JACC. Asia最新文献

{"title":"Impact of Nonadherence to Any Antiplatelet Therapy After PCI With Drug-Eluting Stents on Critical Outcomes","authors":"Yuichiro Mori MD, MPH ,&nbsp;Tim Friede PhD ,&nbsp;Satoshi Hattori PhD ,&nbsp;Kyohei Yamaji MD, PhD ,&nbsp;Shingo Fukuma MD, PhD","doi":"10.1016/j.jacasi.2025.03.008","DOIUrl":"10.1016/j.jacasi.2025.03.008","url":null,"abstract":"<div><h3>Background</h3><div>Lifelong antiplatelet therapy after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is strongly recommended. However, the extent and temporal variation in the risk of nonadherence to this recommendation remain unclear.</div></div><div><h3>Objectives</h3><div>The aim of this study was to investigate how nonadherence to any antiplatelet therapy after PCI affects critical cardiac events and whether this effect varies over time.</div></div><div><h3>Methods</h3><div>This cohort study analyzed Japanese nationwide insurance claims and health checkup records of working-age patients who underwent PCI with DES between April 2016 and March 2022. Nonadherence was defined as prescription coverage of antiplatelet therapy &lt;50% within preceding 90 days. Landmark-time survival analysis with propensity-score matching was conducted every 5 days from 90th to 1,095th days after PCI. The primary outcome was a composite of all-cause death, myocardial infarction, or cardiopulmonary arrest. Results were synthesized to assess temporal variation in the risk magnitude.</div></div><div><h3>Results</h3><div>Among 40,902 patients (mean age, 58.3 ± 8.3 years; 5.5% women [2,240 of 40,902], median [IQR] follow-up: 653 days [Q1-Q3: 235-1,233 days]), nonadherence was observed in 1.18% (421 of 35,582) at 90 days and 4.70% (579 of 12,312) at 1,095 days after PCI. Critical cardiac events were more frequent in nonadherent patients (HR: 2.50 [95% CI: 1.92-3.26]; <em>P</em> &lt; 0.001), with no significant temporal variation across landmark times.</div></div><div><h3>Conclusions</h3><div>Nonadherence to any antiplatelet therapy after PCI was associated with a more than 2-fold increase in critical cardiac events, irrespective of post-PCI timing throughout 3 years. These findings emphasize the need for sustained efforts by health care providers and patients to maintain drug adherence over a prolonged period.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 6","pages":"Pages 758-768"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060351","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":"Current Practice of Guideline-Directed Medical Therapy After Acute Heart Failure Hospitalization","authors":"Koshiro Kanaoka MD, PhD ,&nbsp;Yoshitaka Iwanaga MD, PhD ,&nbsp;Koki Takegawa MD ,&nbsp;Wataru Fujimoto MD, PhD ,&nbsp;Yuichi Nishioka MD, PhD ,&nbsp;Tomoya Myojin MD ,&nbsp;Katsuki Okada MD, PhD ,&nbsp;Tatsuya Noda MD, PhD ,&nbsp;Tomoaki Imamura MD, PhD ,&nbsp;Yoshihiro Miyamoto MD, PhD","doi":"10.1016/j.jacasi.2025.01.015","DOIUrl":"10.1016/j.jacasi.2025.01.015","url":null,"abstract":"<div><h3>Background</h3><div>Few studies have provided nationwide, longitudinal data on practice patterns of guideline-directed medical therapy (GDMT) for heart failure.</div></div><div><h3>Objectives</h3><div>The authors aimed to clarify the doses and patterns of up-titration or discontinuation of GDMT following admission for acute heart failure and to determinants associated with its continuation in Japan.</div></div><div><h3>Methods</h3><div>We retrospectively included data, from the Japanese nationwide health insurance claims database, of patients hospitalized for acute heart failure without a recent history of hospitalization. Patients initiated on GDMTs during hospitalization were followed up for 12 months. We analyzed patient baseline characteristics associated with continuation 12 months after discharge by using a logistic regression model.</div></div><div><h3>Results</h3><div>Of 791,917 included patients, 405,605 (51.2%) were initiated on ≥1 GDMTs during the index hospitalization. These therapies were frequently discontinued within 3 months of discharge. The proportions of patients for whom the target dose was achieved at 12 months were 10.5%, 7.6%, 8.3%, 23.1%, 7.4%, and 60.2% for beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, angiotensin receptor-neprilysin inhibitor, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter 2 inhibitors, respectively. Beta-blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitor were more likely to be discontinued for older patients with anemia and dementia, whereas mineralocorticoid receptor antagonists were more likely to be discontinued for patients with chronic kidney disease, compared with other GDMT categories.