Breastfeeding Medicine最新文献

{"title":"Human Milk Melatonin Across Early Lactation in Preterm Birth: Maternal, Pregnancy, and Neonatal Correlates.","authors":"Nicolina Anagnostatou, Elena Vakonaki, Eleftherios Panteris, Zacharenia Golemi, Thomas Lamprakis, Antonios Makrigiannakis, Manolis N Tzatzarakis, Eleftheria Hatzidaki","doi":"10.1177/15568253261494547","DOIUrl":"https://doi.org/10.1177/15568253261494547","url":null,"abstract":"<p><strong>Background: </strong>Melatonin is a multipotent neuroendocrine transducer. Human-milk melatonin is the sole source of exogenous melatonin in the neonatal period, this being especially true for premature infants. This study aimed to examine maternal, pregnancy, and neonatal correlates of human-milk melatonin concentrations measured at three predefined lactational stages-colostrum, transitional, and mature milk-in mothers of preterm infants, as well as the variation of melatonin concentration in human milk during the first postnatal month, possibly shedding light on an understudied area of neonatal nutrition.</p><p><strong>Methods: </strong>This longitudinal observational cohort enrolled 101 mothers who delivered 128 infants before 35 completed weeks of gestation. Melatonin was quantified by ELISA in daytime milk samples obtained at T1 (postnatal days 2-5), T2 (days 10-14), and T3 (days 20-28).</p><p><strong>Results: </strong>Human-milk melatonin declined across early lactation, with significantly lower concentrations in mature milk than in colostrum (T3 versus T1: geometric mean ratio [GMR]: 0.74, 95% confidence interval [CI]: 0.62-0.88, <i>p</i> < 0.001). Fetal growth restriction (FGR) was associated with lower melatonin concentrations after adjustment for the predefined maternal and pregnancy covariates (GMR: 0.76, 95% CI: 0.58-1.00, <i>p</i> = 0.046). No significant correlation was found with any of the other maternal, obstetric, or neonatal demographic characteristics.</p><p><strong>Conclusions: </strong>This longitudinal study indicates that daytime human-milk melatonin decreases from colostrum to mature milk during the first postnatal month in mothers of preterm infants. Among the maternal, pregnancy, and neonatal factors examined, FGR was the only factor independently associated with lower milk melatonin concentrations. These findings support the need for larger longitudinal studies combining maternal, placental, and milk melatonin measurements in order to clarify the biological basis of this association and its possible clinical relevance for infants born preterm.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"15568253261494547"},"PeriodicalIF":2.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126705","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":"ABM-It's a Family Affair!","authors":"Julie Ware","doi":"10.1177/15568253261473863","DOIUrl":"10.1177/15568253261473863","url":null,"abstract":"","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"610-612"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705338","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":"Donor Human Milk Utilization in a Level 1 Newborn Unit of a High-Volume Delivery Hospital: A Cautionary Tale.","authors":"Lindsey Daggle, Courtney Port, Victoria Kim, Stephanie DeVeau-Rosen, William Hickman, Karen Bodnar","doi":"10.1177/15568253261470601","DOIUrl":"10.1177/15568253261470601","url":null,"abstract":"<p><strong>Introduction: </strong>Donor human milk (DHM) is an alternative to formula for supplementation of breastfed newborns and has been associated with higher in-hospital exclusive breast milk feeding rates. Its use has increased substantially, most recently among term newborns, yet there is scarce data to describe patient characteristics and volumes administered. We aimed to characterize DHM utilization in our level 1 nursery.</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional study of newborns discharged in 2022 from the level 1 nursery. Variables included sex, gestational age, birth weight, delivery type, hypoglycemia diagnosis, DHM volume, and length of stay. DHM use was compared across preferred language, race, ethnicity, and payer type using chi-square testing.</p><p><strong>Results: </strong>A total of 10,432 discharges were reviewed-those transferred to Neonatal Intensive Care Unit (NICU) or another unit were excluded. Of 9,074 newborns receiving level 1 care, 1,094 (12.1%) received DHM. Newborns born between 35 and 37 weeks gestation, delivered by cesarean section, or diagnosed with hypoglycemia or small for gestational age were more likely to receive DHM (<i>p</i> < 0.05). DHM was also more common among newborns whose birth parent preferred the English language, identified as White or non-Hispanic, or had non-Medicaid insurance (<i>p</i> < 0.05). 6,552.6 ounces were consumed, with a total median of 3.9 ounces per newborn (dose range 2-50 mL).