (2%) patient in the CAG arm required a change of dressing compared to 23 (46%) in the standard arm (<i>p</i> < 0.001). During the 30-day follow-up period, no significant differences between the two arms in terms of change of dressing or complications were reported.</p><p><strong>Conclusion: </strong>CAG provides an immediate benefit at the end of PICC insertion that lasts for up to 1 h after the end of the procedure. The use of CAG would improve the organization of the catheter placement unit and reduce the need for post-procedure nursing care.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251369058"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980022","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":"Flow-mediated dilation facilitates radial artery cannulation in patients undergoing intravenous general anesthesia: A prospective randomized controlled trial.","authors":"Qian Zhuo, Xintong Zou, Yanya Zheng, Hongbo Wang, Shuyu Hu, Juncheng Xiong, Liangrong Wang","doi":"10.1177/11297298241273615","DOIUrl":"10.1177/11297298241273615","url":null,"abstract":"<p><strong>Background: </strong>Flow-mediated dilation (FMD) is commonly used as a diagnostic tool to assess endothelial function, and compared with other methods for stimulating radial artery dilation, FMD offers several advantages such as non-invasiveness, ease of execution, minimal equipment requirements, and negligible risk. The study aimed to investigate the effect of FMD in facilitating radial arterial cannulation in the context of intravenous general anesthesia.</p><p><strong>Methods: </strong>Eighty patients undergoing intravenous general anesthesia and requiring radial artery cannulation were randomized 1:1 to the FMD group and control group. Patients in the FMD group received an upper arm occlusion for 5 min after anesthesia induction, and the cuff was placed without inflation for the equivalent duration in the control group. The primary outcome was first-attempt success rate. Secondary outcomes were the diameter and percentage of dilation of radial artery, overall success rate, total number of attempts, cannulation time, and occurrence of procedure-related complications.</p><p><strong>Results: </strong>Intravenous anesthetic agents significantly dilated the radial artery (<i>p</i> < 0.05), which was further increased by FMD. An increase in both the first-attempt and overall success rate of radial artery cannulation was demonstrated with the use of FMD (67.5% vs 42.5%, <i>p</i> < 0.05). The total number of attempts needed to cannulate the radial artery was reduced in the FMD group as compared with the control group (<i>p</i> < 0.05), but no differences in cannulation time and procedure-related complications were found between the two groups (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>FMD induced by a 5-min upper arm occlusion may facilitate radial artery cannulation in patients undergoing intravenous general anesthesia.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1547-1555"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047601","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 management of high flow arteriovenous fistula and possible solutions.","authors":"Fabrizio Cristiano, Massimo Lodi","doi":"10.1177/11297298241287946","DOIUrl":"10.1177/11297298241287946","url":null,"abstract":"<p><strong>Background: </strong>The development of a high flow rate arteriovenous fistula (AVF) can expose the patient to development of heart failure due to increased cardiac preload and pulmonary hypertension.</p><p><strong>Objectives: </strong>AVF flow measurement (Qa) is considered a screening tool for AVF surveillance, aiming to evaluate the access dysfunction and prevent complications, like a non-maturation, suspected stenosis, high-flow AVF, and distal ischemia. In the upper arm AVF, a high Qa may develops, which can expose the patient to the risk of high-output heart failure and ischemia. Although, the exact threshold to define high-flow access is not universally accepted, AVF with a Qa of 1-1.5 L/min or cardio-pulmonary recirculation (Qa/CO) >20% are considered at risk.</p><p><strong>Subjects: </strong>In our work we describe the treatment performed in three patients with high flow AVF treated with DRIL technique with interposition of a Prosthetic Patch, revascularization procedures such as distal inflow revision or RUDI and with innovative technique a \"tench snout,\" removal the previous anastomosis and reconstruction of the integrity of the radial artery at the terminal in pre and post anastomosis. A PTFE prosthetic segment measuring 5 cm in length and 5 mm in diameter was interposed, terminally anastomosed with the efferent cephalic vein and terminally lateral with the radial artery, reducing the anastomosis to approximately 4 mm.</p><p><strong>Results: </strong>All treated patients showed a clear improvement in the clinical picture in particularly heart failure. The calculation of the post-intervention flow rate approximately 1500 mL/min.</p><p><strong>Conclusion: </strong>The patient on hemodialysis with arteriovenous fistula must be constantly monitored with clinical examination, monitoring during the hemodialysis session and color Doppler ultrasound of the AVF with calculation of the flow rate. The surgical technique used for flow reduction is chosen on the surgical experience of each operator with the main objective of preserving the autologous AVF.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1748-1753"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513626","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":"Optimizing central venous access devices insertion in thrombocytopenic patients: Balancing efficacy and safety.","authors":"Hossein Farsavian, Mahdi Davoodi, Mohammad Javad Najafi, Mahmoud Manouchehri Amoli, Ahmad Zahmatkesh, Mahmoud Nazarpour","doi":"10.1177/11297298241273612","DOIUrl":"10.1177/11297298241273612","url":null,"abstract":"<p><strong>Introduction: </strong>Recently, the rising incidence of trauma, cancer, and critical illnesses has led to a growing necessity for Central Venous Access Devices (CVADs). Inserting CVADs in thrombocytopenic patients is still challenging. This study tries to shed light on the safety and associated risks of CVADs insertion in this high-risk group, with the ultimate goal of informing clinical practice and aiding in decision-making processes.