{"title":"Comparative efficacy of swallowing therapies for dysphagia to prevent pneumonia in patients with acute or subacute stroke: A network meta-analysis of randomized controlled trials","authors":"Akane Ando, Koichi Ando, S. Oka, T. Iijima, K. Oe","doi":"10.15369/sujms.34.47","DOIUrl":"https://doi.org/10.15369/sujms.34.47","url":null,"abstract":"","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89892872","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 profile of pro-inflammatory cytokine expression in human Delta-1-induced monocyte-derived Langerhans cell-like dendritic cells after stimulation with Toll-like receptor ligands","authors":"R. Takahashi, S. Iwamoto, T. Tanioka, Kohei Maeda","doi":"10.15369/sujms.33.67","DOIUrl":"https://doi.org/10.15369/sujms.33.67","url":null,"abstract":"Monocyte-derived Langerhans cell-like dendritic cells (Mo-LCs) are involved in epidermal disorders such as psoriasis in murine models. However, the roles of Mo-LCs in the pathogenesis of psoriasis in humans remain unclear. Also, the contribution of notch ligand delta-like 1 (DLL-1), expressed on keratinocytes, to Mo-LC functions requires clarification. Here, we established a new method of stimulating Mo-LCs derived from CD14+ monocytes with immobilized human DLL-1 to generate induced Mo-LCs (DI (+)Mo-LCs). The DI (+) Mo-LCs were compared to the dendritic cells derived from monocytes (Mo-DCs) cultured with interleukin-4 (IL-4) and granulocyte-macrophage colony-stimulating factor (GM-CSF), and M1 macrophages (Mφ) derived from monocytes cultured with GM-CSF. The DI (+)Mo-LCs were found to produce significant amounts of IL15, IL23A, and interferon-β (IFNB1) in response to the Toll-like receptor (TLR)3 agonist Polyinosinic-polycytidylic acid (Poly (I:C)) or TLR4 agonist lipopolysaccharide (LPS) despite their low expression of tumor necrosis factor (TNF). In conclusion, we have established a new method to generate DI (+)Mo-LCs. We have also discovered that DI (+)Mo-LCs have a unique capacity for producing IL15 and IL23A, which are related to the pathogenesis of psoriasis. Our data contribute to a better understanding of the roles of Mo-LCs in epidermal defense and pathogenesis.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"91 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80870422","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":"Sudden-onset nonhemorrhagic Rathke’s cleft cyst mimicking apoplexy: A case report and literature review","authors":"Tomomi Yoshiyama, D. Tanioka, T. Mizutani","doi":"10.15369/sujms.33.143","DOIUrl":"https://doi.org/10.15369/sujms.33.143","url":null,"abstract":"Most Rathke’s cleft cysts (RCCs) are asymptomatic. Of the symptomatic RCCs, those that rapidly develop and cause hemorrhagic RCC apoplexy are particularly rare. In this study, we report a case of nonhemorrhagic RCC apoplexy that is an acute-onset RCC without intracystic hemorrhage. This study included a 21-year-old male patient. His chief complaints were severe headache with sudden disturbance of consciousness, visual disturbance, and double vision. Head computed tomography (CT)/magnetic resonance imaging (MRI) and clinical course indicated a hemorrhagic RCC apoplexy that is an acute-onset RCC with intracystic hemorrhage, a nonhemorrhagic RCC apoplexy, or a pituitary apoplexy. We then performed endoscopic transsphenoidal surgery. Histopathological examinations revealed a nonhemorrhagic RCC apoplexy. The preoperative diagnosis makes it difficult to distinguish between acuteonset hemorrhagic RCC apoplexy, nonhemorrhagic RCC apoplexy, and pituitary apoplexy. We compared 26 cases of hemorrhagic RCC apoplexy with cases of nonhemorrhagic RCC apoplexy by reviewing previous literatures. Furthermore, we have determined the characteristics of nonhemorrhagic RCC apoplexy. Knowledge on these characteristics may be useful in the differential diagnosis. For the differential diagnosis and treatment of RCC apoplexy and pituitary apoplexy, it is important to appropriately perform surgical treatment and make an accurate diagnosis based on surgical and pathological findings.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80961341","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}
Emina Masuda, Akiko Ishizaki, K. Hirano, T. Iwasaki, T. Sambe, Chiaki Sawaguchi, S. Hironaka
