Surgical technology international最新文献

{"title":"Implementing Triage-Bot: Supporting the Current Practice for Triage Nurses.","authors":"Kim Sears, Sam Belbin, Elyas Rashno, Drishti Sharma, Kevin Woo, Farhana Zulkernine, Ciprian Daniel Neagu, Bita Amani, Furkan Alaca","doi":"10.52198/24.STI.44.WH1804","DOIUrl":"10.52198/24.STI.44.WH1804","url":null,"abstract":"<p><p>In Canada, emergency departments (ED) have 15.1 million unscheduled visits every year; this has been suggested to indicate that patients rely on ED to address the gaps experienced by 6.5 million Canadians who lack a primary care provider. When this large number of visits is coupled with a predicted shortage of 100,000 nurses in Canada by 2030, ED can be expected to face resource limitations, which highlights the importance of triage systems as a source of immediate support. Technology that incorporates innovative analytical methods, automation of routine, and efficient processing can be leveraged to enhance patient outcomes, streamline clinical processes, and improve the overall quality and efficiency of healthcare delivery. This paper aims to highlight how the Triage-Bot, a proposed AI system, can assist ED nurses when triaging patients. The Triage-Bot system is based on the Canadian Triage and Acuity Scale (CTAS), which currently serves as a standardized and highly effective tool for prioritizing patient care in emergency departments across the country. Pre-set and open-ended questions are asked using voice and video, allowing patients to describe their health concerns and conditions. Triage-Bot automatically measures the following vital signs: heart rate (HR), heart rate variability (HRV), oxygen saturation (SpO2), respiratory rate (RR), blood pressure (BP), blood glucose (BG), and stress. The system uses artificial intelligence models, particularly those with a deep learning approach that simultaneously analyzes both the user's facial expression and voice tone. Implementation: A systematic review addressed the implications of AI in nursing and concluded that it could contribute to patient care by providing personalized instructions and/or remotely monitoring patients. The Triage-Bot system can be implemented in healthcare facilities, such as emergency department waiting rooms. The information it collects can then be added to a patient's health records to support nurses in assessing the severity of each patient's condition. Limitations: If the system is accessed without a nurse's guidance, it is imperative that the user receives information regarding when to visit a healthcare provider or ED. Continuous improvements in Triage-Bot's accessibility for patients with varying abilities are required to ensure that the system remains user-friendly during times of illness. The voice and text interaction can also be influenced by a user's understanding of language, culture, and age-related factors.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"44 ","pages":"61-65"},"PeriodicalIF":0.8,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141992391","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":"Surgical Tips for Robotic Assisted Laparoscopic Abdominal Cerclage: A Minimally Invasive Approach.","authors":"Viviana DE Assis, Hasan Alhasan, Emad Mikhail","doi":"10.52198/24.STI.44.GY1794","DOIUrl":"10.52198/24.STI.44.GY1794","url":null,"abstract":"<p><p>Preterm birth is the leading cause of perinatal and neonatal morbidity and mortality in the developed world. An important cause of preterm birth is cervical insufficiency, leading to membrane prolapse, premature rupture of membranes, and mid-trimester pregnancy loss. A cerclage can be placed vaginally or abdominally to treat cervical insufficiency. In cases of failed prior transvaginal cerclage (TVC), transabdominal cerclage (TAC) is the alternative. The procedure can be completed via laparoscopy or open approach. The suture is placed at the internal os giving greater structural support.1 In this article, we review the definition of cervical incompetence, we present the indications for TAC, we discuss the outcomes of minimally invasive TAC compared to open approach, and we review surgical tips and tricks for robotic assisted (RA) TAC placement that can be used prior to pregnancy or in early gestation. The included images delineate the surgical technique for safe placement of robotic assisted laparoscopic abdominal cerclage in the management of cervical insufficiency.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"44 ","pages":"185-188"},"PeriodicalIF":0.8,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180655","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":"Treatment of an Exposed Achilles Tendon within a Refractory Mixed Arterial Venous Leg Ulcer with the Novel Use of Pericardium Allograft in Combination with Amniotic Allografting, Synthetic Extracellular Matrix, and Acellular Dermis Allografting: A Case Report.","authors":"Arthur Evensen, Arthur Evensen, Lee Curbo, Samta Batra","doi":"10.52198/24.STI.44.WH1775","DOIUrl":"10.52198/24.STI.44.WH1775","url":null,"abstract":"<p><p>Xenografts, commonly from porcine or bovine sources, have decades-long documented use in reconstructive surgery, including the repair of Achilles tendons. Despite decellularization processes, the risk of antigenicity with xenografts still poses a threat for graft failure. Allograft tissues reduce the risk of immune response and provide greater likelihood of successful grafting. SteriGraft® Pericardium (BSP) (Bone Bank Allografts, San Antonio, Texas) is a lyophilized allograft obtained from the pericardial sac that has undergone sterilization and processing for use in the surgical repair. The aim of this case study was to highlight the novel use of human pericardium allograft in the repair of an exposed Achilles tendon within a vascular ulceration with the concomitant use of synthetic extracellular matrix, amniotic allografting, dermal allografting, and negative pressure wound therapy to achieve healing of the wound and restoration of limb function.