Ethiopian Journal of Health Sciences最新文献

{"title":"Artificial Intelligence in Radiology for Ethiopia.","authors":"Kumlachew Abate Mekonen, Shimels Hussien Mohammed, Tesfaye Kebede, Alemayehu Bedane, Ashenafi Aberra Buser","doi":"10.4314/ejhs.v34i1.1S","DOIUrl":"10.4314/ejhs.v34i1.1S","url":null,"abstract":"","PeriodicalId":12003,"journal":{"name":"Ethiopian Journal of Health Sciences","volume":"34 Spec Iss 1","pages":"1-2"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902802","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":"Isolated Prostate Tuberculosis Mimicking Prostate Cancer.","authors":"Tesfaye Kebede Legesse, Semira Abrar Issa, Yodit Abraham Yaynishet, Tesfahun Amsal Dessie, Tewodros Yalew Gebremariam, Birhanu Kassie Reta","doi":"10.4314/ejhs.v34i1.10S","DOIUrl":"10.4314/ejhs.v34i1.10S","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) remains the deadliest infectious disease globally, with the kidneys being the most frequently affected organ in the genitourinary system. Isolated prostate involvement by tuberculosis is rare and may mimic prostate cancer. This case report aims to highlight the diagnostic challenges and therapeutic responses associated with isolated prostate tuberculosis, particularly in the context of significantly elevated prostate-specific antigen (PSA) levels in a TB-endemic region.</p><p><strong>Case presentation: </strong>A 69-year-old male was referred to Tikur Anbessa Specialized Hospital (TASH) with obstructive lower urinary tract symptoms (LUTS) lasting seven months. He had previously undergone transurethral resection of the prostate (TURP), with histopathological findings suggestive of benign prostatic hyperplasia (BPH). Further investigation revealed an extremely elevated PSA level of 1768 ng/ml. Magnetic Resonance Imaging (MRI} raised high suspicion for locally advanced prostate cancer; however, a repeat biopsy and histopathology ultimately diagnosed TB prostatitis. The patient responded successfully to anti-tuberculosis therapy.</p><p><strong>Conclusion: </strong>Isolated prostate involvement by M. tuberculosis is rare, and extremely elevated PSA levels are unusual. Histopathological examination is a confirmatory test, but results can be falsely negative if a representative sample is not obtained. Therefore, a high degree of clinical suspicion, particularly in endemic areas, along with repeat biopsy, is crucial for accurate diagnosis.</p>","PeriodicalId":12003,"journal":{"name":"Ethiopian Journal of Health Sciences","volume":"34 Spec Iss 1","pages":"67-72"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902818","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":"Review of St. Paul's Hospital Millennium Medical College Radiology Program: Stakeholders' Viewpoints.","authors":"Kumlachew Abate Mekonen, Alemayehu Bedane, Ashenafi Aberra Buser, Tesfaye Kebede, Shimels Hussien Mohammed","doi":"10.4314/ejhs.v34i1.2S","DOIUrl":"10.4314/ejhs.v34i1.2S","url":null,"abstract":"<p><strong>Background: </strong>St. Paul's Hospital Millennium Medical College (SPHMMC) has offered radiology specialty training for a decade. To mark its 10th anniversary and assess the program's status, this study aimed to gather stakeholders' perspectives on its functioning.</p><p><strong>Methods: </strong>The assessment was conducted from June 15 to July 5, 2024, using a stratified cross-sectional study design. A total of 211 participants were recruited through exhaustive sampling from alumni, faculty, students, referring physicians, and patients. Data were collected via web-based and paper-based questionnaires, where stakeholders rated the core functions of the SPHMMC radiology program (curriculum, teaching, research, and imaging practices) on a 5-point scale and provided additional feedback.</p><p><strong>Results: </strong>Overall, 78% of stakeholders regarded the program's curriculum as highly relevant. However, teaching quality and research were viewed negatively, with only 19% and 11% of radiologists rating these aspects positively. Referring physicians considered radiology reports relevant (68%) but often found them incomplete and untimely (73%), with only 2% deemed timely. Over 80% of patients expressed dissatisfaction with the imaging services and were unwilling to recommend them.</p><p><strong>Conclusions: </strong>While positive perceptions of the curriculum and imaging services suggest program strengths, the negative feedback on teaching and research quality indicates the need for improvements to maintain SPHMMC's commitment to quality education and services.</p>","PeriodicalId":12003,"journal":{"name":"Ethiopian Journal of Health Sciences","volume":"34 Spec Iss 1","pages":"3-10"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902830","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":"Clinical and Radiological Features of Perianal Fistula: An MRI-Based Study in Addis Ababa, Ethiopia.","authors":"Semira Abrar Issa, Tesfaye Kebede Legesse, Assefa Getachew Kebede, Alemayehu Bedane Worke, Ashenafi Aberra Buser","doi":"10.4314/ejhs.v34i1.6S","DOIUrl":"10.4314/ejhs.v34i1.6S","url":null,"abstract":"<p><strong>Background: </strong>Perianal fistula refers to an abnormal connection between the anal canal and the perianal skin or perineum. Magnetic Resonance Imaging (MRI) plays a crucial role in accurately characterizing perianal fistulas, which informs surgical strategies and helps minimize recurrence.