Katalin Fogarasi , Gábor Simon , Attila Gátos , Gábor Gyenes , Péter Gergely , Zoltán Patonai
{"title":"Head or skull injury? Consequences of using mistranslated ICD diagnosis category: Multicenter, blinded, randomized controlled analysis","authors":"Katalin Fogarasi , Gábor Simon , Attila Gátos , Gábor Gyenes , Péter Gergely , Zoltán Patonai","doi":"10.1016/j.jflm.2025.102815","DOIUrl":"10.1016/j.jflm.2025.102815","url":null,"abstract":"<div><div>Emergency care units in Hungary treat approximately 140–180 thousand head injuries of varying se'verity each year. These head injuries are mainly caused by traffic accidents, assaults, or domestic accidents. The outpatient care record contains details about the circumstances and underlying mechanisms of the head injury, the results of physical and imaging examinations, and therapeutic recommendations. The record also contains standardized codes for the diagnoses and the interventions performed, using the BNO (Betegségek Nemzetközi Osztályozása) classification, the Hungarian version of the international diagnostic classification system ICD (International Classification of Diseases). These records are important for financial reasons and for statistical purposes. The injury diagnoses consist of the ICD codes with the related diagnostic categories and in most cases also the corresponding Latin diagnoses describing the injuries sustained. The ICD categories often appear as Hungarian translations of the Latin diagnoses in the detailed Medical Diagnostic Reports on Injuries (MDRI). In Hungary, MDRI reports are prepared by physicians at the request of criminal prosecutors for forensic evaluation. In practice, however, MDRIs are usually based on the primary outpatient records. Head injuries are diagnosed using the codes in ICD Chapter 19, S00-S09. Translation errors may occur when ICD is adapted for different languages, resulting in different applications of certain diagnostic codes.</div><div>The present study investigates the use and frequency of the ICD-10 code S07.1 in Hungarian MDRIs issued for forensic evaluation. The results of our study show that, due to an inaccurate translation, superficial head injuries (specifically, bruises) are incorrectly coded in Hungary with S07.1, which in ICD-10 is reserved for severe head injuries (crushing injury of the skull).</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"110 ","pages":"Article 102815"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Challenges and considerations in forensic entomology: A comprehensive review","authors":"Sarika Bansode , Abhay Morajkar , Vinod Ragade , Vitthal More , Kiran Kharat","doi":"10.1016/j.jflm.2025.102831","DOIUrl":"10.1016/j.jflm.2025.102831","url":null,"abstract":"<div><div>Forensic entomology is the study of insect biology as it relates to societal problems that come to the attention of the legal profession and that often must be resolved by legal proceedings. These problems come under the purview of medico-criminal entomology. Forensic entomology is the study of arthropods, especially insects, their identification, post-mortem intervals (PMI), crime scene details associated with crimes and other aspects of the courts and judicial system. Understanding the predictable succession patterns of Diptera and Coleoptera on decomposing remains is crucial for accurately determining the post-mortem interval in forensic investigations. Beetles and blowflies play a critical role in the decomposition process, with beetles often appearing later and blowflies swiftly colonizing remains, making both essential for accurately estimating the post-mortem interval and understanding decomposition dynamics. Insects, particularly flies, serve as crucial forensic tools, allowing for detecting drugs, poisons, and other substances long after traditional tissue samples degrade. Their ability to retain and reveal evidence, even in severely decomposed or altered remains, significantly enhances the accuracy of criminal investigations. Recent advancements in forensic entomology, such as integrating infrared spectroscopy, omics technologies, and molecular taxonomy, have significantly improved the precision and scope of forensic investigations. These tools, combined with thorough validation processes, enable forensic scientists to identify species, estimate post-mortem intervals, and interpret complex cases with greater accuracy and reliability. However, challenges such as environmental influences, insect behavior, body concealment, faunal succession limitations, and gaps in knowledge and resources present obstacles to accuracy and standardization. This review summarises key insect species involved in crime Investigation, PMI Intervals and their significance, Recent advances, Challenges and limitations so that entomotoxicologists can analyze challenging cases recovered after a long period this review also analyses the scope of entomotoxicology in the area of death investigations.