</p><p><strong>Conclusions: </strong>DHM use in the level 1 nursery varied by clinical and sociodemographic factors, revealing inequities. In addition, some doses exceeded recommended supplemental volumes. Future efforts should focus on ensuring equitable access to DHM, standardized dosing and discontinuation guidelines, and evaluation of impacts on exclusive breastfeeding rates.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"587-594"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673040","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":"Breastfeeding Outcomes After Radiofrequency Ablation and Surgical Excision of Fibroadenomas Compared to Natural History: A Retrospective Cohort Study.","authors":"Merve Tokocin, Adnan Gundogdu, Turan Pehlivan, Osman Cem Yilmaz, Atilla Çelik","doi":"10.1177/15568253261457852","DOIUrl":"10.1177/15568253261457852","url":null,"abstract":"<p><strong>Background: </strong>Fibroadenomas, common benign breast tumors in women of reproductive age, are increasingly managed with minimally invasive radiofrequency ablation (RFA) or surgical excision. However, their impact on breastfeeding outcomes remains underexplored. We aimed to assess breastfeeding ability and breast tissue changes in women treated with RFA or surgery compared to those with untreated fibroadenomas.</p><p><strong>Methods: </strong>In this retrospective cohort study, we evaluated 153 women with biopsy-confirmed fibroadenomas across five groups: RFA with prior breastfeeding (RFA-PreBF; <i>n</i> = 26), RFA with posttreatment breastfeeding (RFA-PostBF; <i>n</i> = 22), surgical excision with prior breastfeeding (Surgical-PreBF; <i>n</i> = 30), surgical excision with posttreatment breastfeeding (Surgical-PostBF; <i>n</i> = 20), and noninterventional with breastfeeding (Observation-BF; <i>n</i> = 55). Breastfeeding ability was assessed using a 5-point scale, and breast tissue changes were evaluated via ultrasound at 18 months, and all breastfeeding attempts occurred at a minimum of 12 months postprocedure. Fisher's exact test compared complete lactation failure rates, and a power analysis validated the study design (Fig. 1).</p><p><strong>Findings: </strong>The combined RFA group (<i>n</i> = 48) had a higher complete lactation failure rate (14.6%) than the Observation-BF group (3.6%; Fisher's exact test, <i>p</i> = 0.045). Similarly, the combined surgical group (<i>n</i> = 50) had a higher complete lactation failure rate (16.0%) than the Observation-BF group (<i>p</i> = 0.034). When pooled, the combined intervention group (<i>n</i> = 98) showed a complete lactation failure rate of 15.3% versus 3.6% in the Observation-BF group. Residual tissue correlated with lactation impairment in the RFA group (Spearman's ρ, <i>p</i> < 0.05). Ultrasound showed no tumor recurrence, with cystic changes in some cases not linked to breastfeeding impairment. Power analysis confirmed 80% power to detect a medium effect size (<i>f</i> = 0.25, Fig. 1), supporting the study's robustness.⁷ RFA-PreBF (<i>n</i> = 26), RFA-PostBF (<i>n</i> = 22), Surgical-PreBF (<i>n</i> = 30), Surgical-PostBF (<i>n</i> = 20), and Observation-BF (<i>n</i> = 55). Breastfeeding ability was assessed using a 5-point scale, and breast tissue changes were evaluated via ultrasound at 18 months. Fisher's exact test compared complete lactation failure rates, and a power analysis validated the study design (Fig. 1).[Figure: see text]Interpretation:RFA and surgical excision are effective for fibroadenoma management but increase the risk of complete lactation failure compared to untreated fibroadenomas. Careful patient selection, precise procedural techniques, and vigilant posttreatment monitoring are essential to optimize breastfeeding outcomes, particularly for women planning future pregnancies.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"559-563"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204017","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":"Examining Relationships Between Multiple Adverse Social Determinants of Health, Maternal Depressive Symptoms, Timing of Solid Food Introduction, and Breastfeeding Duration Among Black or African American Women.","authors":"Courtney N Slater, Liming Huang, Babette S Zemel, Diane L Spatz, J Margo Brooks Carthon, Tanja V E Kral","doi":"10.1177/15568253261464816","DOIUrl":"10.1177/15568253261464816","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding has been shown to reduce the risk of several diseases-including those that disproportionately affect Black or African American women and children. Adverse social determinants of health (SDOH) have been associated with a higher prevalence of postpartum depressive symptoms and are negatively associated with breastfeeding outcomes and the timing of solid food introduction. Prior research has focused on each individual SDOH in isolation and has not, to the best of our knowledge, examined the mediating role of depressive symptoms and timing of introduction to solid foods.</p><p><strong>Objective: </strong>This study aimed to examine (1) the association between multiple adverse SDOH and timing of breastfeeding cessation and (2) if this relationship is mediated by maternal depressive symptoms and the timing of introduction to solid food.