{"title":"Computational fluid dynamics analysis in patients with nasal disease","authors":"Emina Masuda, Akiko Ishizaki, K. Hirano, T. Iwasaki, T. Sambe, Chiaki Sawaguchi, S. Hironaka","doi":"10.15369/sujms.33.88","DOIUrl":"https://doi.org/10.15369/sujms.33.88","url":null,"abstract":"Computational fluid dynamics (CFD) analysis is useful for quantitative assessment in patients with upper airway obstructions. We compared CFD analysis with rhinomanometry (RM) and acoustic rhinometry (AR). Twenty patients with nasal and paranasal diseases who required computed tomography assessment underwent RM and AR. We measured the pressure and velocity at four parts of the upper airway using CFD analysis. Then we evaluated the correlation among CFD analysis, RM, and AR. CFD analysis detected obstruction sites in the nasal airway and pharynx in 14 and 2 patients, respectively. High negative pressure accompanied the nasal obstruction, even behind the nasal cavity. Nasal airway pressure measured using CFD analysis strongly correlated with nasal resistance in RM (Spearman correlation coefficient= 0.853). CFD analysisʼs sensitivity and specificity to detect the obstruction were 84.6% and 57.1%, respectively (compared to those of RM) and 83.3% and 50.0%, respectively (compared to those of AR). The CFD analysisʼs ability to detect obstruction was comparable to that of RM and AR; therefore, it may help evaluate the upper airways in patients with nasal and paranasal diseases. We found impaired nasal ventilation also affected other parts of the upper airway. Further studies with a larger sample size are required to validate the use of CFD analysis for assessing the degree of upper airway ventilation disorders.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72654821","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}
M. Fuyama, Hirokazu Ikeda, Chisato Oyake, Yuta Onuki, Tsuneki Watanabe
{"title":"Clinical usefulness of the attention-deficit hyperactivity disorder rating scale-IV in the treatment of enuretic children undiagnosed with developmental disorders","authors":"M. Fuyama, Hirokazu Ikeda, Chisato Oyake, Yuta Onuki, Tsuneki Watanabe","doi":"10.15369/SUJMS.33.1","DOIUrl":"https://doi.org/10.15369/SUJMS.33.1","url":null,"abstract":"To determine the association between attention-deficit hyperactivity disorder (ADHD) and nocturnal enuresis (NE) and its relation to the effectiveness of NE treatment in children undiagnosed with developmental disorders. A total of 154 children with NE (112 males and 42 females) were included in this study, aged ≥ 5–<15 years, presenting at the Department of Pediatrics, Showa University Fujigaoka Hospital, between January 2016 and June 2017. None of the participants was diagnosed with developmental disorders. We retrospectively evaluated Attention-Deficit Hyperactivity Disorder Rating Scale-IV (ADHD-RS-IV) scores, Dysfunctional Voiding Symptom Score (DVSS), NE clinical characteristics, and efficacy of NE treatment. The mean age was 8.0±2.0 years (standard deviation). Sixty-seven (40.3%) patients presented with daytime incontinence (DI). The mean total ADHD-RS and DVSS scores were 7.7± 8.0 and 6.6±4.3, respectively, and they were significantly correlated (p=0.049). ADHDRS scores were significantly higher in patients with DI than in those without DI (p=0.0006). ADHD-RS scores and large-volume DI (a DVSS subscale item) were significantly correlated. Six months after treatment initiation, patients with <50% improvement (nonresponder) in NE had significantly higher total ADHD-RS scores than those with ≥ 50% improvement (responder) (p=0.007). Even in patients not diagnosed with developmental disorders, ADHD characteristics may influence the clinical course of NE. Evaluation of ADHD characteristics using a screening tool such as the ADHD-RS is important in the NE treatment.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83923935","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}
Ryoji Usui, Yoshifumi Kudo, Chikara Hayakawa, Ryo Yamamura, Hiroshi Maruyama, Akira Matsuoka, K. Ishikawa, Soji Tani, K. Inagaki, T. Toyone
{"title":"Difficulty in surgical procedure selection for myelopathy with atlantoaxial instability in a highly aged patient: A case report of an 85-year-old female who required additional occipitocervical fusion after C1 laminectomy","authors":"Ryoji Usui, Yoshifumi Kudo, Chikara Hayakawa, Ryo Yamamura, Hiroshi Maruyama, Akira Matsuoka, K. Ishikawa, Soji Tani, K. Inagaki, T. Toyone","doi":"10.15369/sujms.33.149","DOIUrl":"https://doi.org/10.15369/sujms.33.149","url":null,"abstract":"Myelopathy with atlantoaxial instability is a relatively rare condition. It is treated with various surgical methods to treat upper cervical problems, including atlantoaxial fusion, occipitocervical fusion, and C1 laminectomy. However, the choice of surgical method, especially in highly aged (≥ 80 years) patients, is controversial. This case report describes the difficulty of selecting the appropriate surgical procedure for upper cervical and occipitocervical diseases in highly aged patients. An 85-yearold woman complained of neck pain and bilateral hand numbness. The Japanese Orthopedic Association score for cervical myelopathy (C-JOA) of the patient was 9 out of a possible score of 17. Plain radiographs showed atlantoaxial subluxation (AAS) and vertical subluxation (VS), whereas magnetic resonance imaging