Frontiers in sleep最新文献

{"title":"Chronic insomnia: are patients also suffering from PTSD symptoms?","authors":"Emma Lardant, François Vialatte, Céline Ramdani, Frédéric Chauveau, C. Gauriau, Léna Storms, Marion Trousselard, Damien Léger","doi":"10.3389/frsle.2023.1207232","DOIUrl":"https://doi.org/10.3389/frsle.2023.1207232","url":null,"abstract":"Insomnia is highly prevalent in the general population, and is commonly associated with somatic and psychiatric comorbidities. However, its origins remain poorly-understood. Recently, adverse childhood events (ACE), including traumatic experiences, have been found to be significantly associated with both insomnia and Post-Traumatic Stress Disorders (PTSD). Many patients with PTSD suffer from sleep disorders. However, we know much less about traumatic childhood experiences in patients with insomnia and PTSD.Our exploratory study investigated a cohort of 43 patients (14 males, 29 females) clinically diagnosed with chronic insomnia at a sleep center, and systematically evaluated their condition using the trauma history questionnaire (THQ), and the PTSD checklist (PCL-5).Our results show that 83.72% of insomnia patients reported at least one traumatic event, while the prevalence of PTSD symptoms was 53.49%. For 11.6% of patients, insomnia began in childhood, while for 27.07% it began in adolescence. PCL-5 scores were associated with higher Insomnia Severity Index (ISI) scores, but not trauma. ISI scores were also higher for women, and positive relationships were observed between ISI scores, PCL-5 scores and the number of self-reported traumatic events among women.These exploratory results highlight that the relationship between PTSD symptoms and insomnia could be sex-specific. They also highlight the importance of PTSD symptoms screening for patients diagnosed with chronic insomnia.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89402524","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":"Obstructive sleep apnea phenotypes eligible for pharmacological treatment","authors":"Marie Bruyneel","doi":"10.3389/frsle.2023.1261276","DOIUrl":"https://doi.org/10.3389/frsle.2023.1261276","url":null,"abstract":"Obstructive sleep apnea (OSA) is a common disorder. Its prevalence is increasing worldwide, partially due to increasing rates of obesity, and OSA has a well-documented impact on physical health (increased risk of cardiovascular and metabolic disorders) and mental health, as well as major socioeconomic implications. Although continuous positive airway pressure treatment (CPAP) remains the primary therapeutic intervention for moderate to severe OSA, other treatment strategies such as weight loss, positional therapy, mandibular advancement devices (MAD), surgical treatment, myofunctional therapy of upper airways (UA) muscles and hypoglossal nerve stimulation are increasingly used. Recently, several trials have demonstrated the clinical potential for various pharmacological treatments that aim to improve UA muscle dysfunction, loop gain, or excessive daytime sleepiness. In line with the highly heterogeneous clinical picture of OSA, recent identification of different clinical phenotypes has been documented. Comorbidities, incident cardiovascular risk, and response to CPAP may vary significantly among phenotypes. With this in mind, the purpose of this review is to summarize the data on OSA phenotypes that may respond to pharmacological approaches.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"277 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80071415","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":"Sleep, internalizing symptoms, and health-related quality of life in children with neurodevelopmental disorders: a cross-sectional analysis of cohort data from three research programs in Canada","authors":"P. Mcphee, S. Georgiades, Andrea Andrade, P. Corkum, A. Vaccarino, Heena Cheema, Rachel Chepesiuk, A. Iaboni, J. Gorter","doi":"10.3389/frsle.2023.1224610","DOIUrl":"https://doi.org/10.3389/frsle.2023.1224610","url":null,"abstract":"The objectives of this study were to determine rates of sleep disturbances in children with neurodevelopmental disorders (NDDs) within and across disorders and compared to typically developing (TD) children and to describe differences above and below the clinical cut-off for sleep disturbances. In addition, we explored the associations between demographic variables, severity of disorder, sleep disturbances, internalizing symptoms, and health-related quality of life (HRQOL) in children with NDDs.We conducted cross-sectional data analyses of an existing database with community-dwelling children with NDDs (n = 1438) and TD children (n = 140) aged 4–12 years. Parent-reported measures on sleep disturbances using the Children's Sleep Habits Questionnaire (CSHQ), internalizing symptoms using the Revised Children's Anxiety and Depression Scale, and HRQOL using the KINDL-R were assessed. Hierarchical linear regression examined the associations between demographic variables, severity of disorder, sleep disturbances, internalizing symptoms, and HRQOL in children with NDDs.Children with NDDs (8.5 ± 2.1 years, 69.9% M) had significantly greater total sleep disturbance index (TSDI) than TD children [(8.6 ± 2.3 years, 60.0% M) (mean difference = 6.88 [95% CI 5.37, 8.40]; p < 0.001) (n = 838 NDDs (58.3%); n = 120 TD (86.7%)]. Children with severe NDDs reported significantly greater TSDI above the clinical cut-off (i.e., ≥41; CSHQ) than those with less severe NDDs (p < 0.001). Internalizing symptoms (β = −0.082 [95% CI −0.144, −0.019]; p = 0.011) and TSDI (β = −0.226 [95% CI −0.380, −0.073]; p = 0.004) were significantly associated with HRQOL in children with NDDs.Surveillance and management of sleep and internalizing symptoms are needed to improve HRQOL in children with NDDs. Commonalities in sleep disturbances for children with NDDs support transdiagnostic interventions to treat sleep.