</p><p><strong>Methods: </strong>This study was conducted as prospective cohort study from September 2020 to September 2023 in Mazandaran University of Medical Sciences, Iran. Individuals aged 18-80 years with a platelet count of less than 50,000/dL included and those designated for subcutaneous port procedures or on anticoagulant and antiplatelet therapy, excluded. Ultrasound-guided CVAD insertion using the Seldinger technique and SIC/FIC strategies performed for participants. Incidence of hemorrhagic complications post-CVAD insertion, requirement for blood product transfusions to amend platelet counts, frequency of non-bleeding complications, and complications related to blood product transfusions monitored.</p><p><strong>Results: </strong>The study comprised 137 participants, 54% of whom were men, with an average age of 46.90 ± 15.70 years. No significant correlation was found between the site of CVAD placement (jugular vs femoral) and the incidence of major or minor bleeding. Femoral catheters were associated with a higher rate of infection. No complications related to transfusion of blood products or mortality seen, indicating that CVAD implantation can be safely performed in patients with thrombocytopenia or coagulation disorders.</p><p><strong>Conclusion: </strong>CVAD insertion in thrombocytopenic patients, even with platelet counts below 10 × 10⁹/L, is safe and associated with minimal complications when performed under ultrasound guidance by experienced surgeons. This finding supports the use of a lower platelet count threshold for CVAD insertion than currently recommended in guidelines, potentially reducing the need for platelet transfusions prior to CVAD placement.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1556-1562"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057419","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":"Collapse of a cephalic arch stent: An atypical complication of hemodialysis vascular access.","authors":"Nídia Marques, Núria Paulo, Joana Ferreira, Armando Mansilha, Luís Coentrão","doi":"10.1177/11297298241281794","DOIUrl":"10.1177/11297298241281794","url":null,"abstract":"<p><p>Access dysfunction is a significant contributor to morbidity in hemodialysis patients. The cephalic arch is a common location of vascular stenosis, with a considerable risk of relapse. While covered stents demonstrated a higher patency rate when compared to percutaneous transluminal angioplasty, their placement has some issues. Stent collapse and guttering are well-documented in arteries but not in arteriovenous fistulas. This report describes an unusual case of a cephalic arch stent collapsing 1 month after its positioning, as evidenced by access dysfunction.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1766-1769"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333101","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":"Comparison of peripheral cannula outcomes, ultrasound-guided placement of deep veins versus blind insertion of superficial veins in children aged 0-18 years: A retrospective study.","authors":"Michela Refosco, Alessandro Mazza, Antuan Divisic, Diana Binotto, Sara Zamberlan, Barbara Schiavon, Beatrice Prodomini","doi":"10.1177/11297298241282369","DOIUrl":"10.1177/11297298241282369","url":null,"abstract":"<p><strong>Background: </strong>The clinical use of ultrasound has increased the chances of successful insertion of all venous access devices, including short peripheral cannulas (SPC) and long peripheral catheters (LPC). The aim of the study was to compare the clinical performance of peripheral cannulas inserted using the traditional \"blind\" technique versus those inserted with ultrasound guidance (US).</p><p><strong>Methods: </strong>In this retrospective study we compared 135 peripheral intravenous cannulations (PIVCs) with ultrasound guidance and 135 PIVCs with blind technique, inserted in children (0-18 years) in the emergency department. All devices were inserted using the catheter-over-needle technique. With the blind technique, superficial arm veins were cannulated using SPCs (1.9 cm, 24G; 2.5 cm, 22G; 3.2 cm, 20G), while with US, deeper non-palpable veins were accessed using SPCs of 3.2 cm, 24G; and LPCs of 6.4 cm, 22G; 6.4 cm, 20G.</p><p><strong>Results: </strong>The accesses were removed electively in 66% of US-PIVCs, with an average duration of the device of 5.3 ± 4.0 days, but only in 30% of Blind-PIVCs, which presented an average duration of 2.5 ± 1.8 days. The longest dwelling time (8.7 ± 5.1 days) was observed in 20G LPCs inserted with US into the basilic vein of the arm; among Blind-PIVCs, the longest duration (3.0 ± 2.1 days) was observed in 22G SPCs inserted into the cephalic vein at the forearm. The most commonly encountered complication in both groups was accidental dislodgment.</p><p><strong>Conclusions: </strong>PIVCs with ultrasound guidance were apparently more effective than the blind ones, reducing the number of successive cannulations. Additionally, LPCs, with their greater length compared to SPCs, have proven to be more durable and may be recommended as emergency venous access in children requiring peripheral access for 4-15 days. Dislodgement should be reduced by improving the securement of the device.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1476-1481"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301888","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":"Effect of virtual reality video application on fistula puncture-associated pain in patients undergoing hemodialysis: Assessor-blinded randomized trial.","authors":"Nese Altınok Ersoy, Gülşah Kesik, Fatih Dede","doi":"10.1177/11297298241295447","DOIUrl":"10.1177/11297298241295447","url":null,"abstract":"<p><strong>Objective: </strong>To elucidate the effect of virtual reality video application on fistula puncture-associated pain in patients undergoing hemodialysis.