HAND最新文献

{"title":"A Readability Study of Carpal Tunnel Release in 2023.","authors":"Ankur Kayastha, Kirthika Lakshmanan, Michael J Valentine, Hunter D Kramer, James Kim, Nicholas Pettinelli, Robert C Kramer","doi":"10.1177/15589447241232095","DOIUrl":"10.1177/15589447241232095","url":null,"abstract":"<p><strong>Background: </strong>The National Institutes of Health (NIH) and the American Medical Association (AMA) recommend a sixth-grade reading level for patient-directed content. This study aims to quantitatively evaluate the readability of online information sources related to carpal tunnel surgery using established readability indices.</p><p><strong>Methods: </strong>Web searches for \"carpal tunnel release\" and \"carpal tunnel decompression surgery\" queries were performed using Google, and the first 20 websites were identified per query. WebFX online software tools were utilized to determine readability. Indices included Flesch Kincaid Reading Ease, Flesch Kincaid Grade Level, Coleman Liau Index, Automated Readability Index, Gunning Fog Score, and the Simple Measure of Gobbledygook Index. Health-specific clickthrough rate (CTR) data were used in order to select the first 20 search engine results page from each query.</p><p><strong>Results: </strong>\"Carpal tunnel release\" had a mean readability of 8.46, and \"carpal tunnel decompression surgery\" had a mean readability of 8.70. The range of mean readability scores among the indices used for both search queries was 6.17 to 14.0. The total mean readability for carpal tunnel surgery information was found to be 8.58. This corresponds to approximately a ninth-grade reading level in the United States.</p><p><strong>Conclusion: </strong>The average readability of carpal tunnel surgery online content is three grade levels above the recommended sixth-grade level for patient-directed materials. This discrepancy indicates that existing online materials related to carpal tunnel surgery are more difficult to understand than the standards set by NIH and AMA.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"562-571"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982814","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":"Interspecialty Variation in Perioperative Health Care Resource Usage for Carpal Tunnel Release.","authors":"Azeem Tariq Malik, James S Lin, Sonu Jain, Hisham Awan, Safdar N Khan, Kanu S Goyal","doi":"10.1177/15589447241233710","DOIUrl":"10.1177/15589447241233710","url":null,"abstract":"<p><strong>Background: </strong>We investigated whether any interspecialty variation exists, regarding perioperative health care resource usage, in carpal tunnel releases (CTRs).</p><p><strong>Methods: </strong>The 2010 to 2021 PearlDiver Mariner Database, an all-payer claims database, was queried to identify patients undergoing primary CTRs. Physician specialty IDs were used to identify the specialty of the surgeon-orthopedic versus plastic versus general surgery versus neurosurgery. Multivariate logistic regression analysis was used to identify whether there was any interspecialty variation between the use of health care resources.</p><p><strong>Results: </strong>A total of 908 671 patients undergoing CTRs were included, of which 556 339 (61.2%) were by orthopedic surgeons, 297 047 (32.7%) by plastic surgeons, 44 118 (4.9%) by neurosurgeons, and 11 257 (1.2%) by general surgeons. In comparison with orthopedic surgeons, patients treated by plastic surgeons were less likely to have received opioids, nonsteroidal anti-inflammatory drugs, oral steroids, and preoperative antibiotic prophylaxis but were more likely to have received steroid injections and electrodiagnostic studies (EDSs) preoperatively. Patients treated by neurosurgeons were more likely to have received preoperative opioids, gabapentin, oral steroids, preoperative antibiotic prophylaxis, EDSs, and formal preoperative physical/occupational therapy and less likely to have received steroid injections. Patients treated by general surgeons were less likely to receive oral steroids, steroid injections, EDSs, preoperative formal physical therapy, and preoperative antibiotic prophylaxis, but were more likely to be prescribed gabapentin.</p><p><strong>Conclusions: </strong>There exists significant variation in perioperative health care resource usage for CTRs between specialties. Understanding reasons behind such variation would be paramount in minimizing differences in how care is practiced for elective hand procedures.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"555-561"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989804","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":"Greening Hand Surgery: Targeted Measures to Reduce Waste in Ambulatory Trigger Finger and Carpal Tunnel Decompression.","authors":"Ruth Tevlin, Jasmine A Panton, Paige M Fox","doi":"10.1177/15589447231220412","DOIUrl":"10.1177/15589447231220412","url":null,"abstract":"<p><strong>Background: </strong>Operating rooms (ORs) produce approximately 70% of hospital waste. Greening strategies in the OR aim to reduce the environmental impact of surgery while maintaining patient safety and outcomes. The aim of this study was to strategically reduce waste and cost associated with common ambulatory hand procedures by implementing a 3-stage \"green case\" plan over a 1-year period in a high-volume tertiary referral hand surgery division.