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"150 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77393097","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":"Bedtime routines, development, and caregiver educational attainment in toddlerhood","authors":"Joey Lam, A. Williamson, Zainab Salih, Megan Heere, J. Mindell","doi":"10.3389/frsle.2023.1197297","DOIUrl":"https://doi.org/10.3389/frsle.2023.1197297","url":null,"abstract":"Implementing a consistent bedtime routine is an empirically supported intervention to improve sleep in toddlers, but little is known about its association with social-emotional outcomes, and among children living in lower socioeconomic status (SES) contexts.This study examined the longitudinal associations between bedtime routines, social-emotional development, and caregiver educational attainment in toddlers presenting to primary care.Caregivers of 40 toddlers (Mage = 12.85 months, 57.5% female, 62.5% Black/African American) completed questionnaires on sociodemographic factors and child bedtime routine consistency at their 12-month well visit. At the 15- and 24-month well visits, data were collected on child bedtime routine consistency and social-emotional development, including the Brief Infant-Toddler Social and Emotional Assessment (BITSEA) for social-emotional problems and competency and the Ages and Stages Questionnaire (3rd edition; ASQ-3) to assess communication and personal-social skills.Overall, the majority of families engaged in a consistent bedtime routine (≥5 nights/week) at all time points (63% at 12 months, 75% at 15 months, and 86% at 24 months). Controlling for concurrent bedtime routine consistency, toddlers with a more consistent bedtime routine at 12 months exhibited less dysregulation at age 15 months. Toddlers without a consistent bedtime routine at 15 months exhibited more externalizing and internalizing problems and dysregulation at 24 months. Furthermore, there was a significant interaction between bedtime routine consistency at 15 months and caregiver education for internalizing problems at 24 months, such that toddlers of caregivers with a high school education or less who lacked a consistent bedtime routine showed the most internalizing problems.Clinicians should consider recommending that families with toddlers incorporate a nightly bedtime routine not only to improve overall sleep health, but also to potentially optimize toddlers' positive social-emotional and behavioral trajectories, especially in families with lower educational attainment.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90519205","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 role of the WatchPAT device in the diagnosis and management of obstructive sleep apnea","authors":"C. D. Campbell, I. Sulaiman","doi":"10.3389/frsle.2023.1148316","DOIUrl":"https://doi.org/10.3389/frsle.2023.1148316","url":null,"abstract":"Obstructive sleep apnea (OSA) is a common condition affecting an estimated 936 million individuals worldwide, leading to a considerable demand for diagnostic services. Polysomnography, the current gold standard for diagnosis, is resource intensive and inconvenient for patients and healthcare providers. The WatchPAT is an unobtrusive device for home OSA diagnosis. It utilizes peripheral arterial tomography in conjunction with heart rate, oximetry, actingraphy, and respiratory movements for the diagnosis of OSA. It has good correlation with polysomnography for OSA diagnosis and also reports sleep time and sleep staging. The WatchPAT device has reported sensitivities of 81–95%, specificities of 66–100%, positive predictive values of 79–96%, and negative predictive values of 92% for the determination of the apnea–hypopnea index (AHI). It has also been studied and its use validated in a variety of patient populations, including children, older adults, pregnant women, and those with comorbid medical conditions. The device has also been adopted for use in screening for cardiac arrhythmia and central sleep apnea, although neither use has become widespread. With the emergence of telemedicine and an increasing demand for sleep services, the WatchPAT device can be a useful aid in OSA diagnostics.