BMC Emergency Medicine最新文献

{"title":"Optimizing CPR performance: the role of body composition and ergonomic positioning.","authors":"Tayfun Aygun, Olcay Karaoglu, Hakan Senturk, Arif Keskin, Nurullah Yucel, Gulam Hekimoglu","doi":"10.1186/s12873-025-01348-z","DOIUrl":"10.1186/s12873-025-01348-z","url":null,"abstract":"<p><strong>Background: </strong>Quality cardiopulmonary resuscitation (CPR) is associated with improved survival rates in prehospital arrest cases. Although CPR guidelines emphasize compression depth, rate, and recoil, individual anatomical and biomechanical factors influencing CPR performance remain underexplored. This study aims to determine the optimal CPR position by focusing on individual positional conditions and anthropometric data to improve CPR effectiveness and guide team member selection in emergency scenarios.</p><p><strong>Methods: </strong>A cross-sectional study involving 123 paramedic associate degree students was conducted. Anthropometric measurements including upper extremity length, biceps circumference, and femur length were obtained. CPR performance was assessed using a feedback-capable mannequin, with data collected on compression depth, frequency, rhythm quality, and compression/decompression ratios. Positional parameters such as knee and hip angles, distance between knees, and distance from the mannequin were recorded and analyzed in relation to CPR outcomes.</p><p><strong>Results: </strong>Male participants demonstrated significantly higher CPR quality scores than females (65.09 ± 28.26 vs. 48.85 ± 27.11, p = 0.004). Positive correlations were found between BMI (r = 0.239, p = 0.008), upper extremity length (r = 0.364, p < 0.001), biceps circumference (r = 0.350, p < 0.001), and CPR quality metrics. A moderate inter-knee position (shoulder-width distance) provided superior compression depth and rhythm stability compared to narrow or wide positions (p < 0.001).</p><p><strong>Conclusion: </strong>Anthropometric and positional factors significantly influence CPR performance. Emergency team members with appropriate physical profiles (e.g., greater muscle mass, limb length, BMI) and adopting occupational ergonomic factors (e.g., moderate knee range, limited joint flexion) may improve CPR quality in the prehospital setting.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"187"},"PeriodicalIF":2.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147701","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":"Impact of emergency fast track on treatment time and outcomes in acute stroke: a systematic review and meta-analysis.","authors":"Ying Shen, Yuying Lao, Xiening Xu","doi":"10.1186/s12873-025-01336-3","DOIUrl":"10.1186/s12873-025-01336-3","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate the effectiveness of emergency fast track in improving the efficiency of acute stroke management and enhancing clinical outcomes, thereby providing evidence-based support for optimizing emergency care workflows.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in CNKI, Wanfang Data, VIP Database, PubMed, Embase, Web of Science, and the Cochrane Library to identify studies on the application of emergency fast track in acute stroke. Data synthesis was performed using Review Manager 5.4 software. The primary measures included pre-hospital waiting time, time from hospital admission to diagnosis, time from diagnosis to treatment, length of stay in the emergency fast track, rescue success rate, and patient satisfaction rate. Sensitivity analysis was used to assess the robustness of the results, and publication bias was evaluated using Begg's and Egger's tests.</p><p><strong>Results: </strong>A total of 30 studies were included. The meta-analysis indicated that emergency fast track significantly reduced pre-hospital waiting time (MD = - 4.65, 95% CI: - 5.76 to - 3.53), time from hospital admission to diagnosis (MD = - 8.13, 95% CI: - 9.32 to - 6.93), time from diagnosis to treatment (MD = - 10.95, 95% CI: - 12.32 to - 9.59), and emergency fast track duration (MD = - 7.47, 95% CI: - 9.30 to - 5.64), while significantly increasing the rescue success rate (OR = 5.71, 95% CI: 4.48 to 7.27). Most outcomes showed no significant publication bias, and sensitivity analyses confirmed the stability of the results.</p><p><strong>Conclusion: </strong>The emergency fast-track protocol significantly reduces critical timeframes in acute/critical care pathways, including: pre-hospital delay, door-to-imaging time, imaging-to-treatment interval, and fast-track dwell time. Concurrently, it enhances the rescue success rate (proportion of successfully stabilized patients). These demonstrated clinical benefits support its widespread implementation in stroke emergency systems. Further validation through multicenter high-quality trials is recommended to establish efficacy generalizability.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"186"},"PeriodicalIF":2.