</p><p><strong>Materials and methods: </strong>This secondary data analysis used data from an existing, longitudinal birth cohort study with Black or African American women (<i>n</i> = 242). Multivariable logistic regression and regression-based causal mediation analyses were used to address the objectives of this study.</p><p><strong>Results: </strong>Findings showed multiple adverse SDOH were associated with increased odds of stopping breastfeeding at 4 and 6 months of age (4 months: odds ratio [OR] = 3.49, 95% confidence interval [CI]: 1.11, 10.97; 6 months: OR = 5.03, 95% CI: 1.54, 16.47). This relationship was partially mediated by the introduction of solid foods at 4 months of age (indirect effect: OR = 1.53, 95% CI = 1.18, 2.34) but not mediated by maternal depressive symptoms.</p><p><strong>Conclusions: </strong>Multiple adverse SDOH demonstrated relationships with the timing of both breastfeeding cessation and introduction to solid foods.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"548-558"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13383052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367048","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":"It Takes a Village, and We Are That Village.","authors":"Julie Scott Taylor","doi":"10.1177/15568253261471494","DOIUrl":"10.1177/15568253261471494","url":null,"abstract":"","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"539-540"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454700","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":"Long-Term Weight Trajectories in Infants Receiving Prolonged Breastfeeding: Impact of Formula Supplementation.","authors":"Rona Krinsky-Dror, Ronit Lubetzky, Dror Mandel, Hadar Moran-Lev","doi":"10.1177/15568253261461838","DOIUrl":"10.1177/15568253261461838","url":null,"abstract":"<p><strong>Objective: </strong>This study compared weight trajectories in infants breastfed for at least 1 year, with or without formula supplementation.</p><p><strong>Study design: </strong>A retrospective cohort of 252 infants followed in well-baby clinics. All infants were breastfed ≥12 months and received complementary foods at 4-6 months. Of these, 174 received no formula, and 78 received daily formula supplementation. Anthropometric data were collected from birth to 5 years of age.</p><p><strong>Results: </strong>Among males, those breastfed without formula had significantly lower body weight between 13 and 18 months compared with those receiving formula (10.20 kg vs. 10.97 kg, <i>p</i> < 0.001). From 19 months onward, no significant weight differences were observed and trajectories converged through 5 years.</p><p><strong>Conclusion: </strong>Prolonged breastfeeding in male infants is associated with lower weight in early toddlerhood; however, differences resolve by age two. These findings suggest early variations may represent physiological patterns. Further controlled studies are needed.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"579-586"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148326795","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":"Ultrasound-Guided Microwave Ablation Versus Open Surgery for Benign Breast Disease: Impact on Postoperative Lactation.","authors":"Hui Zhang, Yang Wang, Chao Hou, Jin-Xiu Yan, Hong Chang","doi":"10.1177/15568253261464815","DOIUrl":"10.1177/15568253261464815","url":null,"abstract":"<p><strong>Background: </strong>Benign breast disease (BBD) is common in adult women. While ultrasound-guided microwave ablation (MWA) is an established minimally invasive treatment, its comparative impact on postoperative lactation, particularly mastitis, remains understudied. This study aimed to evaluate mastitis outcomes following MWA versus open surgery for BBD.</p><p><strong>Methods: </strong>In this retrospective study, 79 patients (105 nodules) treated between January 2018 and August 2023 were included 41 patients (62 nodules) underwent MWA and 38 patients (43 nodules) underwent open surgery. All patients lactated within 5 years post-procedure. The primary outcome was the incidence of lactational mastitis without systemic symptoms (MWoSS) and mastitis with systemic symptoms (MSS). Patient satisfaction was also assessed.</p><p><strong>Results: </strong>The incidence of MWoSS was significantly lower in the MWA group (19.5%) than in the open surgery group (50.0%). Similarly, MSS occurred in 4.9% of the MWA group versus 34.2% of the open surgery group. Multivariate analysis identified open surgery as an independent risk factor, associated with a 4.13-fold increased risk of MWoSS (OR = 4.125, 95% CI: 1.517-11.218) and a 10.14-fold increased risk of MSS (OR = 10.140, 95% CI: 2.107-48.793). Patient satisfaction was significantly higher in the MWA group (9.29 ± 0.72 vs. 8.15 ± 1.13, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Compared to open surgery, ultrasound-guided MWA for BBD is associated with a significantly lower risk of postoperative mastitis and higher patient satisfaction, supporting its use for women of reproductive age, particularly when future breastfeeding is planned.