</div></div><div><h3>Conclusions</h3><div>Initiation and up-titration of GDMTs were insufficient in nationwide clinical practice. Our results may help clinicians improve titration of GDMTs.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 6","pages":"Pages 786-795"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203385","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":"Guideline-Directed Medical Therapy in Heart Failure","authors":"Meixiang Xiang MD, PhD","doi":"10.1016/j.jacasi.2025.03.004","DOIUrl":"10.1016/j.jacasi.2025.03.004","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 6","pages":"Pages 796-798"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052557","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":"Epidemiology of Valvular Heart Disease in Asia Pacific Region","authors":"Kent Chak-yu So MBChB ,&nbsp;Jonathan Yap MD ,&nbsp;Guang-yuan Song MD ,&nbsp;Karl Poon MBBS ,&nbsp;Shih-Hsien Sung MD ,&nbsp;Mann Chandavimol MD ,&nbsp;Kentaro Hayashida MD ,&nbsp;Duk-Woo Park MD ,&nbsp;See-Hooi Ewe MD ,&nbsp;Mi Chen MD ,&nbsp;Vyanne Hei-tung Chan MBBS ,&nbsp;Juri Iwata MD ,&nbsp;Tarinee Tangcharoen MD ,&nbsp;Paul Tern MD ,&nbsp;Han-Su Park MD ,&nbsp;Mirvat Alasnag MD ,&nbsp;Yohei Ohno MD ,&nbsp;Jimmy Kim Fatt Hon MD ,&nbsp;Rohan Bhagwandeen MD ,&nbsp;Minoru Tabata MD, PhD, MPH ,&nbsp;Yat-yin Lam MD","doi":"10.1016/j.jacasi.2025.03.011","DOIUrl":"10.1016/j.jacasi.2025.03.011","url":null,"abstract":"<div><div>Valvular heart disease poses a significant health burden in the Asia-Pacific region, with its epidemiology varying widely across countries caused by diverse socioeconomic and health care situations. Rheumatic heart disease remains prevalent, especially in low- to middle-income areas, while degenerative valvular diseases are emerging in developed regions caused by an aging population. Significant disparities in access to health care and intervention result in variable clinical outcomes. In the past decade, transcatheter interventions have revolutionized the management of patients with valvular heart disease globally. In the Asia-Pacific region, the uptake and development of transcatheter valvular interventions has been slow until recent years. Continued collaboration across the Asia-Pacific region is essential to mitigate the impact of the upcoming surge of valvular heart disease in this diverse and rapidly changing area.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 6","pages":"Pages 718-743"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112590","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":"Regional Heterogeneity in the Risk of Thrombosis and Bleeding in Patients With Peripheral Artery Disease","authors":"Shinya Goto MD, PhD ,&nbsp;Daisuke Yamasawa MD, PhD ,&nbsp;Shinichi Goto MD, PhD","doi":"10.1016/j.jacasi.2025.03.007","DOIUrl":"10.1016/j.jacasi.2025.03.007","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 6","pages":"Pages 755-757"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112600","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":"Safety and Efficacy of Half-Half Inflation Strategy in Pulmonary Artery Stenosis Caused by Fibrosing Mediastinitis","authors":"Hongling Su MD ,&nbsp;Yaling Chen MD ,&nbsp;Aqian Wang MD ,&nbsp;Kaiyu Jiang MD ,&nbsp;Yating Zhao MD ,&nbsp;Mengfei Jia MD ,&nbsp;Bo Li MD ,&nbsp;Xuechun Sun MD ,&nbsp;Wenjie Dong MD ,&nbsp;Yunshan Cao PhD, MD","doi":"10.1016/j.jacasi.2025.03.005","DOIUrl":"10.1016/j.jacasi.2025.03.005","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 6","pages":"Pages 817-819"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060580","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":"Frailty Assessment Tools Influence the Outcome Associations Among Patients With Diabetes","authors":"Jui Wang PhD ,&nbsp;Szu-Ying Lee MD ,&nbsp;Chia-Ter Chao MD, PhD ,&nbsp;Jenq-Wen Huang MD, PhD ,&nbsp;Kuo-Liong Chien MD, PhD","doi":"10.1016/j.jacasi.2025.02.014","DOIUrl":"10.1016/j.jacasi.2025.02.014","url":null,"abstract":"<div><h3>Background</h3><div>Frailty, characterized by aging-associated physiological reserve decline, leads to functional loss and adverse outcomes. Patients with diabetes mellitus (DM) have a high frailty risk. However, whether frailty assessment results derived from different tools diverge regarding their outcome correlations remains unclear.