Contraception最新文献

{"title":"Satisfaction with and Feasibility of No-Test Telehealth Medication Abortion vs In-Person Care with Ultrasound in the United States.","authors":"C Finley Baba, Lauren J Ralph, M Antonia Biggs, Colleen McNicholas, Amy Hagstrom Miller, Daniel Grossman","doi":"10.1016/j.contraception.2026.111459","DOIUrl":"https://doi.org/10.1016/j.contraception.2026.111459","url":null,"abstract":"<p><strong>Objectives: </strong>To compare patients' satisfaction with telehealth medication abortion (MA) and mail-order pharmacy dispensing to in-person care with ultrasound and describe the models' feasibility.</p><p><strong>Study design: </strong>We conducted a prospective, observational study among MA patients <70 days gestation, aged > 15, from four clinic systems in six U.S. states from 2021-2023. Participants completed electronic surveys assessing satisfaction (extremely/very vs somewhat/slightly/not) with three models of MA care (telehealth + mail, telehealth + pick-up, and in-person with ultrasound) and we abstracted chart data from medical records. We conducted multivariable logistic regression to estimate adjusted proportions of satisfaction, and described feasibility including timeliness and condition of receipt of medications, and unwanted abortion disclosure, due to the model of care received.</p><p><strong>Results: </strong>Of 543 patients enrolled, 439 (81%) responded to satisfaction items. A higher adjusted proportion of the telehealth + mail group were extremely/very satisfied with MA overall than the in-person group (94% vs 80%, p<.05), and with level of privacy during the visit (99% vs 82%, p<.05). High adjusted proportions of patients in all groups described being extremely/very satisfied with support (90%-100%) and information (94%-100%) received. Descriptively, almost all (99%) received medications <70 days gestation, 96% within 3 days, all in good condition, and no participants reported unwanted disclosure of their abortion because someone saw the medications.</p><p><strong>Conclusion: </strong>More mail-order telehealth patients reported being extremely/very satisfied with MA than those accessing in-person care. Telehealth models are highly feasible and should be offered to those who need or desire them.</p><p><strong>Implications: </strong>Our findings add to a body of evidence demonstrating high patient satisfaction with and feasibility of telehealth models of MA, underscoring the rationale for expanding access to these models of provision.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111459"},"PeriodicalIF":2.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679360","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":"Stroke in combined hormonal contraceptive users treated with triptans.","authors":"Gasper Letnar, Klaus Kaae Andersen, Tom Skyhøj Olsen","doi":"10.1016/j.contraception.2026.111458","DOIUrl":"10.1016/j.contraception.2026.111458","url":null,"abstract":"<p><strong>Objectives: </strong>The extent of triptan use among users of combined hormonal contraceptives (CHC) is unknown. Likewise, it is unclear whether triptan use influences the risk of stroke in CHC users. In a Danish population of CHC users, we examined the prevalence of triptan use and assessed its impact on stroke risk.</p><p><strong>Study design: </strong>In this historical cohort study based on registries covering the Danish female population aged 18-49 years 2004-2021 we investigated incidence rate ratios (IRR) and incidence rate differences (IRD) of ischemic (IS) and hemorrhagic (ICH) stroke in users of CHCs who had been prescribed triptans compared with those without triptan use. Poisson regression models adjusting for age, ethnicity, education, calendar year and risk factors were applied.</p><p><strong>Results: </strong>Among 1711,757 women, 982,962 (57%) were CHC users, contributing 4446,000 person-years of CHC use. Of these, 98,399 (10%) had used triptans, contributing 325,000 person-years. CHC users with triptan prescriptions had an increased risk of IS compared to users without prescriptions (IRR 1.60; 95% CI 1.33,1.92); IRD range by age group 2-42/100,000 person-years). Stroke risk was independent of triptan prescription frequency and ethinylestradiol dose. Compared with women who use neither CHCs, other hormonal contraceptives, nor triptans, CHC users with triptan prescriptions had an increased risk of IS (IRR 2.61; 95% CI: 2.21-3.08). Risk was not increased for ICH.</p><p><strong>Conclusions: </strong>Among approximately one million Danish CHC users, 10% had been prescribed triptans. In this population the risk of IS was increased 1.60-fold compared with those without triptan use. Triptan use constitutes a risk factor for IS in CHC users. Although the absolute risk is generally low, it is highest among the oldest users.</p><p><strong>Implications: </strong>Among approximately one million Danish CHC users, 10% had been prescribed triptans, and in this group the risk of ischemic stroke was 1.60 times higher. Among CHC users with migraine, triptan use should be regarded as a risk factor for ischemic stroke and taken into account when considering CHCs as a contraceptive option.