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"110 ","pages":"Article 102831"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Postmortem redistribution of carbofuran and benzofuranol in rats determined using solid phase extraction by HPLC-MS/MS","authors":"Zhang Wen-ji","doi":"10.1016/j.jflm.2025.102812","DOIUrl":"10.1016/j.jflm.2025.102812","url":null,"abstract":"<div><div>Carbofuran has been implicated in many homicide and suicide cases worldwide. We investigated the postmortem redistribution of carbofuran and its main metabolite benzofuranol using the rat model. Carbofuran (50 mg/kg) was intragastric administrated, followed by euthanasia 1 h post injection. Tissues including cardiac blood, lung, liver, kidney, spleen, brain, myocardium, and thigh muscle were collected at different postmortem intervals (0, 12, 24, 48, 72, and 96 h). The samples were extracted using solid phase extraction cartridges filled with self-prepared multi-wall carbon nanotubes based molecular imprinting polymers, and analyzed using validated liquid chromatography tandem mass spectrometry method. The concentrations of carbofuran and benzofuranol were found both influenced by postmortem redistribution and postmortem degradation throughout the postmortem period. The carbofuran concentration increased in cardiac blood, liver and kidney, but decreased in lung, while benzofuranol concentration increased in cardiac blood, liver, spleen, and kidney. The benzofuranol in cardiac blood and liver is more prominent than carbofuran after 80 h after death, which implies that benzofuranol could be regarded as an alternative marker in carbofuran poisoning cases for the corpse died for a long time when carbofuran could hardly be detected. These findings provide a valuable aiding information when determining the cause of death of carbofuran poisoning.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"110 ","pages":"Article 102812"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ikram Kort , Khaled Bchir , Mohamed Belleli , Ons Hmandi , Syrine Mannoubi , Mohamed Allouche
{"title":"Complex versus simple suicides in Northern Tunisia: A 17 years autopsy-based study","authors":"Ikram Kort , Khaled Bchir , Mohamed Belleli , Ons Hmandi , Syrine Mannoubi , Mohamed Allouche","doi":"10.1016/j.jflm.2025.102827","DOIUrl":"10.1016/j.jflm.2025.102827","url":null,"abstract":"<div><h3>Background</h3><div>Complex suicide, whether planned or unplanned, presents significant challenges for forensic specialists and judicial authorities. Although rare, each case requires a thorough examination of both the body and the scene of death.</div><div>This study aims to analyze the pattern of complex suicide victims in northern Tunisia, comparing them with simple suicide cases.</div></div><div><h3>Methods</h3><div>This was a retrospective observational study with retrospective data collection. We included all cases of simple and complex suicides, autopsied at the Department of Legal Medicine of Tunis, from 2005 to 2021.</div></div><div><h3>Results</h3><div>In total, 72 complex suicides (3.3 % of 2153 suicide fatalities) were identified, with 35 planned and 37 unplanned complex suicides. Males represented 77.8 % of the cases and their mean age was 42.2 ± 15 years. A history of mental illness was reported in 31.9 %. Two suicide methods were used in 93.1 % of cases. The most frequent combination was poisoning and hanging (29.2 %), followed by drowning and falling from a height (12.5 %). The most common single methods were hanging (48.6 %), poisoning (55.6 %), sharp force (31.9 %), and fall from a height (25.0 %). The latter three methods were significantly higher than simple suicides (p < 0.001).</div></div><div><h3>Conclusions</h3><div>Complex suicide is infrequent and presents significant investigative challenges. A detailed analysis of the victim's background, an on-site inspection of the scene, reconstruction of the events, and a complete autopsy are essential to determine the cause and manner of death.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"110 ","pages":"Article 102827"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vanita Parekh , Anna Brkic , Janine McMinn , David Williams , Caleb Boxx , Laura Bailey , Jane Van Diemen
{"title":"Informing therapeutic care and legal process in assault cases involving non-fatal strangulation","authors":"Vanita Parekh , Anna Brkic , Janine McMinn , David Williams , Caleb Boxx , Laura Bailey , Jane Van Diemen","doi":"10.1016/j.jflm.2025.102826","DOIUrl":"10.1016/j.jflm.2025.102826","url":null,"abstract":"<div><h3>Background</h3><div>Non-fatal strangulation (NFS) is a major risk factor for female homicide. Victims may present in a variety of clinical settings. In this study, we analysed reported signs, symptoms and injuries following NFS.</div></div><div><h3>Methods</h3><div>This is a clinical audit of 170 NFS victims who underwent a documented clinical examination, including forensic photography.</div></div><div><h3>Results</h3><div>Patients reported neck pain (77.6 %), an inability to breathe (60 %), headache (55.9 %), sore throat (52.9 %) and voice changes (47.1 %). In 76.5 % neck injuries were detected comprising non-petechial bruising (59.2 %), linear abrasions (scratch marks) (25.4 %), neck swelling (12.3 %), petechial haemorrhage (7.7 %) and ligature marks (1.5 %) with no detectable neck injury in 23.5 % of cases. There was no typical patient profile of NFS signs, symptoms or injuries or correlation of any signs, despite extensive interrogation by statistical analyses.