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"44 ","pages":"66-70"},"PeriodicalIF":0.8,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857839","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":"The Role of a New Hinged Total Knee Arthroplasty System for Use in a Variety of Complex Knee Scenarios: A Case Series.","authors":"Daniel Hameed, Bryan D Springer, Arthur L Malkani, Michael A Mont","doi":"10.52198/24.STI.44.OS1799","DOIUrl":"10.52198/24.STI.44.OS1799","url":null,"abstract":"<p><p>Hinged knee arthroplasties are commonly used in scenarios where there are major ligament deficiencies or bone loss around the knee. They are applicable in native knees with major deformities and during revisions. They can also be used as a salvage procedure after distal femoral resection. The new modular hinged device system, namely the Triathlon Hinge Knee (THK) System (Stryker, Mahwah, New Jersey), reflects the advancements of third-generation design and enhances surgical flexibility by allowing streamlined integration with the Triathlon Total Stabilized (TS) System (Stryker, Mahwah, New Jersey) and the Global Modular Replacement System (GMRS, Stryker, Mahwah, New Jersey). Additionally, the Triathlon Revision Tibial Baseplate (Stryker, Mahwah, New Jersey) has been launched as part of THK and is compatible with the Modular Rotating Hinge (MRH , Stryker, Mahwah, New Jersey) femur, which allows the Revision Baseplate to replace the existing tibial component while leaving the existing MRH Femoral Component in place. The Triathlon Revision Tibial Baseplate enables orthopaedic surgeons to use constrained or hinged prostheses, including both distal and total femoral replacement options, without changing the Tibial Baseplate. This is because the TS, MRH, THK, and GMRS femurs are compatible with the new Triathlon Revision Tibial Baseplate. Additionally, the system can be augmented with metaphyseal cone constructs to help provide a stable foundation for reconstruction. This report explores the application of a new modular hinged device system in various scenarios, starting with (1) complex primary hinged knee arthroplasty, followed by revision hinged knee arthroplasty cases including (2) failed TKA with medial collateral ligament (MCL) dysfunction, (3) severe arthrofibrosis post-TKA, (4) revisions for prosthetic joint infection, (5) extensor mechanism deficiency, and (6) arthrofibrosis with extensor mechanism disruption, concluding with a case of (7) distal femoral arthroplasty for periprosthetic fracture post-failed TKA.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"44 ","pages":"243-250"},"PeriodicalIF":0.8,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564378","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":"Decreasing Perioperative Opiate Use During Pancreaticoduodenectomy Using Transversus Abdominus Plane Blocks: A Review of the Literature.","authors":"Carla R Edgley, Jorge G Zarate Rodriguez, Chet W Hammill","doi":"10.52198/24.STI.44.GS1765","DOIUrl":"10.52198/24.STI.44.GS1765","url":null,"abstract":"<p><strong>Background: </strong>Pancreatoduodenectomy is a highly complex surgical procedure associated with high postoperative morbidity and mortality. Treatment of postoperative pain is crucial to preventing chronic pain and further complications. Opioids are the leading treatment modality for acute postoperative pain for all surgical procedures in the US, contributing to the opioid epidemic, a crisis causing death and lifelong impairment in many patients. Multimodal analgesia techniques, such as the transversus abdominis plane (TAP) block, are suggested to reduce perioperative opioid usage. This exploratory literature review aims to investigate the use of TAP block in postoperative pain and opioid use in patients undergoing pancreatoduodenectomy.</p><p><strong>Materials and methods: </strong>A search strategy developed from Cochrane best practice recommendations was applied to a comprehensive search of PubMed, Scopus, and PsycINFO databases, yielding three articles of relevance in patients having pancreatic surgery.</p><p><strong>Results: </strong>Previous research demonstrates TAP block efficacy in decreasing opiate consumption after major abdominal surgery; however, there is a paucity of data regarding opioid consumption in pancreatoduodenectomy patients.</p><p><strong>Conclusion: </strong>Research in relation to TAP block analgesia is varied given the variety of approaches, techniques, and timing of the TAP block procedure. Future research should seek to elucidate the role of TAP blocks in reducing postoperative pain and opioid consumption in pancreatoduodenectomy patients.