</div></div><div><h3>Objectives</h3><div>The authors analyzed associations between different frailty assessment results and DM patients’ outcomes</div></div><div><h3>Methods</h3><div>Between 2008 and 2016, adults (age &gt;40 years) with type 2 DM were identified from the National Taiwan University Hospital Integrated Medical Database. The frailty assessment was performed using modified FRAIL scale and frailty index. Cox proportional hazard and Poisson regression analyses were used to determine the relationship between frailty and multiple outcomes after multivariate adjustment.</div></div><div><h3>Results</h3><div>In total, 30,012 patients (mean 64.1 years, 45.4% women) with type 2 DM were included. The 2 frailty assessments were moderately positively correlated (r = 0.49; 95% CI: 0.48-0.49). After a median of 7.1 years (Q1-Q3: 3.9-10.4 years) of follow-up, FRAIL-identified mild and moderate-to-severe frailty did not correlate with a high mortality probability, but frailty index–identified severe and moderate frailty did. However, FRAIL-identified moderate-to-severe frailty correlated with a higher probability of all-cause hospitalization (incidence rate ratio [IRR]: 1.2; 95% CI: 1.09-1.32), intensive care unit admission (IRR: 4.19; 95% CI: 1.69-10.38), and cardiovascular hospitalization (IRR: 1.46; 95% CI: 1.28-1.66), whereas frailty index–identified mild, moderate, and severe frailty increased the probability of all-cause and cardiovascular hospitalizations only.</div></div><div><h3>Conclusions</h3><div>We observed major discrepancies in outcome associations between FRAIL scale and frailty index among DM patients. Carefully selecting tools for measuring DM-associated frailty is important.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 6","pages":"Pages 799-810"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065256","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":"Developing an ML-Based Pretest Probability Model of Obstructive CAD in Patients With Stable Chest Pain.","authors":"Guanhua Dou, Jia Zhou, Ziqiang Guo, Dongkai Shan, Xi Wang, Tao Li, Xinghua Zhang, Lei Xu, Mei Zhang, Xudong Lv, Junjie Yang, Yundai Chen","doi":"10.1016/j.jacasi.2025.03.015","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.03.015","url":null,"abstract":"<p><strong>Background: </strong>Updated pretest probability models (ESC2019, the PTP model supported by the European Society of Cardiology after a pooled analysis; and RF-CL, the risk factor-weighted model) are recommended for initial evaluation of patients with stable chest pain before coronary computed tomography angiography to reduce unnecessary examination by recent guidelines. However, the reliability of those pretest probability models has not been fully investigated, especially in Chinese population.</p><p><strong>Objectives: </strong>This study aims to build a machine learning-based pretest probability model in patients with stable chest pain and compare it with ESC2019 and RF-CL model in a Chinese population.</p><p><strong>Methods: </strong>This is an analysis of the Chinese registry in China, with a large scale, foresight, and a multicenter cohort. Obstructive coronary artery disease refers to at least 1 lesion ≥70% diameter stenosis in main branches or ≥50% left main stenosis by coronary computed tomography angiography. A pretest probability model, the C-STRAT (Chinese Registry in Early Detection and Risk Stratification of Coronary Plaques) score, was conducted by an ensemble machine learning algorithm in training data set and compared with other pretest probability models.</p><p><strong>Results: </strong>In the testing data set, the C-STRAT score gave the best performance in discrimination evaluation (AUC: 0.769; 95% CI: 0.753-0.784). It also performed well in calibration evaluation. The integrated discrimination improvement and net reclassification improvement of the C-STRAT score were positive compared with other pretest probability models.</p><p><strong>Conclusions: </strong>A high-performance pretest probability model derived from machine learning algorithm was developed based on a multicenter Chinese population and expected to facilitate the decision making for downstream tests. (Chinese Database of National Coronary Plaques Registry; ChiCTR1800015864).