</div></div><div><h3>Conclusions</h3><div>To assist with therapeutic care and forensic evidence collection following NFS, signs, symptoms and injuries should be documented. A lack of detectable injury to the neck following NFS does not exclude NFS. In addition, detectable injury may indicate a defensive response by the patient and/or multiple applications of force.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"110 ","pages":"Article 102826"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Establishing the truth in deaths in custody: From an analysis of the Italian context to prospects for quality improvement in forensic pathology","authors":"Donato Morena , Cecilia Lugi , Matteo Scopetti , Martina Padovano , Emanuela Turillazzi , Raffaella Rinaldi , Paola Frati , Vittorio Fineschi","doi":"10.1016/j.jflm.2025.102830","DOIUrl":"10.1016/j.jflm.2025.102830","url":null,"abstract":"<div><div>Attention to cases of death in custody and their prevention is an issue of increasing concern. However, the available epidemiological data on these events remain scarce and uncertain, hindering a comprehensive understanding of the issue and the effective implementation of intervention strategies. After reviewing the definition of death in custody and international legislation regarding systematic approaches to forensic investigations, our study aimed to analyze the available data within the Italian context and compare it with international findings. We discussed the emerging critical points to identify potential solutions. Epidemiological data from registers, reports, and individual international studies were extracted and analyzed. A statistical comparison was conducted for data obtained from the records of the Italian Department of Penitentiary Administration for the period 1992–2021. A significant and moderate correlation emerged between the average incarcerated population per year and the number of deaths due to natural causes (r = 0.459, p = 0.005), while no significant correlation emerged between the first and the number of deaths due to suicide (r = 0.294, p = 0.058). In addition, no significant correlations emerged between the overcrowding index and the number of deaths due to natural causes or suicide (respectively, p = 0.703 and p = 0.056). Furthermore, a concerning discrepancy emerged between national and international data regarding the causes of death in custody, especially for suicides, along with a lack of in-depth and certain data. The relevance of the issue sets the necessity of a reflection on the need for changes at multiple levels. From a legislative perspective, it is proposed to establish a forensic investigation for all deaths in custody. Such a function could be assumed by specialized university centers, independent of other institutions, capable of ensuring training, research, high quality, and timely delivery of results. The implementation of protocols and procedures, along with the recording of easily accessible data, could ultimately ensure the safety of results and transparency, triggering a socially beneficial virtuous cycle.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"110 ","pages":"Article 102830"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Uterine leiomyosarcoma as a rare cause of fatal retroperitoneal haemorrhage due to compression and rupture of the renal vein","authors":"Giorgia Lodetti , Stefano Tambuzzi , Salvatore Andreola, Guendalina Gentile, Riccardo Zoja","doi":"10.1016/j.jflm.2025.102804","DOIUrl":"10.1016/j.jflm.2025.102804","url":null,"abstract":"<div><div>Abnormal uterine bleeding (AUB) can be caused by uterine tumors, both benign and malignant, although they rarely lead to fatal vascular complications. We present a case of a woman found dead in her home, in which the autopsy highlighted a massive retroperitoneal haemorrhage extending to the left renal lodge and a voluminous uterine tumor of stony consistency and exophytic growth weighing 2250g. The histopathological examination identified the mass as a leiomyosarcoma and demonstrated the presence of a dilation with rupture of the left renal vein, in the absence of neoplastic cells infiltrating the vascular wall.</div><div>On these findings, it was concluded that the neoplastic mass had caused external compression of the left renal vein, leading to its rupture and to a fatal retroperitoneal haemorrhage. The case was considered of interest as it involved a peculiar etiopathogenetic mechanism causing a lethal complication from uterine leiomyosarcoma which has not yet been reported in the literature.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"110 ","pages":"Article 102804"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Roy Amritha, P. Parvana, K.S. Riza, Isukapatla Arjun Rao