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"2015 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73742439","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":"“Something is wrong!” A qualitative study of racial disparities in parental experiences of OSA detection in their child","authors":"A. Chung, Leone Farquharson, A. Gopalkrishnan, S. Honaker","doi":"10.3389/frsle.2023.1193539","DOIUrl":"https://doi.org/10.3389/frsle.2023.1193539","url":null,"abstract":"Approximately 3% of American children are affected by obstructive sleep apnea (OSA), yet Black children are 2–4 times more likely to experience OSA compared to White children. Little is known about parental experiences in detection, diagnosis, and treatment of OSA in their child, and how these experiences may differ by race. The study objective was to highlight convergent and divergent experiences between and across Black and White parents in the OSA detection process for their child.We conducted 27 semi-structured interviews with mothers whose child was referred for a diagnostic overnight polysomnogram (PSG) to assess for OSA. Parents described how their child was referred for a PSG and their perceptions and feelings throughout the detection process. Data were analyzed using a thematic descriptive approach. Frequency of themes were examined by race. Themes that were unique to one racial group were categorized as divergent, whereas themes described by individuals from both groups were categorized as convergent. Within the convergent themes, we examined the prevalence within each racial group, noting those that were more prevalent (>10% difference in prevalence) in one race or the other.The sample included 19 Black and 8 White mothers, who were 36 years old on average. Qualitative analysis yielded 21 themes across 5 categories that captured divergent and convergent experiences across Black and White mothers during the OSA detection process for their child. Divergent themes that were unique to Black mothers included It Takes a Village—Teacher, Misplaced Blame, Missing the Day/night Connection, Trust in Provider, and the belief that Snoring is Normal. Only one divergent theme among White parents emerged, worries about Dying in Ones Sleep. Additional convergent themes were identified that were more prevalent in one race compared to the other.Black and White mothers experienced different paths to detection and diagnosis for their child's sleep disordered breathing, that are affected by individual awareness, education, patient-provider interactions, and experiences with the healthcare system. Divergent themes such as Misplaced Blame among Black mothers were a potential indication of racism and health disparities.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77166309","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":"Health disparities in the detection and prevalence of pediatric obstructive sleep apnea","authors":"Maureen E. McQuillan, Ian C. Jones, Haneen F. Abu Mayyaleh, Shajna Khan, S. Honaker","doi":"10.3389/frsle.2023.1225808","DOIUrl":"https://doi.org/10.3389/frsle.2023.1225808","url":null,"abstract":"Pediatric Obstructive Sleep Apnea (OSA) is associated with negative health outcomes, behavior problems, and poor academic performance when left untreated. Prior research has shown that children from racial and ethnic minority backgrounds and those living in lower socioeconomic status (SES) homes or neighborhoods have higher prevalence of OSA but lower likelihood of receiving evidence-based care for OSA. Disparities in pediatric OSA detection (e.g., timely assessment and diagnosis) likely contribute to this observed inequity in receiving treatment. A polysomnogram (PSG) is the gold standard for diagnosing OSA but completing PSG can be challenging. Study aims were to examine racial, ethnic, and SES differences in (1) OSA prevalence and severity and (2) OSA detection, specifically PSG completion rates, timing since referral, and age of diagnosis.Children (aged 1–18, N = 1,860, 56% male) were referred for PSG during a 6-month period. Participants' racial/ethnic background were as follows: 64.8% White non-Hispanic, 23.5% Black non-Hispanic, 9.4% White Hispanic, and 2.4% other. Children predominantly had Medicaid insurance (64.5%). SES was measured by insurance type and neighborhood SES using the Distressed Communities Index (DCI) for each participant's zip code (Economic Innovations Group; https://eig.org/dc). Covariates included child age and sex, BMI, premature birth status, and smoke exposure in the home.We replicated previous research by showing that children from minority racial/ethnic backgrounds and lower SES backgrounds had higher prevalence rates of OSA and worse disease severity. Across racial, ethnic, and socioeconomic backgrounds, only 31.6% of the children referred successfully completed PSG. Insurance coverage (Medicaid or private vs. self-pay), was an important factor in predicting earlier timing and better completion rates of PSG, which is essential for successful diagnosis and treatment of pediatric OSA.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78492827","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 impact of bariatric surgery on breathing-related polysomnography parameters—Updated systematic review and meta-analysis","authors":"S. Mashaqi, Anas Rihawi, P. Rangan, K. Ho, Mateen Khokhar, Sonia Helmick, Y. Ashouri, D. Combs, Iman Ghaderi, S. Parthasarathy","doi":"10.3389/frsle.2023.1212936","DOIUrl":"https://doi.org/10.3389/frsle.2023.1212936","url":null,"abstract":"We conducted this systematic review and meta-analysis (SRMA) to evaluate the impact of bariatric surgery on obstructive sleep apnea (OSA) as represented by the following polysomnography (PSG) parameters: apnea-hypopnea index (AHI), oxygen desaturation index (ODI), mean oxygen desaturation (mean SpO2), total sleep time spent with SpO2 < 90% (T-90), and the nadir of oxygen saturation (L SpO2).A comprehensive search of the literature was conducted in Ovid MEDLINE, Embase, and Scopus databases from inception to March 31, 2023. Only articles written in English were reviewed. The analysis of all outcomes was performed using a random-effects model. We included 30 studies (two randomized controlled trials and 28 observational studies) in the final quantitative synthesis with a total of 1,369 patients.We concluded that bariatric surgery (regardless of the type) was associated with reduction in AHI [MD 23.2 events/h (95%CI 19.7, 26.8)], ODI [MD 26.8 events/h (95%CI 21.6, 32.1)], mean SpO2 [MD−1.94% (95%CI −2.5, −1.4)], T-90 [MD 7.5min (95%CI 5.0, 10.0)], and L SpO2 [MD 9.0% (95%CI −11.8, −6.3)].Our SRMA results are updates to previously published results and continue to support the positive impact of bariatric surgery on OSA and sleep-related hypoxia.