Acta Medica Lituanica最新文献

{"title":"Lithium Induced Amenorrhea: A First Case Report","authors":"Balakumar Ke, Vidhya Egambarame, Vandana Tayal","doi":"10.15388/amed.2024.31.1.5","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.5","url":null,"abstract":"A 19-year-old female, known case of bipolar disorder had history of amenorrhea (absence of menstruation) for three years. While other causes of amenorrhea such as CNS, pregnancy, other medications, and thyroid issues were ruled out, she was found to have hyper-prolactinemia. Although antipsychotic medications are known to cause amenorrhea due to dopamine receptor blockade, which may result in hyperprolactinemia, the patient’s symptoms began before she started these medications. Only drug that she was on for long period is lithium. Current literature shows mixed evidence about lithium’s impact on prolactin levels, which can affect menstruation. This case may represent the first report of lithium causing amenorrhea through elevated prolactin levels. Clinicians should be aware of this potential side effect and monitor patients accordingly. Further studies are needed to confirm and understand this potential link.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"28 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140427313","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":"An Unusual Case of Denervation Changes of the Intercostal Muscles Associated with Intercostal Neuralgia in a Patient with Chest Pain","authors":"R. Botchu, Lorraine Aspland, Sisisth Ariyaratne, James Burgess, Gurjit Bhogal, David Beale","doi":"10.15388/amed.2024.31.1.4","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.4","url":null,"abstract":"Musculoskeletal aetiologies account for most patients presenting with chest pain. Intercostal neuralgia is a lesser-known cause of musculoskeletal chest pain, which can present a diagnostic challenge with nonspecific imaging findings. We report a case of a 31-year-old male who presented with severe lower thoracic and chest wall pain following a suspected viral infection, where Magnetic Resonance Imaging (MRI) revealed characteristic features of denervation oedema within the affected intercostal muscles. This pattern of imaging findings in intercostal neuralgia is sparely described in the current literature. MRI along with history and examination was crucial in diagnosing the condition and excluding other potential causes of musculoskeletal chest wall pain on this occasion. The patient’s symptoms were subsequently managed conservatively. The case highlights the importance of considering intercostal neuralgia as a potential cause of chest wall pain, particularly in the setting of post viral infection and absence of preceding mechanical musculoskeletal injury and explores an uncommon yet characteristic imaging finding which may be important in diagnosing the condition.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"99 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140426489","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":"Spontaneous Resolution of Congenital Intrahepatic Portosystemic Shunt.","authors":"Taraprasad Tripathy, Sandeep Behera, Ranjan Patel, Tanmay Dutta, Aditi Kumar, Amit Kumar Satpathy","doi":"10.15388/Amed.2024.31.2.14","DOIUrl":"10.15388/Amed.2024.31.2.14","url":null,"abstract":"<p><p>Congenital portosystemic shunts (CPSS) are a rare type of congenital abnormality. It results from abnormal embryonic development by the fourth week of fetal life. Congenital portosystemic shunts are believed to signify persistent communication between the portal and vitelline venous systems. Both extrahepatic and intrahepatic shunts are possible. They may develop on their own or in association with other congenital abnormalities. With regard to shunt type and size, symptoms vary widely. The anatomy of the shunt and associated abnormalities can be assessed by computed tomography and magnetic resonance angiography. The treatment plan is based on the type of shunt, its location and level of function, the patient's age, and the severity of their symptoms.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 2","pages":"382-387"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587386","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":"A Review of Open Access, No-Fee Journals Indexed in PubMed and Scopus for Publishing Image Reports in Medical Research.","authors":"Gabriele Gaggero","doi":"10.15388/Amed.2024.31.2.21","DOIUrl":"10.15388/Amed.2024.31.2.21","url":null,"abstract":"<p><strong>Background: </strong>Aspects of medicine can be conveyed through paradigmatic images (anatomical-surgical, radiological, microscopic) in image reports, a type of article more immediate than case reports. The aim of this review is to find journals allowing the publication of image reports and that are free of charge, open access and indexed in the best databases.</p><p><strong>Methods: </strong>The search started with a Boolean string and followed the PRISMA 2020 guidelines. Eligibility criteria were: English language, human medicine field, international DOI and ISSN codes applied, free of charge, open access, PubMed/Scopus indexed.