showed spinal cord compression and myelomalacia at C1-2. The patient underwent a C1 laminectomy to minimize invasive procedures. After surgery, her symptoms improved, and her C-JOA score increased to 12. Fifteen months after surgery, her neurological conditions gradually deteriorated again. Her VS progressed postoperatively, with spinal canal restenosis at the craniovertebral junction. After an additional occipitocervical fusion, her symptoms improved, and she had no evidence of recurrence at her final follow-up. Although surgeons tend to choose less-invasive procedures when treating highly aged patients, appropriate surgical procedures may be required (even if invasive for the patient) when less-invasive treatments failed. Hence, it is important to avoid over-selecting less-invasive surgical procedures for highly aged patients.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90656309","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}
Naomi Kobinata, Hideto Yoshikawa, Yuji Iwasaka, N. Kawate
{"title":"Relationship between musical and linguistic abilities in patients with aphasia","authors":"Naomi Kobinata, Hideto Yoshikawa, Yuji Iwasaka, N. Kawate","doi":"10.15369/SUJMS.33.34","DOIUrl":"https://doi.org/10.15369/SUJMS.33.34","url":null,"abstract":"This retrospective study aimed to investigate the relationship between musical and linguistic abilities in patients with aphasia. We reviewed the clinical records of 32 stroke patients with aphasia admitted to subacute rehabilitation units between May 2014 and August 2018. We analyzed the results of melody and rhythm reproduction tests and subtests of auditory comprehension and speech sections in the Standard Language Test of Aphasia ( SLTA ) collected upon admission and discharge. The Spearman rank correlation coefficient ( rs ) was used to analyze the correlation between 1 ) the increase in melody reproduction test scores and SLTA auditory comprehension subtest scores, 2 ) the increase in melody reproduction test scores and SLTA speech subtest scores, 3 ) the increase in rhythm reproduction test scores and SLTA auditory comprehension subtest scores, and 4 ) the increase in rhythm reproduction test scores and SLTA speech subtest scores. There were significant positive correlations between melody reproduction and auditory comprehension subtest scores on the SLTA: “ word comprehension ” ( n = 14, rs = 0.57, p < 0.05 ) and “ following verbal instructions ” ( n = 31, rs = 0.42, p < 0.05 ) . An SLTA speech subtest score ― action naming ― was positively correlated with rhythm reproduction ( n = 31, rs = 0.44, p < 0.05 ) . This study implies that melody reproduction ability is related to auditory comprehension and that rhythm reproduction ability is related to speech production in patients with aphasia after experiencing a stroke.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88957454","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}
Daishiro Yamaoka, Takanari Fujii, Kota Nagaoka, Takeshi Shimizu, Hiroaki Kise, Nobuo Oyama, H. Tomita, Y. Nakano, K. Mizuno
{"title":"The influence of body fat percentage in the anthropometric prediction of cardiac structure size in infants","authors":"Daishiro Yamaoka, Takanari Fujii, Kota Nagaoka, Takeshi Shimizu, Hiroaki Kise, Nobuo Oyama, H. Tomita, Y. Nakano, K. Mizuno","doi":"10.15369/sujms.33.103","DOIUrl":"https://doi.org/10.15369/sujms.33.103","url":null,"abstract":"Predicting normal values of cardiovascular structure size are essential in managing congenital and pediatric heart diseases. Conventionally, normal values of cardiovascular structure size are predicted based on body surface area ( BSA ) , which is calculated from the infant ʼ s weight and height. However, the predicted normal values may be more accurate if the actual body composition measurement is considered because there are large individual differences in lean body mass ( LBM ) and fat mass ( FM ) . The objective of this study was to evaluate the efficacy of measuring body fat percentage using the PEA POD Infant Body Composition System, a novel pediatric body composition measurement tool, in assessing cardiovascular structures focused on the diameters of the aortic valve ( AVD ) and mitral valve ( MVD ) and the left ventricular mass ( LVM ) in infants. We evaluated the associations between diameters of the AVD and MVD, LVM, and percent body fat (% BF ) using the PEA POD system at term-equivalent age ( 37 - 42 weeks ) . AVD and MVD were not significantly different between groups with high or low % BF, whereas the differences between the predicted normal values and AVD and between the predicted normal values and MVD were significantly larger in the high % BF group than those in the low % BF group ( p < 0.05 and p < 0.01, respectively ) . The high % BF group had significantly larger LVM/ height 2.16 than the low % BF group ( p < 0.05 ) , whereas no significant difference in LVM/BSA was found between the two groups. Body composition evaluating cardiovascular structure in the existing methods for predicting normal values for valve diameter and LVM are significantly influenced by % BF.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84756050","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}