{"title":"Psychological autopsy: Overview of equivocal deaths, suicides and homicide-suicides","authors":"Roy Amritha, P. Parvana, K.S. Riza, Isukapatla Arjun Rao","doi":"10.1016/j.jflm.2025.102813","DOIUrl":"10.1016/j.jflm.2025.102813","url":null,"abstract":"<div><div>Psychological autopsy studies are a method to understand the causes of equivocal deaths. Suicides and homicide-suicide are the result of various events. The understanding of an individual's life before their death, by interviewing the next of kin, provides some insight into the causes. The research articles dealing with psychological autopsy studies through case studies of suicide or homicide-suicide instances, obtained from different search engines, shed light on the mental health, Alcohol use disorder (AUD), and Drug use disorders (DUD) of individuals before death. The primary characteristic of suicides in a population of late twenties to early fifties was romantic relationship conflicts. In contrast, suicides in the teenage years and early twenties were characterized primarily by a lack of familial acceptability and, to a lesser extent, self-acceptance. Simultaneously, there was a high risk of suicidal behavior and commission of acts among the DUD patients, getting treatment without psychiatric diagnosis and therapy. Over time, the psychological autopsy technique has shown to be quite helpful in determining the risk factors for suicidal behavior. The study helps to develop multiple rehabilitation and mental awareness that need to be created among various populations so that the suicide and homicide-suicide rates can be reduced.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"110 ","pages":"Article 102813"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The mechanism of serum cell-free DNA release in postmortem subjects and novel markers to estimate the postmortem intervals","authors":"Junko Fujihara","doi":"10.1016/j.jflm.2025.102814","DOIUrl":"10.1016/j.jflm.2025.102814","url":null,"abstract":"<div><div>Cell-free DNA (cfDNA) is DNA released from dying cells into the serum. The aim of the present study is to elucidate the mechanism of cell-free DNA (cfDNA) release in postmortem subjects by assaying Cytokeratin 18 (M30 and M65), cyclophilin A (CyPA), and myeloperoxidase (MPO) levels and to evaluate whether these levels are useful as markers for estimating postmortem intervals. Serum (<em>n</em> = 54) was sampled from postmortem autopsied Japanese subjects. cfDNA was extracted and M30, M65, CyPA, and MPO in serum were assayed by enzyme-linked immunosorbent assay. Significantly higher serum levels of M30, M65, and MPO were observed in postmortem subjects than in living subjects. Although the difference was smaller, CyPA was also significantly higher in postmortem subjects than in living subjects. In addition, serum M30 and MPO levels were significantly correlated with cfDNA concentrations in postmortem subjects. Furthermore, M30 levels slightly increased according to the postmortem interval, and MPO levels at 2.5 days were significantly higher than those at <2 days. The result of regression analysis revealed a significant difference between M30/MPO levels and postmortem intervals. These findings suggested that elevated levels of cfDNA in postmortem subjects are released by apoptosis and neutrophils via NETosis and that M30 and MPO levels can be used as markers to estimate postmortem intervals.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"110 ","pages":"Article 102814"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xing-yu Ma , Tian-qi Wang , Ke-shuang Tang , Ya-qi Yang , Zhi-xin Bai , Xuan Zhang , Dong Zhao
{"title":"Study on forensic diagnostic biomarker combination for acute ischemia heart disease based on postmortem biochemistry","authors":"Xing-yu Ma , Tian-qi Wang , Ke-shuang Tang , Ya-qi Yang , Zhi-xin Bai , Xuan Zhang , Dong Zhao","doi":"10.1016/j.jflm.2025.102825","DOIUrl":"10.1016/j.jflm.2025.102825","url":null,"abstract":"<div><div>Sudden cardiac death (SCD) caused by ischemia heart disease (IHD) has traditionally been identified through autopsy and microscopic examination. However, these methods are limited in diagnosing cases of acute ischemia heart disease (AIHD) without typical myocardial necrosis and excessive reliance on the subjective experience of experts. Postmortem biochemistry is crucial in the assisted diagnosis of SCD in forensic medicine. We evaluated the expression levels of six sensitive biomarkers of myocardial injury in the training-set comprising 78 cases of acute ischemia (AI), 23 cases of acute myocardial infarction (MI), and 37 cases who died of high falls. The results showed that CK-MB, cTnI, BNP, LDH, and HBDH may be of great significance in diagnosing sudden death of AIHD. Among these, BNP, LDH, and HBDH are particularly useful for distinguishing between AI and acute MI. Using receiver operating analysis, we identified that the combination of five biomarkers-BNP, cTnI, CK-MB, LDH, and HBDH-achieved a significantly higher diagnostic accuracy for AIHD, with an AUC of 0.910. This combination outperformed the traditional three-biomarker combination (CK-MB, cTnI, BNP), which was considered highly accurate but only had an AUC of 0.857. Additionally, a three-biomarker combination (BNP, HBDH, and LDH) demonstrated clear advantages in differentiating between AI and acute MI, with an AUC of 0.794. Validation-set results proved that the strategy of finding the unique combination based on postmortem biochemistry is effective. It can provide valuable information for the discrimination of AIHD and the identification of AI and acute MI.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"110 ","pages":"Article 102825"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143194660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}