</p><p><strong>Results: </strong>15,504,000 items were retrieved; 102 met all criteria. Instructions to authors were screened to extract journals that allowed image reports: 39 (39/39 Scopus-indexed; 29/39 PubMed-indexed). Most were in oncology (6/39) and general medicine (5/39), followed by neuroscience, fetal/pediatric and nephrology (4/39 each), urology, dermatology, hematology (3/39 each), thoracic/pleural/peritoneal diseases (2/39), and finally endocrinology, cytology, rheumatology, ophthalmology, gastroenterology (1/39 each). 21/39 allowed a single image; word count ranged from 100 to 1500. 32/39 reported a maximum number of references (range: 0-20), while 15/39 reported a maximum number of authors (range: 2-6).</p><p><strong>Conclusions: </strong>Compared to the vast publishing landscape, there are very few English-language, open access, PubMed/Scopus-indexed medical journals that allow free of charge publication of image reports. The majority are in the fields of oncology and general medicine, but other specialties are also represented. Image reports are usually articles with a limited number of words, references and authors allowed, as their purpose is much more a practical/didactic take-home message rather than a broad research with many authors. The review shows that image reports, still important for their educational value in medical knowledge transfer, are freely publishable and consultable in journals with international visibility.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 2","pages":"245-253"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587469","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":"Conservative Management of Delayed Submucosal Bleeding after Per-Oral Endoscopic Myotomy: A Case Report.","authors":"Martina Marrelli, Dario Biasutto, Benedetto Neri, Serena Stigliano, Citterio Nicolò, Monica Pandolfi, Gianluca Andrisani, Francesco M Di Matteo","doi":"10.15388/Amed.2024.31.2.15","DOIUrl":"10.15388/Amed.2024.31.2.15","url":null,"abstract":"<p><p>Per-Oral Endoscopic Myotomy (POEM) is recognized as the first-line therapy for achalasia, considering its high clinical efficacy and safety. Among the most important adverse events, bleeding or hematoma in the submucosal tunnel has incidence of approximately 1%. We describe the case of woman affected by type II achalasia, treated with POEM, who presented delayed bleeding with submucosal hematoma after starting anticoagulant therapy with subcutaneous low molecular weight heparin (LMWH). She presented with moderate-to-severe chest pain, stable vital signs and no evidence of arterial active bleeding. Therefore, urgent esophagogastroduodenoscopy was not performed, and the patient was treated conservatively with fasting, antibiotics, LMWH discontinuation and close medical supervision. After 10 days the condition was resolved, and the patients safely discharged. The present case report adds support to the safety and efficacy of conservative management of submucosal hematomas occurring after POEM.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 2","pages":"388-393"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587486","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":"Emergency Medicine Assistants in the Field of Toxicology, Comparison of ChatGPT-3.5 and GEMINI Artificial Intelligence Systems.","authors":"Hatice Aslı Bedel, Cihan Bedel, Fatih Selvi, Ökkeş Zortuk, Yusuf Karancı","doi":"10.15388/Amed.2024.31.2.18","DOIUrl":"10.15388/Amed.2024.31.2.18","url":null,"abstract":"<p><strong>Objective: </strong>Artificial intelligence models human thinking and problem-solving abilities, allowing computers to make autonomous decisions. There is a lack of studies demonstrating the clinical utility of GPT and Gemin in the field of toxicology, which means their level of competence is not well understood. This study compares the responses given by GPT-3.5 and Gemin to those provided by emergency medicine residents.</p><p><strong>Methods: </strong>This prospective study was focused on toxicology and utilized the widely recognized educational resource 'Tintinalli Emergency Medicine: A Comprehensive Study Guide' for the field of Emergency Medicine. A set of twenty questions, each with five options, was devised to test knowledge of toxicological data as defined in the book. These questions were then used to train ChatGPT GPT-3.5 (Generative Pre-trained Transformer 3.5) by OpenAI and Gemini by Google AI in the clinic. The resulting answers were then meticulously analyzed.</p><p><strong>Results: </strong>28 physicians, 35.7% of whom were women, were included in our study. A comparison was made between the physician and AI scores. While a significant difference was found in the comparison (F=2.368 and p<0.001), no significant difference was found between the two groups in the post-hoc Tukey test. GPT-3.5 mean score is 9.9±0.71, Gemini mean score is 11.30±1.17 and, physicians' mean score is 9.82±3.70 (Figure 1).