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111458"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617128","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":"OB-GYN job satisfaction in a changing landscape of legal restrictions on their practice.","authors":"Frances E Cates, Catherine E Aiken, Abigail R A Aiken","doi":"10.1016/j.contraception.2026.111455","DOIUrl":"10.1016/j.contraception.2026.111455","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the experiences of obstetrician-gynecologists (OB-GYNs) in U.S. states with restrictive and non-restrictive abortion laws to understand their perspectives on the changing political landscape and how these changes affect job satisfaction in the post-Dobbs era.</p><p><strong>Study design: </strong>We conducted semi-structured interviews with 24 OB-GYNs from states with restrictive and non-restrictive abortion laws from April-December 2024. Fourteen OB-GYNs practiced in restrictive states; nine practiced in non-restrictive states; and one practiced in both. Interviews lasted 25 min on average and were audio-recorded via Zoom. We transcribed and de-identified recordings and used Nvivo v. 14 for inductive thematic analysis.</p><p><strong>Results: </strong>OB-GYNs from restrictive and non-restrictive states described the impact of abortion laws on their practice. Restrictive-state OB-GYNs described their inability to offer the full scope of care, fulfill patient expectations, and how circumstances in which they were hindered from following evidence-based care guidelines could lead to unsafe clinical situations. Across states, OB-GYNs conveyed frustration towards the impact of politics on reproductive health, fear of legal repercussions, and anxiety towards future restrictions. Political tensions amplified burnout for some. OB-GYNs felt that reproductive healthcare is underappreciated and underfunded.</p><p><strong>Conclusions: </strong>Consistently feeling limited in their ability to provide optimal care creates emotional burdens among OB-GYNs in restrictive states. Fear of legal fallout heightens risk for unsafe clinical scenarios in all states and could be addressed through institutional support and legal clarifications. OB-GYNs' growing perception that reproductive healthcare is underappreciated suggests broader dissatisfaction that requires action to ensure a sustainable workforce.</p><p><strong>Implications: </strong>OB-GYNs experience challenges fulfilling patient needs and managing changing reproductive health policies. They also experience dissatisfaction with the politicization of reproductive healthcare. Developing spaces for peer support and advocating for legal clarifications could facilitate better clinical decision-making and quality of care.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111455"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617116","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":"Assessing motivating factors for IUD self-removal through focus groups and simulation.","authors":"Melissa L Wong, Rushina Pancholi, Leanne Yinusa-Nyahkoon, Katharine O White, Elisabeth Woodhams","doi":"10.1016/j.contraception.2026.111456","DOIUrl":"10.1016/j.contraception.2026.111456","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate motivating factors for IUD self-removal in IUD ever-users and the attitudes of simulated removal in supporting IUD removal decision-making.</p><p><strong>Study design: </strong>We conducted three semi-structured focus group discussions grounded in the Theory of Planned Behavior to identify perceptions around self-removal and promoting IUD self-removal among IUD ever-users. We defined promoters as tools or resources to support IUD self-removal. Participants performed simulated standard IUD removal using a model. The research team used thematic analysis to code focus group transcripts and identify themes centered around promoters and perceptions of IUD self-removal.</p><p><strong>Results: </strong>Participants (n = 25) were 18-33 years old and from the greater Boston region. Our primary themes were: 1) information about IUD self-removal is a means to centering patients' needs and 2) participants desire support and resources regarding IUD self-removal. Participants largely viewed IUD self-removal as positive because it was a mechanism to manage side effects, control what is in their body, and mitigate negative healthcare experiences and restrictions within the healthcare system. IUD removal simulation decreased fear and increased perceived control.</p><p><strong>Conclusions: </strong>IUD self-removal is a desired, yet underutilized method of IUD discontinuation. Participant consideration of self-removal reflected the desire for control in the setting of systemic healthcare and clinician-based barriers. Participants wanted more self-efficacy in IUD removal experiences, which may be the most important aspect of removal to some respondents. Clinicians can support IUD self-removal by providing instruction on steps to self-removal and allowing patients to practice self-removal with simulation in the office.</p><p><strong>Implications: </strong>IUD self-removal is a desired method of IUD discontinuation that may afford reproductive autonomy in the setting of systemic and clinician-based barriers. Participants requested support for IUD self-removal from their clinicians, which could include anticipatory counseling, use of simulation models, or supporting attempted self-removal in the office.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111456"},"PeriodicalIF":2.