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"44 ","pages":"105-114"},"PeriodicalIF":0.8,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289040","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":"Autologous Blood-Derived Products (ABDPs) for the Treatment of Chronic Wounds.","authors":"Allegra L Fierro, Carolyn Foley, Tomer Lagziel, John C Lantis","doi":"10.52198/24.STI.44.WH1752","DOIUrl":"10.52198/24.STI.44.WH1752","url":null,"abstract":"<p><p>Autologous blood-derived therapies have emerged as a unique and promising treatment option for chronic wounds. From whole blood clots to spun-down clot constituents, these therapies are highly versatile and tend to have a lower cost profile, allow for point-of-service preparation, and inherently carry minimal to no risk of rejection or allergic reaction when compared to many alternative cellular and matrix-like products. Subsequently, a diversity of processing systems, devices, and kits have surfaced on the market for preparing autologous blood-derived products (ABDPs) and many have demonstrated preclinical and clinical efficacy in facilitating chronic wound healing. However, not all ABDPs are created equal, and the lack of standardization among product formulations and cell concentrations as well as varying complexities in preparation protocols has led to unreliable substrate viabilities and overall inconsistent conclusions on efficacy. Additionally, external factors, such as the ease of drawing blood, the health of a patient's blood, and the reimbursement landscape have dissuaded some practitioners from incorporating ABDPs into an algorithm of care for recalcitrant wounds. Here, we attempt to categorize ABDPs into \"classes\" and examine their efficacy, advantages, and limitations when used as both a primary therapy and an adjunct for treating chronic wounds as well as comment on some potential considerations that may help gear future product development and application.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"44 ","pages":"37-51"},"PeriodicalIF":0.8,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336870","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":"Are Metal Ion Levels Elevated After Dual Mobility Acetabular Systems: Minimum Five-Year Analyses.","authors":"Daniel Hameed, Jeremy Dubin, Zhongming Chen, Nipun Sodhi, Michael A Mont, Steven F Harwin","doi":"10.52198/24.STI.44.OS1767","DOIUrl":"10.52198/24.STI.44.OS1767","url":null,"abstract":"<p><strong>Introduction: </strong>While dual mobility systems in total hip replacements have demonstrated reduced dislocation and revision occurrences, concerns persist about the potential elevation of metal ions in the bloodstream, leading to negative tissue reactions. Notably, there's a scarcity of research spanning over five years post-surgery that examines cobalt and chromium levels after such implants. This study aimed to delve into these metal ion concentrations after a five-year period, building on previous metal-ion findings. We focused on: (1) cobalt concentrations in blood and urine; (2) chromium concentrations in blood and urine; (3) cobalt variations based on follow-up duration and specific implant metrics (e.g., offset, cup dimension, stem, and neck inclination); and (4) chromium variations based on the same parameters.</p><p><strong>Materials and methods: </strong>We tracked 57 individuals who received THA using modular dual mobility systems from January 1, 2011, to December 31, 2016, for an average span of six years (ranging from five to 10 years). At the final check-up, we measured cobalt and chromium levels in serum, plasma, blood, and urine. We also evaluated parameters like head composition and dimension, stem offset, cup dimension, and stem-neck inclination.</p><p><strong>Results: </strong>Cobalt concentrations remained minimal, with average blood and urine values being 0.8+0.6mcg/L (standard <1.8mcg/L) and 1.2+1.0mcg/L (standard <2.8mcg/L), respectively. Two individuals exhibited a slight increase in blood cobalt concentration by 0.1 and 0.2mcg/L. Chromium averages in blood and urine were also minimal, with readings of 0.9+0.2mcg/L (standard <1.2mcg/L) and 1.3 + 0.5mcg/L (standard <2mcg/L), respectively. One individual had a marginally increased blood chromium concentration of 1.3mcg/L. Evaluations considering ceramic or cobalt-chrome heads, up to a decade of follow up, or varying implant metrics showed negligible variations in metal ion concentrations.</p><p><strong>Conclusion: </strong>The findings reveal that over a minimum of five years (average = six years; span, five to 10 years), cobalt and chromium concentrations in patients' systems remained within normal limits and were clinically insignificant, irrespective of the follow-up duration, head material, or implant specifications. This underscores the efficacy of dual mobility systems in ensuring minimal metal ion presence.