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at a single diagnostic imaging center in Addis Ababa, utilizing retrospectively collected data from May 2023 to June 2024. All patients referred for suspected perianal fistulas were included. MRI scans were reviewed by a radiologist in body imaging fellowship and a body imaging subspecialist. Findings, along with sociodemographic data, were documented in a structured questionnaire and analyzed using SPSS.</p><p><strong>Results: </strong>The study encompassed 304 primary fistula tracts in 276 patients, with 233 (84.4%) being male. Complex fistulas were identified in 83 patients (30.1%), 43 (15.6%) had secondary extensions, and 64 (27.1%) presented with abscess collections. The most common type of fistula, according to the Parks classification, was intersphincteric, observed in 263 cases (86.5%). The St. James University Hospital grades 1 and 2 were predominant, representing 176 (57.9%) and 62 (20.4%) of the cases, respectively. A significant association was found between complex fistulas, higher Parks grades, and the total length of the fistula tract.</p><p><strong>Conclusion: </strong>This study elucidates MRI patterns of perianal fistulas, revealing that over one-third of patients had complex fistulas. This underscores the importance of preoperative MRI for effective surgical planning and reducing recurrence rates.</p>","PeriodicalId":12003,"journal":{"name":"Ethiopian Journal of Health Sciences","volume":"34 Spec Iss 1","pages":"31-38"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902805","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":"Management Outcome and Associated Factors of Necrotizing Soft Tissue Infections in an Ethiopian Tertiary Care Hospital: A-Five-Year Review.","authors":"Esubalew T Mindaye, Fitsum Terefe","doi":"10.4314/ejhs.v34i5.4","DOIUrl":"10.4314/ejhs.v34i5.4","url":null,"abstract":"<p><strong>Background: </strong>Necrotizing soft tissue infection (NSTI) is one of the deadliest diseases among surgical infections. Prompt timely diagnosis and urgent surgical intervention with supportive care are cornerstones of patient management. This study aimed to assess patient outcomes and associated factors of adult patients diagnosed and surgically treated for NSTIs at Saint Paul's Hospital Millennium Medical College (SPHMMC), Ethiopia from January 2015 to December 2019.</p><p><strong>Method: </strong>An institution-based cross-sectional study was conducted by reviewing medical records of patients treated for NSTIs at SPHMMC in the 5 years study period. A five-section survey instrument was developed, and the collected responses were cleaned and entered into Epi data (v3.1) and exported to SPSS (v.26). Statistical analysis of associated factors was done with binary logit regression model.</p><p><strong>Result: </strong>Medical records of 110(84%) patients were retrieved and nine out of ten subjects were male with a median age of 42 years (IQR- 34-62yrs) The leading clinical presentations were painful swelling 96(87.3%), fever 79(71.8%) and foul-smelling discharge 62(56.4%). Five out of ten participants have known comorbidity and 9 out of 10 patients have specified predisposing events before their infection. The majority (86.3%) underwent surgical debridement and amputation was done for eighteen patients. The average length of hospital stay was 27 days (2 to 112 days range) with mortality rate of 20%. advanced age, shock at presentation, post-operative anemia, and infection involving the torso were significantly associated with poor patient outcomes.</p><p><strong>Conclusion: </strong>Surgical management of NSTIs has favorable result and patient presentation and anatomical location of the lesion determine patient outcome.</p>","PeriodicalId":12003,"journal":{"name":"Ethiopian Journal of Health Sciences","volume":"34 5","pages":"365-372"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406440","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":"The Prolonged Hospital Stays at Nigerian Teaching Hospitals: Roles of Medical Social Workers.","authors":"Oluwagbemiga Oyinlola, Raimi Olalekan Adeleke, Abimbola Afolabi","doi":"10.4314/ejhs.v34i5.11","DOIUrl":"10.4314/ejhs.v34i5.11","url":null,"abstract":"<p><p>Prolonged hospital stays in Nigerian teaching hospitals pose a significant challenge to patient care and hospital management, exacerbated by socio-economic and systemic factors. This case study report looked at the multifaceted role of medical social workers in addressing these challenges, focusing on their efforts in providing psychosocial support, coordinating care, and advocating for patients within a strained healthcare system. This case-study highlights the impact of resource constraints and inadequate hospital practices on patient outcomes, emphasizing the psychological toll on patients and their families. It underscores the critical role of medical social workers as they navigate complex healthcare landscapes to mitigate the adverse effects of extended hospitalizations. This calls for a comprehensive approach to address these systemic issues, including policy reforms, increased healthcare funding, and strategic improvements in hospital administration. Hence the urgency of systemic change to ensure a more resilient and compassionate healthcare environment for all Nigerians.