</p><p><strong>Design: </strong>Attention controlled and assessor-blinded randomized trial.</p><p><strong>Materials and methods: </strong>Attention controlled and assessor-blinded randomized trial was conducted 28 patients at the hemodialysis center of City Hospital. The patients in the intervention group (<i>n</i> = 14) participated in 12 hemodialysis sessions with virtual reality video application under the researcher's supervision. The patients in the control group (<i>n</i> = 14) received a 6-min training session on diet compliance. The Sociodemographic Form and Visual Analog Scale were used to collect data in person at various time points: baseline (t0), during the 1st to 12th hemodialysis sessions (t1-t12), and 1 week after implementation (t13).</p><p><strong>Results: </strong>Virtual reality video application helped in effectively decreasing pain over time, as revealed by significant differences in the measurements at t1-t12 and t13 (<i>p</i> < 0.05). Time-based variations in within-group differences revealed that the median fistula puncture-associated pain values were significantly higher at baseline and t13 measurements in the intervention group (<i>p</i> < 0.05). In contrast, no significant differences were observed in the median fistula puncture-associated pain values in the control group (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>In patients undergoing hemodialysis, the application of virtual reality helps decrease fistula puncture-associated pain values. Advances in technology, particularly virtual reality, may play a vital role in shaping the future of healthcare.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1619-1627"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565426","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":"Radial artery haemostasis after coronary angiography: A scoping review.","authors":"David José Teixeira Rodrigues, César Teixeira, Vitor Parola, Paulo Marques","doi":"10.1177/11297298241290567","DOIUrl":"10.1177/11297298241290567","url":null,"abstract":"<p><strong>Background: </strong>Nursing care in interventional cardiology is vital during perioperative stages, especially with coronary angiography. Radial artery access is now preferred, requiring proper haemostasis to prevent complications. Standardised protocols are needed for effective and economical haemostasis methods. This review aims to map the literature on haemostasis of the radial artery after coronary angiography, an area not previously reviewed.</p><p><strong>Methods: </strong>Following the Joanna Briggs Institute methodology for scoping reviews, two reviewers independently selected studies based on eligibility criteria. Data were extracted using a specially developed tool, with disagreements resolved through discussion or a third reviewer. Data synthesis is presented in tabular form and narrative summary. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews guidelines were followed. Searches were conducted in PubMed, CINAHL Complete, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Scopus, Opengrey, DART-Europe e-theses portal and six key interventional cardiology reference sites.</p><p><strong>Results: </strong>From 43 manuscripts, four haemostasis methods for the radial artery after coronary angiography were identified: manual compression (<i>n</i> = 5), compression bandages (<i>n</i> = 16), compression devices (<i>n</i> = 30) and haemostatic patches (<i>n</i> = 7). Nearly 70% (<i>n</i> = 30) of references focused on compression devices. Nine techniques were used to evaluate haemostasis methods, with visual inspection (34 references) and Doppler ultrasound (17 references) being the most common. Only nine haemostasis methods lacked an associated protocol.</p><p><strong>Conclusion: </strong>This scoping review identifies four primary haemostasis methods post coronary angiography: manual compression, compression bandages, compression devices and haemostatic patches, with compression devices being the most frequently discussed. The variability in evaluation techniques, predominantly visual inspection and ultrasound, underscores the need for standardised guidelines. The absence of protocols for some methods further highlights the necessity for uniform standards to improve consistency and reliability in clinical practice. Standardising these methods and protocols is essential to enhance patient outcomes and advance the field.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1466-1475"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633544","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":"A uremic patient with autogenous arteriovenous fistula developed tension blisters after initial puncture.","authors":"Yingdong Guo, Lili Wang, Liming Liang, Zunsong Wang, Shiyong Qin, Xianglei Kong","doi":"10.1177/11297298241300657","DOIUrl":"10.1177/11297298241300657","url":null,"abstract":"<p><p>Tension blisters usually occur in the presence of local swelling or excessive pressure. Tension blisters after puncture injury are relatively rare in uremic patients who use autogenous arteriovenous fistula (AVF) for hemodialysis treatment. In this report, the patient we reported developed tension blisters after the initial puncture injury. Arterial CTA revealed obvious stenosis of the right subclavian vein and the patient was diagnosed with venothoracic outlet syndrome (VTOS). In this case, the occurrence and development of tension blisters after dialysis puncture injury were observed. Furthermore, the etiology, treatment measures, and methods for preventing the occurrence of tension blisters are illuminated to further improve the quality of vascular access.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1778-1781"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775001","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}