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136272","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":"Association between endotracheal intubation and outcomes of nonshockable out-of-hospital cardiac arrest in Japan.","authors":"Mai Nakai-Uchida, Masato Uchida, Shinobu Tamura, Atsushi Kubo, Kosei Kunitatsu, Tsuyoshi Nakashima, Ryosuke Horitani, Yoshinori Kajimoto, Shigeaki Inoue, Masaya Hironishi","doi":"10.1186/s12873-025-01341-6","DOIUrl":"10.1186/s12873-025-01341-6","url":null,"abstract":"<p><strong>Background: </strong>Patients with nonshockable out-of-hospital cardiac arrest (OHCA) have poor outcomes compared with those with shockable rhythm. The optimal strategy for advanced airway management (AAM) for these patients remains controversial. This study aimed to compare outcomes between prehospital endotracheal intubation (ETI) and supraglottic airway (SGA) for adults with witnessed and nonshockable OHCA.</p><p><strong>Methods: </strong>We compared the outcomes according to airway management using a nationwide, population-based Japanese registry (All-Japan Utstein Registry) between 2005 and 2021. The study population included adults with witnessed, nontraumatic, nonshockable OHCA who received prehospital AAM by emergency medical service (EMS) personnel. The outcomes were return of spontaneous circulation (ROSC), 1-month overall survival, and 1-month survival with a favorable neurological outcome, defined as a Cerebral Performance Category score of 1 or 2. To adjust for confounding factors between the ETI and SGA groups, we used propensity score analysis with inverse probability of treatment weighting (IPTW) and performed a sensitivity analysis using overlap weighting.</p><p><strong>Results: </strong>A total of 147,088 patients were included: 30,797 (20.9%) received ETI and 116,291 (79.1%) received SGA. After IPTW adjustment, patients receiving ETI had significantly higher rates of ROSC (19.3% vs. 11.1%; odds ratio [OR] 1.51; 95% confidence interval [CI] 1.48-1.54), 1-month survival (6.4% vs. 4.5%, OR 1.44; 95%CI 1.40-1.49), and 1-month survival with favorable neurological outcomes (1.0% vs. 1.0%, OR 1.11; 95%CI 1.04-1.20) than those receiving SGA. The sensitivity analysis confirmed robust associations for ROSC (OR 1.53; 95%CI 1.45-1.61) and 1-month survival (OR 1.48; 95%CI 1.36-1.60), but the association with favorable neurological outcome was not statistically significant (OR 1.11; 95%CI 0.93-1.34).</p><p><strong>Conclusion: </strong>In this Japanese nationwide Utstein registry cohort study with IPTW adjustment, for adult witnessed OHCA patients with initial nonshockable rhythm, prehospital ETI was associated with significantly higher rates of ROSC and 1-month survival, compared to prehospital SGA. These findings suggest that ETI, when performed by EMS personnel, has the potential to improve outcomes in these patients with OHCA.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"185"},"PeriodicalIF":2.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136208","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":"Comparison of dispatching after motor vehicle accidents - effects of the TPS-eCall system on dispatching time.","authors":"Bastian Brune, Fabian Haut, Maximilian Wolf, André Nohl, Frank Herbstreit, Christian Waydhas, Marcel Dudda, Lars Becker","doi":"10.1186/s12873-025-01361-2","DOIUrl":"10.1186/s12873-025-01361-2","url":null,"abstract":"<p><strong>Background/objectives: </strong>Over the past 50 years, the concept of the golden hour of shock was established as one of the central tenets of emergency trauma medicine. A shorter duration of prehospital care correlates with a positive change in outcome in numerous studies. Dispatching by the public safety answering points has hardly been discussed to date. Thanks to improved vehicle safety, additional accident data is now available to the emergency call centers.</p><p><strong>Methods: </strong>We investigated the effects of third-party system emergency calls (TPS-eCalls), which have become mandatory in new passenger cars in the EU in 2018, on dispatching in the emergency medical services (EMS). For this purpose, we linked the data of a public-safety answering point (PSAP) and an EMS. All emergency service deployments from 01/01/2023 to 31/12/2023 were evaluated. N = 1546 rescue missions were dispatched after motor vehicle accidents (MVA), 111 after TPS-eCall-alerts, 1435 after conventional alerts.</p><p><strong>Results: </strong>Dispatching in the PSAP currently took longer after TPS-eCall alerts than conventional alerts (01:39 ± 01:40 min vs. 02:41 ± 02:01 min, p ≤ 0.001). The differences were only significant in the case of accidents involving ≤ 2 passengers.</p><p><strong>Conclusions: </strong>TPS-eCall data will be available increasingly. The future expansion data availability offers the opportunity to include objective accident data (airbag deployment, number of occupants, change of velocity) in the dispatching process. Adequate technical connection can improve dispatching and shorten preclinical treatment, especially for complex events with more than 2 passengers.