</p>","PeriodicalId":12003,"journal":{"name":"Ethiopian Journal of Health Sciences","volume":"34 5","pages":"421-424"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406446","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":"The Impact of Contrast Media on Lumbar Spine Bone Mineral Density Measured by Quantitative Computed Tomography.","authors":"Lahari R Shetty, Kaushik Nayak, Priyanka","doi":"10.4314/ejhs.v34i5.3","DOIUrl":"10.4314/ejhs.v34i5.3","url":null,"abstract":"<p><strong>Background: </strong>Osteoporosis is a bone disease caused by decrease in bone mineral density (BMD). Quantitative computed tomography (QCT) has proven to be an effective tool to measure the BMD of the lumbar spine. Therefore, the objective of the study is to investigate the impact of intravenous contrast media (CM) on BMD of lumbar spine measured by QCT.</p><p><strong>Methods: </strong>This is a prospective study and included a total of 141 patients (females: 71, males: 70) referred for contrast enhanced computed tomography (CECT) abdomen. First, the plain scan of abdomen was done. Contrast media was injected intravenously followed by acquisition of arterial and portovenous phase (PV) of abdomen. Plain, arterial and PV phases axial CT images were loaded on Philips BMD analysis application. A circular region of interest (ROI) measuring 30-40 mm² was placed at all five lumbar vertebrae (L1-L5) and value of BMD was obtained in mg/cm³.</p><p><strong>Results: </strong>Paired t-test was used to compare BMD in plain, arterial and PV phase. There was significant difference (p <0.05) in BMD (L1-L5) between plain (110.86±36.61 mg/cm³), arterial (117.04±37.95 mg/cm³) and PV phase (127.52±40.9 mg/cm³). The study also noted significant difference between males and females in BMD of lumbar spine (L1-L5) for plain and CECT abdomen (p <0.05).</p><p><strong>Conclusion: </strong>The BMD was highest for PV phase of the CECT abdomen. Therefore, the study concludes that BMD values are highly influenced by intravenous contrast media injections.</p>","PeriodicalId":12003,"journal":{"name":"Ethiopian Journal of Health Sciences","volume":"34 5","pages":"359-364"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406443","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":"Long-term Clinical Outcomes of Posterior Spinal Stabilization Using Adeolu's Technique: A Prospective Study from Nigeria.","authors":"T B Rabiu","doi":"10.4314/ejhs.v34i5.9","DOIUrl":"10.4314/ejhs.v34i5.9","url":null,"abstract":"<p><strong>Background: </strong>Due to resource constraints, advanced spinal stabilization methods such as pedicle screws are unavailable at our center. Adeolu's technique, which employs low-cost and readily available vertical struts and spinal process wires, has been used as an adjunct in treating various spinal conditions to achieve rigid spinal constructs. This study evaluates the long-term clinical outcomes of this technique.</p><p><strong>Methods: </strong>Nineteen patients treated with Adeolu's technique were prospectively followed to assess clinical outcomes. Primary outcomes included symptom reduction, absence of adverse events or need for re-intervention, and radiological evidence of stabilization and unrestricted mobilization. Secondary outcomes included back pain intensity, implant-related complications (rotation, migration, back-out, fracture), wound infection, worsening neurological status, and need for implant removal Data were analyzed using SPSS with simple descriptive statistics.</p><p><strong>Results: </strong>The average follow-up period was 4.1 years (Range: 0.1 - 9.0 years). Patients' ages ranged from 20 to 81 years (Mean: 48.5). Indications for surgery included lumbar spondylosis (7, 36.8%), spinal trauma with unstable fractures (4, 21.1%), spinal tumors (4, 21.1%), and Pott's disease (4, 21.1%). All patients achieved satisfactory primary outcomes. Implant rotation was observed in 4 patients (21.1%), and implant migration in 1 patient (5.3%), requiring removal. Superficial surgical site infection occurred in 2 patients (10.5%). No implant fractures, deep infections, or worsening neurological status were noted.</p><p><strong>Conclusion: </strong>Adeolu's technique is effective for a range of spinal pathologies, with favorable long-term clinical outcomes.