</p><p><strong>Conclusions: </strong>It is clear that GPT-3.5 and Gemini respond similarly to topics in toxicology, just as resident physicians do.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 2","pages":"294-301"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587490","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":"Patent Ductus Arteriosus Stenting via Percutaneous Common Carotid Artery Access for Ductus Dependent Pulmonary Blood Flow in Newborns and Infants: Experience in Latvia.","authors":"Zanda Grīnberga, Elizabete Zaharāne, Pauls Sīlis, Valts Ozoliņš, Normunds Sikora, Elīna Ligere","doi":"10.15388/Amed.2024.31.2.5","DOIUrl":"10.15388/Amed.2024.31.2.5","url":null,"abstract":"<p><strong>Background: </strong>Newborn patients with cyanotic congenital heart diseases with ductus-dependent pulmonary blood flow require neonatal repair, or palliation with a secure source of pulmonary blood flow, up to definitive surgical correction or palliation of the malformation. There is growing experience of percutaneous patent ductus arteriosus stenting to maintain the ductal flow. Patients in need of PDA stenting are newborns or small infants and recent data suggests that a weight of <4 kg increases the risk of thrombosis from femoral arterial catheterisation. Carotid access for newborn cardiac catheterisation avoids femoral arterial injury and improves the catheter course for certain transvasal procedures.</p><p><strong>The aim of this study: </strong>was to report the Riga Children's Clinical University Hospital`s (CCUH) 7 year experience of patent ductus arteriosus stenting using the percutaneous transcarotidal approach in newborn babies and small infants with ductus-dependent critical heart diseases.</p><p><strong>Methods: </strong>A retrospective review of all newborn and small infants who underwent transcatheter arterial duct stenting through the percutaneous carotid artery approach at the CCUH in Riga, Latvia between the years 2013 and 2020.</p><p><strong>Results: </strong>In total, 8 patients underwent PDA stenting using the transcarotid approach between the years 2013 and 2020 in CCUH. The approach in all cases was chosen based on the anatomical features seen on echocardiography. In two cases, early restenting was necessary, while other patients had no procedure-associated complications. In the long term follow-up of 4 patients in two cases, dopplerography of the accessed common carotid artery showed stenotic changes up to 50%.</p><p><strong>Conclusions: </strong>PDA stenting using the transcarotid approach is currently considered a relatively safe method and does not have a greater risk of developing postprocedural complications compared to the transfemoral approach. Transcarotidal PDA stenting in neonates and small infants with ductus-dependent critical congenital heart disease is possible in small volume paediatric cardiac surgery centre to stabilise the patient prior to definitive surgery or palliation of complex CHD. The vascular access should be chosen depending on the anatomical features of the patient and the competency of the cardiac interventionalist. From our experience, long-term changes in the affected common carotid artery may develop in a substantial number of cases, they may not be clinically significant in midterm follow-up period but have to be reevaluated. However, further randomised studies are necessary with large cohorts and longer follow-up period.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 2","pages":"264-274"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587256","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":"Human Leucocyte Antigen Class II Risk and Protective Alleles in Women with Cervical Intraepithelial Neoplasia.","authors":"Olga Plisko, Jana Žodžika, Irina Jermakova, Inta Liepniece-Karele, Jeļena Eglīte, Dace Rezeberga","doi":"10.15388/Amed.2024.31.1.1","DOIUrl":"10.15388/Amed.2024.31.1.1","url":null,"abstract":"<p><strong>Background: </strong>Persistent human papillomavirus (HPV) infection is a necessary cause for development of cervical precancerous lesions and cervical cancer, however, only a small percentage of women progress to cervical cancer. The local immune response, determined, among other factors, by Human Leucocyte Antigen (HLA) genes, is thought to be significant. Still the results of genome studies are inconsistent and differ between ethnical populations. The aim of the study was to assess an association between HLA-DQA1*; DQB1*; DRB1* allele's genetic variants between women with cervical precancerous lesions and healthy controls in Latvia.</p><p><strong>Materials and methods: </strong>From January until April 2017 we enrolled 84 consecutive patients referred for colposcopy to Riga East University Hospital (Latvia) due to abnormal cervical cytology results. 57 women who came for a regular check-up and had normal cytology smears were included in the control group. Material from the cervix was taken for subsequent HLA genotyping of 13 DRB1*, 8 DQA1*, and 12 DQB1* alleles. Colposcopy was performed on all participants. In case of visual suspicion for CIN cervical biopsy was done.