</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268042","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":"Prevalence and Mortality of Cardiovascular-Kidney-Metabolic Syndrome in China: A Nationwide Population-Based Study.","authors":"Congyi Zheng, Anping Cai, Muyi Sun, Xin Wang, Qingjie Song, Xuyan Pei, Xue Cao, Yixin Tian, Gregory Y H Lip, Gianfranco Parati, Zengwu Wang, Yingqing Feng, Zhen Zhou","doi":"10.1016/j.jacasi.2025.04.007","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.04.007","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular-kidney-metabolic (CKM) syndrome is a novel staging framework used to evaluate CKM health. The burden of CKM syndrome in China is relatively unknown, and such data may inform future health priority.</p><p><strong>Objectives: </strong>The purpose of this study was to assess the prevalence and mortality risk across CKM stages.</p><p><strong>Methods: </strong>Nationally representative populations (n = 33,685) were included from the China Hypertension Survey. The weighted prevalence of each CKM stage was calculated. All-cause, cardiovascular (CV), and non-CV death associated with CKM stages were analyzed using Cox regression analysis. Population attributable fraction (PAF) was calculated to estimate the mortality burden related to each CKM stage.</p><p><strong>Results: </strong>Between 2012 and 2015, 18.8% of Chinese adults met criteria for stage 0, 15.5% for stage 1, 42.1% for stage 2, 14.7% for stage 3, and 8.9% for stage 4, with advanced stage (stages 3-4) was 23.6%. After 5-year follow-up, compared with stage 0, adjusted HR for all-cause death in stage 1 was 0.77 (95% CI: 0.51-1.15), stage 2 was 1.36 (95% CI: 1.04-1.77), stage 3 was 2.47 (95% CI: 1.91-3.19), and stage 4 was 4.00 (95% CI: 3.07-5.22). Similarly, adjusted HRs for CV death and non-CV death progressively increased from stage 2 to 4 (both P-trend values < 0.001). For all-cause, CV, and non-CV death, PAFs increased with advancing CKM stages. For instance, for all-cause death, PAFs caused by stages 2, 3, and 4 were 13.4%, 18.6%, and 22.0%.</p><p><strong>Conclusions: </strong>Poor CKM health is widespread in China, underscoring the urgent need for collaborative and comprehensive management strategies to tackle CKM syndrome epidemic.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267971","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":"Interpretable Independent Recurrent Networks for Forecasting Stroke in Atrial Fibrillation.","authors":"Jung-Chi Hsu, Yi-Hsien Hsieh, Yen-Yun Yang, Shu-Lin Chuang, Che Lin, Lian-Yu Lin","doi":"10.1016/j.jacasi.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.04.003","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a major risk factor for transient ischemic attack (TIA)/ischemic stroke (IS).</p><p><strong>Objectives: </strong>Given the dynamic nature of IS risk, this study aimed to predict IS risk in AF patients using a high-dimensional time-series model.</p><p><strong>Methods: </strong>We conducted a cohort study at the National Taiwan University Hospital from 2014 to 2019, including 7,710 AF patients, with external validation in 6,822 patients from the National Taiwan University Hospital Yunlin Branch. The Forecasting Strokes via Interpretable Independent Networks (ForeSIIN) model, based on gated recurrent units, was proposed. Kaplan-Meier analysis with log-rank test evaluated risk group differences.</p><p><strong>Results: </strong>The annual TIA/IS incidence rate ranged from 181.96 (95% CI: 164.42-200.93) to 15.81 (95% CI: 12.38-20.18) per 1,000 person-years, with an overall incidence of 42.40 (95% CI: 39.60-45.39). The ForeSIIN model achieved the best prediction with an area under the receiver-operating characteristics curve of 0.764 (95% CI: 0.722-0.810), compared with the CHA₂DS₂-VASc score (AUC: 0.650; 95% CI: 0.596-0.699) and other nonsequential models: extreme gradient boosting AUC: 0.722 (95% CI: 0.676-0.769), support vector machine AUC 0.691 (95% CI: 0.637-0.741), random forest AUC: 0.689 (95% CI: 0.637-0.742). External validation showed area under the receiver-operating characteristics curve of 0.646 (95% CI: 0.618-0.671) and area under the precision-recall curve of 0.222 (95% CI: 0.184-0.259). Feature impact analysis identified the top 5 factors: history of TIA/IS, estimated glomerular filtration rate, C-reactive protein, hematocrit, and plasma fasting glucose. Kaplan-Meier analysis showed significant risk differences between ForeSIIN groups (log-rank P < 0.001).</p><p><strong>Conclusions: </strong>The innovative ForeSIIN model demonstrated accurate stroke prediction in AF patients and enhanced the interpretation of dynamic risk factors over time.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268043","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}