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617075","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":"Factors associated with sale of medication abortion drugs without a prescription in pharmacies and drugstores in Addis Ababa, Ethiopia: Findings from a mystery client study.","authors":"Stephanie Andrea Küng, Alice F Cartwright, Bashiru Mohammed, Niguse Tadele, Mahari Yidego, Kidist Lemma, Tesfaye Tufa","doi":"10.1016/j.contraception.2026.111457","DOIUrl":"10.1016/j.contraception.2026.111457","url":null,"abstract":"<p><strong>Objectives: </strong>Little is known about the sale of medication abortion drugs without a prescription in pharmacies and drugstores in Ethiopia. We explored factors associated with sale of abortion pills without a prescription in these settings.</p><p><strong>Study design: </strong>Mystery clients visited 600 outlets in Addis Ababa to request abortion pills without a prescription. We ran tests for association to understand factors associated with sale of medication abortion drugs and descriptively analyzed the reasons mystery clients were not sold the pills.</p><p><strong>Results: </strong>Mystery clients were sold medication abortion drugs in one-quarter of visits (23.5%). In multivariable regression, mystery clients assisted by male staff or outlet managers/owners had significantly higher odds of being sold abortion pills compared to female staff (aOR = 1.61; 95% CI = 1.02-2.54) and to employees/staff (aOR = 1.78; 95% CI = 1.06-2.99). Mystery clients who disclosed their marital status and the reason for wanting an abortion had twice the odds of being sold medication abortion drugs compared to those who were not asked these details (aOR = 2.32; 95% CI = 1.37-3.92; and aOR = 2.05; 95% CI = 1.22-3.46, respectively). The outlet not stocking abortion pills was the main reason mystery clients were not sold pills.</p><p><strong>Conclusions: </strong>The practice of selling abortion pills without a prescription is already happening, and sale of these medications varies significantly by certain staff and visit characteristics. There is potential for involving pharmacists in the expansion of safe abortion services in Ethiopia.</p><p><strong>Implications: </strong>This study provides crucial insights into factors that affect access to abortion care in pharmaceutical outlets in Addis Ababa, Ethiopia. The practice of selling medication abortion drugs without a prescription is happening, and removing barriers to accessing abortion pills from pharmaceutical outlets would greatly expand access to safe abortion in Ethiopia.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111457"},"PeriodicalIF":2.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617070","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":"Liver cirrhosis among females with cystic fibrosis using hormonal contraception.","authors":"Jennifer Chin, Monika Sarkar, Amalia S Magaret, Chialing Hsu, Natalie West, Patricia Walker, Elinor Langfelder-Schwind, Jennifer L Taylor-Cousar, Sigrid Ladores-Barrett, Denis Hadijiliadis, Andrea H Roe, Ahmet Uluer, Sheila Mody, Raksha Jain, Leigh Ann Bray Dayton, Emily M Godfrey","doi":"10.1016/j.contraception.2026.111454","DOIUrl":"10.1016/j.contraception.2026.111454","url":null,"abstract":"<p><strong>Objective: </strong>We assessed incidence of liver cirrhosis, risk factors for developing cirrhosis, and if there is an association between hormonal contraception (HC) use and liver cirrhosis among reproductive-aged females with cystic fibrosis (CF).</p><p><strong>Study design: </strong>Between January 2021 and April 2022, we recruited reproductive-aged females with CF to complete a questionnaire. We linked their responses to the Cystic Fibrosis Foundation Patient Registry (CFFPR) to examine potential risk factors for incident liver cirrhosis and its association with time-varying HC using survival analysis.</p><p><strong>Results: </strong>Among 551 persons with CFFPR survey and registry data, 8 had cirrhosis at first available registry report and 3 were excluded for other reasons. Of the 540 remaining participants, 250 (46.3%) were F508 homozygous, 437 (80.9%) were using modulators, and 28 (5.2%) had new onset cirrhosis. Genotype and modulator use were not associated with cirrhosis incidence (adjusted hazard ratios (aHR) 0.57 with 95% confidence interval (CI) 0.15-2.22 and 0.86 with CI 0.24-3.11, respectively). Over all 5146 years of reporting including a median of 12 years per person, 64.9% of years involved reported non-HC, 23.6% combined HC, and 11.5% progestin-only HC. HC use was not associated with cirrhosis incidence (aHR 0.68 with CI 0.25-1.86 for combined HC and 0.57 with CI 0.13-2.49 for progestin-only HC).</p><p><strong>Conclusion: </strong>In our observational cohort, the incidence of cirrhosis was 5.2%. HC use is not associated with liver cirrhosis. Future research should explore the risk factors in CF for developing liver cirrhosis and its relation with HC use.</p><p><strong>Implications: </strong>In females with cystic fibrosis, hormonal contraception is not associated with liver cirrhosis.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111454"},"PeriodicalIF":2.3,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147577033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in permanent contraceptive use in the United States by demographic characteristics.","authors":"Kari White, Julia Strasser, Jessica D Gipson, Sonya Borrero","doi":"10.1016/j.contraception.2026.111453","DOIUrl":"10.1016/j.contraception.2026.111453","url":null,"abstract":"<p><strong>Objective: </strong>To examine racial/ethnic and income differences in the prevalence of vasectomy and tubal sterilization use among US men and women who do not want more children.