</p><p><strong>Results: </strong>There were 57 \"no CIN\" patients, 23 histologically proven CIN 1 and 61 CIN2+ cases in the study population. CIN2+ was more often associated with DQA1*0401 (OR 6.68, 95% CI 1.47-30.29, p=0.014), DRB*15 (OR 2.99, 95% CI 1.22-7.39, p=0.017), DQB1*0401 (OR 2.91, 95%CI 1.11-7.68, p=0.03), DQA1*0103 (OR 2.72, 95% CI 1.02-7.21, p=0.045), DRB1*11 (OR 2.42, 95% CI 1.10-5.33, p=0.029) and DQB1*0301 (OR 1.94, 95% CI 1.12-3.38, p=0.018). Women with \"no CIN\" more often had DQB1*0501 (OR 0.17, 95% CI 0.04-0.81, p=0.026), DRB1*16 (OR 0.21, 95% CI 0.06-0.78, p=0.019), DQA1*0301 (OR 0.35, 95% CI 0.14-0.87, p=0.024) and DRB1*14 (OR 0.59, 95% CI 0.01-0.46, p=0.007).</p><p><strong>Conclusions: </strong>In the current study we have demonstrated a strong association with risk and protective HLA class II alleles that are determined by the HLA-DRB1*; DQA1*; DQB1*.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 1","pages":"5-11"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559970","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":"A Case of Successful Treatment of Left Ventricular Rupture after Transcatheter Aortic Valve Implantation.","authors":"Rustem Tuleutayev, Kuat Abzaliyev, Alexey Kolesnikov, Igor Kim, Symbat Abzaliyeva","doi":"10.15388/Amed.2024.31.2.3","DOIUrl":"10.15388/Amed.2024.31.2.3","url":null,"abstract":"<p><strong>Background: </strong>The article talks about a patient who had nonrheumatic disease of the aortic valve and had a left ventricular rupture during a transcatheter aortic valve implantation (TAVI) procedure.</p><p><strong>Methods: </strong>The discrepancy between the size of the prosthesis and the size of the native aortic valve (mismatch) led to the need to deploy a second prosthesis, which was dislocated into the left ventricular cavity and led to myocardial damage and the development of tamponade.</p><p><strong>Results: </strong>As a result of timely cardiac surgery and effective measures of the emergency support service, both prostheses were removed from the left ventricular cavity, the aortic valve was replaced with a \"Medtronic Hankock No. 25\" biological prosthesis, and the left ventricular myocardial rupture was sutured.</p><p><strong>Conclusions: </strong>In case of the development of such complications during the transcatheter aortic valve implantation (TAVI) procedure with asystole and cardiac tamponade, it was suggested to conduct cardioplegia (instead of chest compressions).</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 2","pages":"339-350"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587453","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":"A Multicomponent Educational and Rehabilitation Approach in Optimizing Outcomes During the Poststroke Subacute Phase.","authors":"Alma Glinac, Osman Sinanović","doi":"10.15388/Amed.2024.31.2.20","DOIUrl":"10.15388/Amed.2024.31.2.20","url":null,"abstract":"<p><strong>Background: </strong>Poststroke patients often experience cognitive impairments, motor weakness, and difficulties in daily activities. A multicomponent educational-rehabilitation approach offers a holistic treatment by integrating cognitive and motor training with relaxation, adaptive skills training, and motivational components. Despite its potential benefits, there is limited evidence supporting its effectiveness during the subacute stroke phase. This study evaluates the impact of this approach on cognitive functions, upper extremity motor skills, and daily activity independence during the subacute phase.</p><p><strong>Materials and methods: </strong>In a prospective, randomized clinical trial, 40 patients participated in a 20-session multicomponent educational-rehabilitation program consisting of 45-minute sessions, five days a week. This program combined cognitive and motor training with additional components such as relaxation and patient education. The control group (N=30) received standard physical therapy, including electrotherapy and speech therapy as needed. Assessments were conducted at admission, after the final session for the experimental group, and one month later for the control group.</p><p><strong>Results: </strong>The experimental group demonstrated significantly greater improvements in cognitive abilities, upper extremity functionality, and daily activity independence compared to the control group (p < 0.001).</p><p><strong>Conclusion: </strong>The multicomponent educational-rehabilitation approach significantly enhances cognitive function, motor skills, and daily activity independence during the subacute phase of stroke recovery. These findings suggest that this approach offers superior recovery outcomes compared to standard care, warranting further investigation into its long-term effects.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 2","pages":"315-327"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587455","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}