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"184"},"PeriodicalIF":2.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129814","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":"Balancing care needs - a qualitative study on prehospital emergency nurses' experiences of providing self-care advice and home referrals for frail older patients.","authors":"Gabriella Norberg Boysen, Elin Svensson, Caroline Heldtander, Johan Herlitz, Agnes Olander","doi":"10.1186/s12873-025-01355-0","DOIUrl":"10.1186/s12873-025-01355-0","url":null,"abstract":"<p><strong>Background: </strong>The aging population has led to a growing number of frail older patients in prehospital emergency care. These patients often present with complex healthcare needs, posing significant challenges for prehospital emergency nurses (PENs) when assessing the appropriateness of providing self-care advice and recommending that patients remain at home. This study, therefore, aimed to explore the experiences of PENs in giving self-care advice and referring frail older patients to remain at home when this approach is considered the most appropriate course of action.</p><p><strong>Methods: </strong>An exploratory qualitative design was employed, which was based on individual semistructured interviews with ten PENs from an ambulance service organization in southwestern Sweden. The data were analysed via inductive qualitative content analysis, following the approach described by Elo and Kyngäs.</p><p><strong>Results: </strong>The analysis resulted in one main category: Professional discretion and coordinated support for sustainable decision making, along with three generic categories. The findings highlight key dilemmas faced by PENs: navigating uncertainty in frail older patients' cognitive and functional abilities, balancing patient autonomy and self-determination with safety concerns, and managing the ethical tension between respecting dignity and preventing harm. PENs also highlighted dilemmas in communication, where striving for clarity and trust was hampered by language barriers. They further experienced challenges in negotiating power and responsibility with frail older patients and relatives. Limited resources, unclear care structures, and insufficient collaboration with other healthcare providers created additional organizational dilemmas, constraining PENs' ability to make confident, ethically sustainable decisions.</p><p><strong>Conclusion: </strong>This study underscores the complexity of decision-making for PENs when giving self-care advice and referring frail older patients to remain at home. Ensuring safe and sustainable care requires thorough assessments, clear communication, clinical expertise, empathy, and interprofessional collaboration, while future research should also address patients' perspectives and the organizational factors influencing PENs' decisions.</p><p><strong>Clinical trial registration: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"183"},"PeriodicalIF":2.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124111","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":"The use of epinephrine in out-of-hospital cardiac arres : A retrospective study of the effects of administration timing and cumulative doses on outcome in a physician-staffed emergency medical service system.","authors":"Tobias Gruebl, Janine Jungblut, Dennis Rupp, Chung Shing Rex Ha, Birgit Ploeger, Dana Maresa Haag, Davut Deniz Uzun, Christoph Walter Jaenig, Martin Christian Sassen, Bernhard Schieffer, Lars Timmermann, Susanne Betz","doi":"10.1186/s12873-025-01351-4","DOIUrl":"10.1186/s12873-025-01351-4","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"182"},"PeriodicalIF":2.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124114","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":"Predictive modelling in times of public health emergencies: patients' non-transport decisions during the COVID-19 pandemic.","authors":"Hassan Farhat, Cyrine Abid, Guillaume Alinier, Moncef Khadhraoui, Imed Gargouri, Loua Al Shaikh, James Laughton","doi":"10.1186/s12873-025-01340-7","DOIUrl":"10.1186/s12873-025-01340-7","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"181"},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039063","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":"Recognition of stroke symptoms indicative of anterior circulation large-vessel occlusion via telephone and video calls: a simulation study.","authors":"Matthias L Herrmann, Simone Meier, Florian F Schuchardt, Max Henningsen, Nicole Wimmesberger, Diana Rau, Erik Farin-Glattacker, Jochen Brich","doi":"10.1186/s12873-025-01344-3","DOIUrl":"10.1186/s12873-025-01344-3","url":null,"abstract":"<p><strong>Background: </strong>Identifying suspected anterior circulation large-vessel occlusion (aLVO) strokes during emergency calls could enhance dispatch efficiency, particularly in rural areas. However, data on emergency medical dispatchers' (EMDs) ability to recognize aLVO symptoms remain limited. This simulation study aimed to evaluate the feasibility of identifying side-specific arm paresis, side-specific conjugate eye deviation (CED), and aphasia during emergency calls by instructing layperson callers to perform brief, standardized examination steps. Two communication methods were compared: (1) telephone calls and (2) video calls.