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81041366","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":"Sleep and happiness: socio-economic, population and cultural correlates of sleep duration and subjective well-being in 52 countries","authors":"T. Lajunen, E. Gaygısız, Wen Wang","doi":"10.3389/frsle.2023.1118384","DOIUrl":"https://doi.org/10.3389/frsle.2023.1118384","url":null,"abstract":"Getting enough sleep is one of the essential lifestyle factors influencing health and well-being. However, there are considerable differences between countries in how much people sleep on average. The present study investigated how socio-economic factors, population variables, and cultural value dimensions are related to sleep duration in a sample of 52 countries.The study design was ecological, i.e., the aggregate values for each country were obtained, and their correlations to national average sleep duration were analysed. The sleep duration estimates were based on Sleep Cycle Application (Sleep Cycle AB, Gothenburg, Sweden) data. The socio-economic variables included the economic health of a country (GDP per capita), how well a country is governed (governance quality measured with WGI), and the economic inequality (the gap between rich and poor measured with the Gini index) within a nation. The population variables included the urbanisation rate (proportion of people living in urbanised areas), life expectancy at birth, mean years of schooling among the population aged 25 years and older, median age of the population, and the prevalence of obesity (% of adults with BMI ≥ 30). The cultural value dimensions were measured with Hofstede's cultural value dimensions (power distance, individualism, masculinity, uncertainty avoidance, long-term orientation, and indulgence). The data were analysed by using zero-order correlations, partial correlations, and canonical correlation analyses.Results showed a relatively strong intercorrelation between the national average of sleep duration and national happiness, i.e., subjective well-being. Among the socio-economic variables, WGI had the strongest relationship to sleep, whereas among population variables, schooling and obesity had the strongest correlations with sleep. Zero-order correlations between sleep and power distance and individualism were statistically significant, whereas in the partial correlations, individualism and masculinity appeared as important factors. Canonical correlation analysis showed strong correlations between the well-being variables (sleep and happiness) and the socio-economic variables, well-being variables and population variables, and cultural values and well-being variables.The present study is an opening for a new line of research in which sleep is seen as an essential part of societal life and collective well-being.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"97 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72544886","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":"Exercise and autism: exploring caregiver insights on exercise participation and sleep patterns in autistic children in Aotearoa New Zealand","authors":"Olivia Bruce, Sayedeh Fatemeh Sajjadi, B. Galland, J. Gross, G. Dainty","doi":"10.3389/frsle.2023.1132935","DOIUrl":"https://doi.org/10.3389/frsle.2023.1132935","url":null,"abstract":"Autistic children experience sleep disturbances at a higher rate than do neurotypical children. It has been argued that sleep disturbances negatively impact behavior, exacerbate learning difficulties, and decrease the quality of life among autistic children. Increasing exercise has been proposed to address sleep disturbances, however, little is known about how exercise might best be promoted for autistic children in Aotearoa New Zealand. Here, we explored caregivers' lived experiences of their autistic child's sleep disturbances and participation in exercise.Semi-structured interviews were conducted with 15 mothers of autistic children aged between 5 and 10. Mothers also completed the Sleep Disturbances Scale for Children (SDSC).Scores on the SDSC indicated that there was considerable variation in sleep disturbance severity. Eight themes were identified from the interviews: sleep disturbances, the impact of exercise on sleep, exercise activities, whānau involvement in exercise, barriers for participation in exercise, support for participation in exercise, sensory considerations for participation in exercise, and activities specifically for children with special needs.Our findings highlight how challenging sleep disturbances can be for autistic children and their families and how participation in exercise can be promoted to potentially minimize their negative impact.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":"177 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85435947","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}