</p><p><strong>Study design: </strong>We used the male and female samples of the National Survey of Family Growth (2015-2019) and identified respondents ≥ 21 years of age who did not want any or more children. We computed the weighted prevalence of vasectomy use among men and tubal sterilization use among women. We used gender-stratified Poisson regression models that included respondents' race/ethnicity and income separately and controlled for age, number of children, marital status and educational attainment.</p><p><strong>Results: </strong>The sample included 3822 men and 5713 women aged ≥ 21 years who did not want any or more children. Vasectomy prevalence was significantly lower among men who were Black (6.1%), Hispanic (10.1%), and had incomes ≤ 149% of the federal poverty level (FPL; 5.4%), compared to white men (18.3%) and men with incomes ≥ 300% FPL (19.6%). Tubal sterilization prevalence was significantly higher among women who were Black (35.4%), Hispanic (34.7%) and had incomes ≤ 149% FPL (38.8%), compared to white women (24.8%) and women with incomes ≥ 300% FPL (16.5%). Racial/ethnic and income-based differences in vasectomy use remained after multivariable adjustment, whereas differences in tubal sterilization use were attenuated after accounting for demographic characteristics.</p><p><strong>Conclusion: </strong>We observed pronounced differences in permanent contraceptive use by respondents' race/ethnicity and income. A diverse set of sociocultural, partner, and structural factors likely contribute to these differences.</p><p><strong>Implications: </strong>The prevalence of permanent contraceptive method use in the US varies markedly by race/ethnicity and income and trends in opposite directions for vasectomy versus tubal sterilization. Addressing inequitable access to knowledge, health services and insurance coverage would ensure equitable availability of both available for individuals who do not want children.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111453"},"PeriodicalIF":2.3,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147523068","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":"Retraction notice to \"Vaginal misoprostol prior to intrauterine device insertion in women delivered only by elective Cesarean section: A randomized double-blind clinical trial\" [CONTRACEPTION 95 (2017) 538-543].","authors":"Mohamed S Abdellah, Ahmed M Abbas, Aml M Hegazy, Ihab M El-Nashar","doi":"10.1016/j.contraception.2026.111402","DOIUrl":"https://doi.org/10.1016/j.contraception.2026.111402","url":null,"abstract":"","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111402"},"PeriodicalIF":2.3,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517656","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":"Reasons for contraceptive nonuse at two sites in Burkina Faso.","authors":"Leigh Senderowicz, Emma Romell, Brooke W Bullington, Nathalie Sawadogo, Katherine Tumlinson","doi":"10.1016/j.contraception.2026.111452","DOIUrl":"10.1016/j.contraception.2026.111452","url":null,"abstract":"<p><strong>Objective: </strong>We examine reasons for contraceptive nonuse in Burkina Faso.</p><p><strong>Study design: </strong>We draw from a population-based survey of 3929 women, of whom 2462 were nonusers of contraception. We use descriptive statistics to examine the distribution of reasons for nonuse.</p><p><strong>Results: </strong>Over 80% of respondents reported lack of desire or need for contraception as motivating nonuse. Conventional access barriers, like cost or distance, were uncommon.</p><p><strong>Conclusions: </strong>Restricted access to contraception was not a commonly reported barrier to contraceptive use in this context.</p><p><strong>Implications: </strong>Sexual and reproductive health researchers should avoid assuming that nonusers lack contraceptive access. Future research should explore further reasons for contraceptive nonuse.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111452"},"PeriodicalIF":2.3,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517558","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":"Levonorgestrel 52-mg intrauterine device fixation using a hysteroscopic special steel needle surgical system for the treatment of adenomyosis with uterine septum: A case report.","authors":"Meiqi Li, Qianru Li, Suer Zhang, Chenyu Xiao, Leilei Gao","doi":"10.1016/j.contraception.2026.111435","DOIUrl":"10.1016/j.contraception.2026.111435","url":null,"abstract":"<p><p>This case explored a novel surgical method to fix levonorgestrel 52-mg intrauterine devices in patients with adenomyosis and uterine septum. The procedure is convenient and feasible, and successfully applied the technique in a 43-year-old patient with prior levonorgestrel 52-mg intrauterine device detachment. It provides a reference for clinical management.</p>","PeriodicalId":93955,"journal":{"name":"Contraception","volume":" ","pages":"111435"},"PeriodicalIF":2.3,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147492293","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}