Yuri Shiga, H. Narusawa, S. Hironaka, Y. Shibata, Takahiro Funatsu
{"title":"In vitro demineralization of artificial large-scale hydroxyapatite single crystal: Implications of fluoridized tooth enamel for acid resistance","authors":"Yuri Shiga, H. Narusawa, S. Hironaka, Y. Shibata, Takahiro Funatsu","doi":"10.15369/sujms.33.111","DOIUrl":"https://doi.org/10.15369/sujms.33.111","url":null,"abstract":"Fluoride treatment has been well known to improve acid resistance of tooth enamel, leading to the widespread use of fluoride therapies in dentistry such as fluoride rinse and fluoridereleasing dental materials. The effect of fluoridation is likely based on the chemical properties of fluoridized hydroxyapatite; however, nanoscale tiny hydroxyapatite crystals in tooth enamel make it difficult to observe the demineralization pattern of fluoridated enamel versus the untreated enamel at a single crystal level. The purpose of this study was to mimic the demineralization patterns of fluoridated and untreated enamel by means of the newly developed hydrothermally enlarged enamel-like hydroxyapatite single crystals at Showa University. Largescale hydroxyapatite single crystals were hydrothermally produced from polyphosphoric acid and calcium oxide. The crystals were stored in sodium fluoride solutions with four different concentrations for 30 days, then exposed to 3% citric acid solution for up to 60 min. The degradation patterns of each sample were observed using a conventional scanning electron microscope and were analyzed using F K-edge X-ray absorption near edge structure spectra. The surfaces of the hydroxyapatite crystals treated by relatively low concentrations of fluoride showed degradation in citric acid as well as in the untreated control. The hydroxyapatite crystals treated with 1,500 and 9,000 ppm F revealed that the fluoridated outer pillar of the crystals remained mostly intact which made calcium fluoride detectable. Fluoridization of tooth enamel might be preventive of an early acid erosion at a crystal level with a caution of sufficient fluoride concentration and exposure over time. The remaining substantial portion of the crystal pillar implies of highly fluoridized crystals, and a possible remineralization occurs as long as saliva provides minerals required for enamel remineralization by in vivo regulation.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72904340","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}
Hiroki Sato, A. Tanaka, K. Hirai, T. Ebato, H. Inoue, T. Homma, S. Ohta, S. Suzuki, H. Sagara
{"title":"A comparative study of asthma with airflow limitation and asthma-COPD overlap using the forced oscillation technique","authors":"Hiroki Sato, A. Tanaka, K. Hirai, T. Ebato, H. Inoue, T. Homma, S. Ohta, S. Suzuki, H. Sagara","doi":"10.15369/SUJMS.33.25","DOIUrl":"https://doi.org/10.15369/SUJMS.33.25","url":null,"abstract":"The forced oscillation technique ( FOT ) , which requires breathing without forced action, is a useful tool that can measure respiratory impedance. We investigated the physiological differences between asthma with smoking-unrelated airflow limitation and asthma-chronic obstructive pulmonary disease ( COPD ) overlap ( ACO ) using the FOT. Among 275 patients with asthma who presented at the Showa University Hospital from April 2018 through March 2019, 211 were enrolled and assigned into the asthma ( BA ) , asthma with airflow limitation ( AL ) , or ACO groups. Respiratory impedance measured using the FOT were compared among the groups. There were no differences in spirometry data between the AL and the ACO group. The AL group had higher respiratory resistance at 5 Hz ( R5 ) , 20 Hz ( R20 ) , and reactance at 5 Hz than the ACO group, but there was no significant difference in subtracting R20 from R5 ( R5 - R20 ) . R5 and R20 were similar between the ACO and the BA groups, but R5 - R20, resonant frequency ( Fres ) , and low-frequency reactance area were significantly higher in the ACO group than the BA group. Fres yielded the highest area under the curve ( AUC ) to identify airflow limitation, and R20 yielded the highest AUC to identify the ACO group among patients with airflow limitation. 33 patients ACO. Therefore, FOT aids our understanding of the physiological characteristics and provides clues for the treatment in asthmatics with airflow limitation.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75587937","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}