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"564-571"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148560479","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 Effect of Breastfeeding on Cervical Dysplasias.","authors":"Hande Kurt Güven, Tugce Tunc, Cemre Batin Celik Inaltun, Leyla Asker, Elif Yilmaz","doi":"10.1177/15568253261457843","DOIUrl":"10.1177/15568253261457843","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the relationship between breastfeeding and precancerous cervical lesions.</p><p><strong>Materials and methods: </strong>A case control study was conducted at a tertiary training and research hospital between September 1 and November 1, 2023. A total of 168 patients who attended the gynecology outpatient clinic and reported their breastfeeding experiences were included. Patients with abnormal cervical cytology formed the study group (<i>n</i> = 37), while patients with normal cytology formed the control group (<i>n</i> = 131). Breastfeeding duration and patterns were compared between groups.</p><p><strong>Results: </strong>The control group had normal smear results. In the study group, 15 patients had high-grade squamous intraepithelial lesions, and 22 patients had low-grade squamous intraepithelial lesions. Human papillomavirus (HPV) was positive in 54.1% of the study group versus 9.2% of the control group. The mean breastfeeding duration was shorter in the study group (9.18 ± 3.43 months) than the control group (23.6 ± 3.35 months; <i>p</i> < 0.05). Most control group patients breastfed for 13-36 months (35.1%), while most study group patients breastfed for <6 months (48.6%; <i>p</i> < 0.05). Shorter breastfeeding (<6 months) and HPV positivity were the strongest predictors of abnormal cytology. Breastfeeding <6 months increased the risk 9.883-fold compared with >36 months, while HPV positivity increased the risk 27.612-fold.</p><p><strong>Conclusion: </strong>Breastfeeding and longer breastfeeding duration appear to be associated with a lower risk of cervical intraepithelial neoplasia. Given its multiple health benefits, including prevention of gynecological cancers, promoting breastfeeding through public health policies is strongly recommended. Early recognition and prevention of precancerous lesions remain essential to reducing the risk of cervical cancer.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"541-547"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161785","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":"Impact of Integrated Continuous Team Midwifery Care on Breastfeeding Success within the Iranian Health System: A Randomized Controlled Trial.","authors":"Farzaneh Nasiri, Azam Bagheri, Maryam Dastoorpour, Shahla Khosravi, Zahra Abbaspoor","doi":"10.1177/15568253261464817","DOIUrl":"10.1177/15568253261464817","url":null,"abstract":"<p><strong>Introduction: </strong>Supporting women during the perinatal period helps build confidence, strengthens early bonding between mother and baby, and encourages successful breastfeeding. Continuous midwifery care models are one of the ways that support women in this periods.</p><p><strong>Objective: </strong>This study aimed to evaluate the effect of integrated continuous team midwifery care (ICTMC) in enhancing breastfeeding success in the Iranian health system.</p><p><strong>Methods: </strong>In this randomized controlled trial, 200 low-risk primiparous women with a gestational age of less than 12 weeks were recruited from public health centers. Participants were randomly assigned to either the intervention group, which received continuous midwifery care throughout pregnancy, childbirth, and postnatal follow-up, or the control group, which received routine care. The primary outcomes were early skin-to-skin contact and breastfeeding success at the time of discharge and at 4-6 weeks postpartum. Data were analyzed using Stata, employing descriptive statistics, Chi-square, independent <i>t-</i>test, Phi/Cramer's V, and Cohen's <i>d</i>. The <i>p</i> < 0.05 is significant. Data were analyzed with SPSS 26.</p><p><strong>Results: </strong>ICTMC groups were significantly more likely to initiate skin-to-skin contactearly skin-to-skin contact immediately after birth (92% vs. 74%, <i>p</i> < 0.001) and achieve successful breastfeeding at the discharge time (88% vs. 70%, <i>p</i> = 0.002) compared to the control group. At 6 weeks postpartum, breastfeeding success remained higher in the intervention group (82% vs. 65%, <i>p</i> = 0.004).</p><p><strong>Conclusion: </strong>Women with ICTMC, effectively support skin-to-skin contactearly mother-infant bonding and enhance breastfeeding success among low-risk primiparous women. Integrating this model into routine maternal care may improve perinatal outcomes.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"572-578"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148326797","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}