</p><p><strong>Methods: </strong>Forty-eight laypersons interacted with simulated patients presenting various stroke syndromes. Simulated EMDs conducted standardized assessments during simulated emergency calls, guiding laypersons through patient examinations.</p><p><strong>Results: </strong>In 96 telephone-assisted and 95 video-assisted calls, EMDs identified aLVO stroke symptoms with high accuracy. In telephone calls, accuracy was 0.92 for side-specific arm paresis, 0.98 for side-specific CED, and 0.88-0.99 for aphasia. In video calls, accuracy was 0.97 for side-specific arm paresis, 0.97 for side-specific CED, and 0.94-1.00 for aphasia.</p><p><strong>Conclusions: </strong>These findings suggest that EMDs can identify stroke symptoms indicative for aLVO via both telephone and video calls using a standardized dispatch protocol to guide lay bystanders. This study provides a foundation for future real-world research on implementing aLVO detection protocols in emergency dispatch.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"180"},"PeriodicalIF":2.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032782","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":"Difficult calls to emergency medical dispatch centres - a mixed method study.","authors":"Inger K Holmström, Hans Blomberg, Ulrika Winblad, Douglas Spangler","doi":"10.1186/s12873-025-01343-4","DOIUrl":"10.1186/s12873-025-01343-4","url":null,"abstract":"","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"179"},"PeriodicalIF":2.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145028900","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":"Perceptions of workload in emergency care in the Netherlands and how to influence this: a qualitative study.","authors":"Ties Eikendal, Naomi Prudon, Rudolf Bertijn Kool, Patrick Jeurissen, Menno Iskander Gaakeer, Bas de Groot, Simone A van Dulmen","doi":"10.1186/s12873-025-01334-5","DOIUrl":"10.1186/s12873-025-01334-5","url":null,"abstract":"<p><strong>Background: </strong>Adequate staffing and manageable workloads are crucial for high-quality emergency care. However, high perceived workloads in the emergency department (ED) threaten both. Increased demand and staff shortages intensify these issues and cause crowding. Understanding healthcare workers' perspectives on workload is essential for effective policymaking and maintaining a durable workforce. The objective of this study was to explore the current perceived workload of ED professionals, and their vision on how to influence it and to understand the healthcare worker's perspective on proposed healthcare reforms in the Netherlands.</p><p><strong>Methods: </strong>Qualitive study using semi-structured interviews with 33 healthcare professionals (ED physicians, physician assistants and nurses) working in a university medical center, and three general hospitals from March-July 2023. The interviews were audio-recorded and transcribed verbatim. The interview transcripts were coded. An inductive content analysis was performed, where codes were assigned to the transcripts and adjusted. Codes were then sorted into themes on causes of workload, consequences and proposed solutions for reducing the workload.</p><p><strong>Results: </strong>Emergency department professionals identified increasing patient inflow, barriers to patient throughput and output, and staff shortages as key workload causes. Consequences included increased time, mental and psychological demands, leading to stress and reduced job satisfaction. A well-coordinated team and having social interaction with colleagues is seen as a key part of the profession by ED-professionals. Next to that, training and development opportunities contribute to job satisfaction. Proposed solutions involved public education, improved care coordination, technological innovations, and enhanced collaboration within and among hospitals to improve efficiency and job satisfaction, and to reduce perceived workload pressure.</p><p><strong>Conclusions: </strong>Addressing perceived workload is crucial for maintaining quality and accessibility of care. Dutch ED professionals face a high workload leading to stress and lower job satisfaction. To ensure successful changes, adequate preconditions and engaging healthcare professionals in decision-making are crucial. In future research, a stronger focus on effective work habits and processes, including provider satisfaction and workplace well-being, is necessary.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"178"},"PeriodicalIF":2.3,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941601","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}