</p>","PeriodicalId":12003,"journal":{"name":"Ethiopian Journal of Health Sciences","volume":"34 5","pages":"407-412"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406437","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":"\"<i>We want to know the cause of neonate's death to prevent similar incident in the future</i> …\": A Formative Study to Introduce Minimally Invasive Tissue Sampling Procedure at Community Level in Butajira.","authors":"Mirgissa Kaba, Kalkidan Solomon, Tesfamichael Awoke, Tewodros Yalew, Amha Mekasha, Lulu Muhe","doi":"10.4314/ejhs.v34i5.2","DOIUrl":"10.4314/ejhs.v34i5.2","url":null,"abstract":"<p><strong>Background: </strong>Diagnostic autopsy has been in use for long to determine the cause of death. Since recently however 'Minimally Invasive Tissue Sampling' (MITS) is introduced to determine definitive cause of neonatal death. This study describes locally established facilitators to introduce MITS procedures to determine cause of neonatal death in Ethiopia.</p><p><strong>Methods: </strong>Exploratory study was conducted in Butajira community where twenty-two key informants representing community opinion leaders' health care workers, five in depth interviews with parents who recently lost neonates and eight FGDs with community members were completed to generate evidences in line with the research question. Interviews and discussions were audio recorded, transcribed verbatim and analysed facilitated by open-code software. Thematic analysis was applied to identify and interpret patterns of the evidences.</p><p><strong>Results: </strong>In Butajira, ANC and delivery in health facilities was found to have improved over the years. Yet, child death remains an outstanding problem. While different factors were identified to cause the death of a child, relatively few participants choose to accept newborn death as a natural occurrence or will of the creator. Majority of the study participants expressed interest to know definitive cause of death using MITS. Yet, awareness about MITS and how it works was unanimously desired. It was found that husbands and wives are key to authorize MITS procedure while community opinion leaders including religious leaders were identified as key to influence parental decisions for the procedure.</p><p><strong>Conclusion: </strong>Building awareness of the community members and engagement of opinion leaders is critical to introduce MITS.</p>","PeriodicalId":12003,"journal":{"name":"Ethiopian Journal of Health Sciences","volume":"34 5","pages":"351-358"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406406","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":"Urology Training in sub-Saharan Africa: A Survey of Training Directors.","authors":"Anteneh Tadesse Kifle, Saleh Abdelkerim Nedjim, Ziba Ouima Justin Dieudonne, Kaleab Habtemichael Gebreselassie, Marcella Derboise Christelle Biyouma, Rachid Aboutaieb, Mahamat Ali Mahamat, Emmanuel Ugbede Oyibo, Nathnael Abera Woldehana, Chandra Shekhar Biyani","doi":"10.4314/ejhs.v34i5.8","DOIUrl":"10.4314/ejhs.v34i5.8","url":null,"abstract":"<p><strong>Background: </strong>Urology is one of the most rapidly evolving and technologically advanced surgical specialties. However, training programs in Sub-Saharan Africa (SSA) face unique challenges. This study aimed to assess the current status of urology training in SSA and identify areas for improvement, providing crucial insights into the strengths and limitations of these programs.</p><p><strong>Methods: </strong>A 24-discrete items online survey was developed with \"Google Forms\" in English and French. The questionnaire was composed of two parts. The first part assessed general information about the urology training, and the second part evaluated the consultant's or department head's ability to perform and teach endourology procedures.</p><p><strong>Result: </strong>A total of 25 responses were received from 18 countries. The oldest training center is the University of Cape Town, South Africa; the program started in 1950. The number of consultants in the department ranges from 1 to 12, with an average of 4.79. Twenty of the training sites have a compulsory general surgery clinical attachment in their program. Fourteen of the training sites stated that research is mandatory in their curriculum. Fourteen of the centers reported providing laparoscopic urology surgery. Cystoscopy is the most mastered procedure and percutaneous nephrolithotomy (PCNL) is the most difficult procedure to gain any experience with by residents.</p><p><strong>Conclusion: </strong>Urology training in sub-Saharan Africa started late but is increasing in number through time. Urology training in Africa faces multiple challenges, including inadequate number of experts, limited availability of advanced equipment and simulation-based training sites. Training institutions should be encouraged to facilitate research and basic urological skills training.</p>","PeriodicalId":12003,"journal":{"name":"Ethiopian Journal of Health Sciences","volume":"34 5","pages":"397-406"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406428","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}