</p><p><strong>Methods: </strong>A 3-stage greening initiative for hand surgery was designed and implemented in ambulatory open carpal tunnel release (CTR) and trigger finger release (TFR) cases, including: (1) introduction of minor field sterility; (2) implementation of a lean and green minor hand surgery pack and reduced instrument set; and (3) elimination of gown use by surgeons and OR staff. Surgical supply usage and costs were tracked during the study period and compared with control.</p><p><strong>Results: </strong>Each \"green case\" resulted in savings of $105 compared with the control cases from the preceding year, excluding cost savings associated with reduced waste processing. There was a 64% and 75% reduction in waste and costs after greening, respectively. This equates to a minimum institutional annual savings of $51 000 when used for CTR and TFR. There was no observed increase in surgical site infections or complications after the introduction of greening.</p><p><strong>Conclusion: </strong>Greening initiatives can be successfully implemented by surgeons to reduce waste and costs. With targeted greening of CTR and TFR procedures, we significantly reduced waste and decreased costs while maintaining patient safety and outcomes.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"634-641"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073930","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":"Volar Wrist Arthroscopy Portals Using the NanoScope Are Safer Than Traditional Arthroscopy.","authors":"Lauren E Dittman, Nicholas Munaretto, Katharine Hinchcliff, Lauren Dutton, Sanjeev Kakar","doi":"10.1177/15589447231221168","DOIUrl":"10.1177/15589447231221168","url":null,"abstract":"<p><strong>Background: </strong>The NanoScope, given its smaller size, may be further from critical structures when establishing volar wrist arthroscopy portals compared to the traditional 2.7-mm arthroscope.</p><p><strong>Methods: </strong>Ten fresh-frozen latex-injected cadaver specimens were utilized. The volar radial (VR) and volar ulnar (VU) portals were created using an inside-out approach. The volar radial midcarpal (VR-MC) and volar ulnar midcarpal (VU-MC) portals were created using an inside-out approach. The arm was then dissected under 3.5-mm loupe magnification. Digital calipers were used to measure the distance between the portals and the surrounding anatomic structures by two fellowship-trained hand surgeons.</p><p><strong>Results: </strong>The median nerve was on average 1.6, 7.2, 1.8, and 5.6 mm away from the trochar for the VR, VU, VR-MC, and VU-MC, respectively. The median nerve fascia was pierced by the VR portal in one specimen. The radial artery, ulnar artery, and ulnar nerve were not pierced in any specimen. Compared to historical controls, for the VR-MC portal, the NanoScope was further from all critical structures, aside from the radial artery, and did not pierce any neurovascular structures. For the VU-MC portal, the NanoScope was further from the ulnar artery and median nerve and did not pierce any neurovascular structures.</p><p><strong>Conclusion: </strong>In developing volar portals, after placing the cannula through the volar capsule from an inside-out approach, we recommend making a volar incision and dissecting the local anatomic structures to guard against injury. Compared to historical controls, the NanoScope was typically further from neurovascular structures.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"602-606"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139485381","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":"Trigger Finger Release Using Wide-Awake Local Anesthesia No Tourniquet Versus Local Anesthesia With a Tourniquet: A Systematic Review and Meta-analysis.","authors":"Tal Levit, Declan C T Lavoie, Emily Dunn, Lucas Gallo, Achilles Thoma","doi":"10.1177/15589447231222517","DOIUrl":"10.1177/15589447231222517","url":null,"abstract":"<p><p>Trigger finger release (TFR) is a common hand surgery, historically performed using a tourniquet. Recently, wide-awake local anesthesia no tourniquet (WALANT) has gained popularity due to ostensible advantages such as improved patient pain, satisfaction, lower rate of complications, and decreased cost. This systematic review compares outcomes of WALANT for TFR with local anesthesia with a tourniquet (LAWT). MEDLINE, Embase, CINAHL, Web of Science, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched. All English-language peer-reviewed randomized and observational studies assessing TFR in adults were included. Quality of evidence was assessed with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Eleven studies (4 randomized controlled trials, 7 observational) including 1233 patients were identified. In the WALANT group, pain on injection was statistically