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"44 ","pages":"305-310"},"PeriodicalIF":0.8,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319191","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":"Thermal Ablation for Benign Thyroid Nodules and Papillary Thyroid Microcarcinoma.","authors":"Daqi Zhang, Hui Sun, Anna Maria Ierardi, Salvatore Alessio Angileri, Francesco Frattini, Simone Mortellaro, Arianna Ceriello, Jerry Spisani, Gianluca Donatini, Gianlorenzo Dionigi, Giampaolo Carrafiello","doi":"10.52198/24.STI.44.GS1806","DOIUrl":"10.52198/24.STI.44.GS1806","url":null,"abstract":"<p><p>Ultrasound-guided minimally invasive thermoablative (MIT) therapies are a therapeutic option for selected patients with large, hypoenhancing, benign thyroid nodules that cause compression disorders or aesthetic discomfort. MIT, which does not require general anaesthesia, causes thermal necrosis of the treated nodule, which is reduced in size by 50 % without functional consequences, and is indicated for patients who are not too young or in the presence of anaesthesia-related risk factors or recurrence following thyroidectomy or refusal of surgery. For the above indications, MIT complements surgery but does not replace it; it must always be performed in centres and by surgeons with proven technical skills and clinical experience. Subject to appropriate informed consent, the treatment is short-duration, well-tolerated by the patient, safe, and non-invasive. It does not require anaesthesia and complications are rare and transient. MIT, and in particular laser-based procedures (TAL), can also be effective and safe for the treatment of potentially destructible papillary microcarcinoma, as shown by the limited but sufficient literature, including the most recent guidelines, which consider it to be a therapeutic alternative that requires a better understanding of its efficacy and safety.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"44 ","pages":"157-162"},"PeriodicalIF":0.8,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861027","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":"The Importance of Digital Lung Tomosynthesis in Overcoming Computed-Tomography-to-Body Divergence During Bronchoscopic Biopsies of Peripheral Lung Nodules.","authors":"Amit Bobby Mahajan, Joseph Cicenia, Douglas K Hogarth, Omar Ibrahim, Tao Zhao, Krish Badra","doi":"10.52198/24.STI.44.CV1813","DOIUrl":"10.52198/24.STI.44.CV1813","url":null,"abstract":"<p><p>The advent of robotic bronchoscopy coupled with electromagnetic navigation bronchoscopy (EMN) and shape-sensing technology have increased diagnostic yields for peripheral pulmonary nodules compared to traditional bronchoscopy. Yet, diagnostic yields from these bronchoscopic platforms still fall short of where they should be. This shortfall is in large part due to a lack of advanced imaging during peripheral bronchoscopy and computed tomography (CT)-to-body divergence (CTBD). Digital lung tomosynthesis (DLT) is an advanced imaging modality that helps overcome CTBD during bronchoscopic biopsies of lung nodules. DLT is a quasi-3D imaging technique, which reconstructs tomographic images of the lung from a series of 2D fluoroscopic projection images. These images can be acquired either using a digital flat panel fluoroscopy machine or a fluoroscopy machine with a more traditional image-intensifier present in most standard bronchoscopy suites. This review aims to explain the mechanisms of both CTBD and DLT to help diagnose early-stage lung cancer more effectively.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"44 ","pages":"235-239"},"PeriodicalIF":0.8,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141992393","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":"A Decade of Insights: Reevaluating the Use of the Flexible-Fiber CO2 Laser in Brain Tumor Surgery-Efficacy, Challenges, and Lessons Learned.","authors":"Domenico Policicchio, Riccardo Boccaletti, Filippo Veneziani Santonio, Anna Mingozzi, Giosuè Dipellegrini","doi":"10.52198/24.STI.44.NS1776","DOIUrl":"10.52198/24.STI.44.NS1776","url":null,"abstract":"<p><strong>Introduction: </strong>The introduction of flexible fiber technology in the early 2000s revitalized the interest in the CO2 laser for neurosurgical applications, making it suitable for microsurgical procedures. Despite its widespread use, specific indications for the CO2 laser in neurosurgery remains undefined. This study evaluates the efficacy and limitations of the CO2 laser in brain tumor surgery.</p><p><strong>Materials and methods: </strong>This retrospective observational single-center study analyzed the use of the CO2 laser in intracranial neoplasm surgeries from 2011 to 2021. A total of 94 patients were assessed, focusing on demographics, tumor characteristics, surgical duration, complications, and laser-specific issues. We used a five-tiered scoring system to assess laser effectiveness in both debulking and dissection tasks; with resection extent assessed following established guidelines.</p><p><strong>Results: </strong>The CO2 laser was highly effective in debulking solid tumors, achieving a 76.5% gross total resection rate, while being less effective in softer, highly vascularized tumors. The average effectiveness scores for dissection (2.6±0.8) were significantly lower than for debulking (3.2±1.2). Two major complications were directly associated with laser use. Effectiveness improved over time, particularly in the latter half of the study, and varied across tumor types, with notable utility in meningiomas and vestibular schwannomas but lower scores in glial tumors.</p><p><strong>Conclusions: </strong>The CO2 laser is a valuable tool in neurosurgery, especially for solid tumors in specific anatomical locations. Careful patient selection is crucial, and the laser complements rather than replaces conventional surgical tools. Ongoing technological advancements suggest broader future applications in neurosurgery.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"44 ","pages":"360-366"},"PeriodicalIF":0.8,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176378","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}