nonsignificantly lower (mean difference [MD]: -1.69 points, 95% confidence interval [CI] = -4.14 to 0.76, <i>P</i> = .18) and postoperative pain was statistically lower in 2 studies. Patient and physician satisfaction were higher and analgesic use was lower in WALANT. There were no significant differences between groups for functional outcomes or rates of adverse events. Preoperative time was longer (MD: 26.43 minutes, 95% CI = 15.36 to 37.51, <i>P</i> < .01), operative time similar (MD: -0.59 minutes, 95% CI = -2.37 to 1.20, <i>P</i> = .52), postoperative time shorter (MD: -27.72 minutes, 95% CI = -36.95 to -18.48, <i>P</i> < .01), and cost lower (MD: -52.2%, 95% CI = -79.9% to -24.5%) in WALANT versus LAWT. The GRADE certainty of evidence of these results ranges from very low to low. This systematic review does not confirm superiority of WALANT over LAWT for TFR due to moderate to high risk of bias of included studies; further robust trials must be conducted.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"533-541"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139502353","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":"Social Media Posts About Carpal Tunnel Release: A Cross-Sectional Analysis of Patient and Surgeon Perspectives.","authors":"Christopher A Reynolds, Manish P Mehta, Scott Wu, Alexander J Neuville, Alisha Ho, Chirag M Shah","doi":"10.1177/15589447241231293","DOIUrl":"10.1177/15589447241231293","url":null,"abstract":"<p><strong>Background: </strong>Social media provides an increasingly popular, unfiltered source of perspectives on healthcare. The objective of this study is to characterize the landscape of social media posts regarding carpal tunnel release (CTR).</p><p><strong>Methods: </strong>Content was queried from Instagram between February 2, 2019 to August 12, 2021 using the hashtags #carpaltunnelrelease and #carpaltunnelsurgery. The 1500 most-liked posts were analyzed. Poster demographics including age, gender, region, and symptom qualities and post characteristics including type, number, timing relative to surgery, tone, and satisfaction were collected. Categorical variables were compared utilizing chi-squared test. Univariate and multivariate regression were performed.</p><p><strong>Results: </strong>The most popular post types included single photo (55.2%), multiple photos (18.8%), or single video (18.2%). Of all, 70.6% posts had fewer than 50 \"likes.\" Patients accounted for 51.8% of posts, followed by surgeons (13.3%), other health care providers (11.7%), and physical therapists (8.8%). Women (66.7%) outnumbered men (33.3%). Fifty-five percent of posts were domestic. Posts mostly depicted postoperative care (85.6%). The most frequently mentioned symptoms were pain, burning, numbness, and tingling. Of all posts, 45.1% had a positive tone, 49.1% neutral, and 5.7% negative. Univariate analysis revealed that posters who were patients, underwent open CTR, and were female were more likely to post negative sentiments.</p><p><strong>Conclusions: </strong>Most posts regarding CTR are from patients, are postoperative, and are positive or neutral. Although rare, negative posts were more likely to originate from posters who are patients, female, or underwent open CTR. With this information, surgeons will be better prepared to address patient concerns, set patient expectations, and enter the social media themselves.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"572-578"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139930876","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":"Individual Joint Distractions Using Ilizarov Mini-Fixator Device for Chronic Simultaneous Dislocation of the Distal and Proximal Interphalangeal Joints in the Same Finger.","authors":"Satoshi Usami, Kentaro Sonoki, Sanshiro Kawahara","doi":"10.1177/15589447241279598","DOIUrl":"10.1177/15589447241279598","url":null,"abstract":"<p><p>Simultaneous dislocation of the distal and proximal interphalangeal joints is an uncommon injury. Treating chronic cases proves challenging due to severe contractures affecting both joints and surrounding soft tissues. Here, we report an unusual chronic contracture case in a 46-year-old man who suffered a dorsal dislocation of the distal and proximal interphalangeal joints of the little finger. The patient underwent primary joint distraction followed by open reduction, leading to stable radiographic restoration and a functional range of motion in the affected finger 6 months postoperatively. Joint distraction was a reliable approach for the treatment of chronic joint dislocation with severe soft tissue contracture, especially for multiple joint contractures. In addition, the Ilizarov mini-fixator device was effective in enabling individualized traction on both the distal and proximal interphalangeal joints.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"NP1-NP4"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285858","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":"Comparison Between Surgical Techniques for Correction of Congenital Syndactyly: A Systematic Review and Meta Analysis.","authors":"João Matheus Schirlo, André Saad Cleto, Danilo Beltrame, Mayara Beltrame, Thais Scortegagna, Camila Marinelli Martins","doi":"10.1177/15589447241279456","DOIUrl":"10.1177/15589447241279456","url":null,"abstract":"<p><p>This review aimed to assess which surgical technique has better outcomes to correct one of the most common congenital anomalies of the upper limb: syndactyly. The following databases were used in the search: PubMed, Embase, Cochrane (CENTRAL), LILACS, SciELO, Scopus and Web of Science, on October 27, 2022. Studies that described a surgical technique for correcting syndactyly and evaluated surgical complications were included. Studies about noncongenital or foot syndactyly were excluded. The risk of bias was assessed using a specific method for case reports. For synthesis of results, the characteristics of the studies and techniques were demonstrated by a qualitative analysis. Meta-analysis models were applied for complications, functionality, and aesthetic. Seventy-three studies were included, of which 70 were series or case reports, 27 studies did not use skin grafts, and 7 studies used external fixators. To evaluate functional results, 42 studies used only the surgeon's opinion. Meta-analyses showed a higher incidence of scar defects when using skin grafts and of infection when using external fixators. There was no difference for web creep and readmission. Few studies evaluated results using the VSS scale, showing worse scar pigmentation when skin grafts were used, but there was no difference in other parameters (PROSPERO CRD42022368930).</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"523-532"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285854","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":"Rupture of the Fibro-Osseous Septum of the Second Extensor Compartment as the Cause of True Dorsal Trigger Wrist: Case Report.","authors":"Fernando Holc, Pedro Bronenberg Victorica, Mariano O Abrego, Guillermo Azulay, Gerardo L Gallucci, Jorge G Boretto","doi":"10.1177/15589447241284303","DOIUrl":"10.1177/15589447241284303","url":null,"abstract":"<p><p>This article presents a case of a dorsal trigger wrist, which was brought on by a rupture of the fibro-osseous septum of the second extensor compartment. This situation is highly uncommon and has not been previously documented. The septum, which divides the extensor carpi radialis brevis and the extensor carpi radialis longus on the second extensor compartment, is present in almost 45% of the population. The patient underwent surgical reconstruction of the septum, and a complete resolution of symptoms was achieved.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"NP5-NP9"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345534","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":"Extensor Mechanism Damage With Proximal Phalanx Antegrade Intramedullary Screws: A Cadaveric Study.","authors":"Nadiya Yerich, Thomas Lynch, Daniel D Homeier, Candace Metcalfe, Jennifer A Achay, David Wilson, Casey Sabbag","doi":"10.1177/15589447251339502","DOIUrl":"10.1177/15589447251339502","url":null,"abstract":"<p><strong>Background: </strong>Antegrade intramedullary screw instrumentation for treatment of proximal phalangeal fractures has become increasingly common. To date, there has been little investigation describing and quantifying extensor mechanism damage incurred with this treatment option.</p><p><strong>Methods: </strong>Thirty-two fresh cadaveric proximal phalanges (thumbs excluded) underwent percutaneous antegrade screw insertion. Radial-based and ulnar-based intramedullary screws were inserted per phalange, and the sagittal band and/or extensor tendon defect were evaluated. The mean sagittal band violation was measured and calculated as a percentage violation of the whole structure. Measurements were then stratified by finger.</p><p><strong>Results: </strong>The mean radial-sided defect of the sagittal band by length was 11.6% (SD = 8.5%), compared with ulnar-sided defect (12.9%, SD = 7.4%). Across all digits, the mean percentage of total sagittal band disruption was 13.0%. There was a trend toward more sagittal band disruption in the ring finger relative to other fingers. While 3 of the 32 phalange defects were observed in the extensor tendon rather than the sagittal band, no extensor tendon defects exceeded 25% the width of the tendon after screw insertion. There was also no induced subluxation or dislocation of the extensor tendon through passive manipulation of all of the cadaveric specimens.</p><p><strong>Conclusions: </strong>Our study found less than 50% sagittal band disruption with antegrade intramedullary screw insertion into all 32 cadaveric proximal phalanges. Antegrade intramedullary screw fixation of proximal phalangeal fractures can be performed using percutaneous approaches without significant disruption to the extensor mechanism.</p>","PeriodicalId":12902,"journal":{"name":"HAND","volume":" ","pages":"15589447251339502"},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142398","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}