Annals of Medicine & Surgery最新文献

{"title":"DREZotomy in the era of minimally invasive interventions for cancer-related pain management","authors":"Areeba Fareed, Malak A. Hassan, Solay Farhat, Afra Sohail, Rayyan Vaid","doi":"10.1097/ms9.0000000000002288","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002288","url":null,"abstract":"","PeriodicalId":373451,"journal":{"name":"Annals of Medicine & Surgery","volume":"4 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141335342","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":"Frantz’s tumor as incidental finding during Heller myotomy for achalasia: case report and review of literature","authors":"T. Printes, Gustavo Lopes de Castro, Delon Calixto Rabelo, Rubem Alves da Silva Neto, R. A. da Silva Júnior","doi":"10.1097/ms9.0000000000002273","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002273","url":null,"abstract":"\u0000 \u0000 Solid pseudopapillary tumor is a low-grade malignancy of the pancreas and predominantly affects young women. This neoplasm is a rare pancreatic entity with vague clinical presentation. Diagnosis is often incidental through imaging or even during surgical approach for another condition.\u0000 \u0000 \u0000 \u0000 A 22-year-old Brazilian female with gastrointestinal symptoms was diagnosed with achalasia and underwent Heller myotomy. Intra-operatory findings included an enlarging mass in distal pancreas. During follow-up for surgical approach of achalasia, a hypothesis of Frantz’s tumor was stated and spleen preserving distal pancreatectomy was performed.\u0000 \u0000 \u0000 \u0000 The pathological pathways of Frantz’s tumor is still unclear and its connection with chromosomal abnormalities is under investigation. Although the tumor has been reclassified over the years to solid pseudopapillary tumor, surgical resection remains as standard treatment.\u0000 \u0000 \u0000 \u0000 Despite a surgical challenge, surgery presents great prognosis in these patients and long-term survival. High suspicion and proper investigation are fundamental to diagnosis and early treatment.\u0000","PeriodicalId":373451,"journal":{"name":"Annals of Medicine & Surgery","volume":"5 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141335338","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":"Risk factors and diagnostic performance of predictors as a screening technique for gestational diabetes mellitus: a retrospective cross-sectional study","authors":"F. M. Khobrani, Abdullah Mohammad alzahrani, D. S. Binmahfoodh, Rawan A. Hemedy, S. Abbas","doi":"10.1097/ms9.0000000000002247","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002247","url":null,"abstract":"\u0000 \u0000 Gestational diabetes mellitus (GDM) is a condition that can have negative impacts on both mother and baby. Detecting GDM early is crucial, and fasting plasma glucose (FPG) has been suggested as a possible screening method. This retrospective cross-sectional study aims to investigate potential risk factors and complications associated with GDM. Additionally, it aims to establish the diagnostic performance of predictive factors as a screening method for GDM.\u0000 \u0000 \u0000 \u0000 Data were collected from the medical records of 247 pregnant women who visited outpatient Obstetrics clinics between 2021 and 2022. The study investigated potential risk factors and complications associated with gestational diabetes mellitus (GDM), including impaired fasting glucose/impaired glucose tolerance (IFG/IGT), family history of diabetes mellitus (DM), and medical conditions. Moreover, the study evaluated the diagnostic performance of potential predictors as screening techniques for gestational diabetes mellitus (GDM.\u0000 \u0000 \u0000 \u0000 The study found that impaired fasting glucose or impaired glucose tolerance (IFG/IGT) (P<0.001), a history of GDM (P<0.001), and a family history of diabetes mellitus (DM) (P=0.022) were significant factors associated with GDM. Healthy individuals had a lower risk of developing GDM (P<0.001). No significant correlation was found between GDM and macrosomia, hypertension, polycystic ovarian syndrome, or other obstetric complications. Although a weak association was observed between fasting blood glucose levels during the first trimester and GDM, it was not significant.\u0000 \u0000 \u0000 \u0000 In conclusion, this study found that impaired fasting glucose or impaired glucose tolerance (IFG/IGT) and a past history of GDM were significantly associated with GDM. Additionally, a family history of diabetes increased the likelihood of developing GDM, while no significant association was found between GDM and other obstetric complications. Although a weak association was observed between fasting blood glucose levels during the first trimester and GDM, it was not statistically significant.\u0000","PeriodicalId":373451,"journal":{"name":"Annals of Medicine &amp; Surgery","volume":"19 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141340713","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":"Frailty assessment tools and their predictive value in preoperative evaluation for general surgery: a narrative review","authors":"Swizel Ann Cardoso, Jenisha Suyambu, Aamir Amin, Javed Iqbal, R. P. Cardoso, Ather Iqbal, Akarshak Bal, Natasha Varghese Isaac, Nahid Raufi","doi":"10.1097/ms9.0000000000002208","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002208","url":null,"abstract":"The world’s population is ageing rapidly, with projections suggesting a significant increase in the elderly demographic over the next few decades. This shift is likely to result in long periods of infirmity and frailty, thus escalating healthcare demands. Frailty has been investigated almost exclusively in the elderly because of its association with the senior population. It is considered to be an unavoidable aspect of old age, rather than a variable aspect of ageing. It has been linked to a greater risk of falls and decreased mobility, increased hospitalizations, institutionalization, and mortality. Due to elevated complication risk, the frail group required expert surgical treatment and specialised care. Various models have been described in recent years, including the Frailty Phenotype model, the Edmonton Frailty scale, and the Clinical Frailty scale, among many others. Each model employs several components to assess an individual’s frailty. There is, however, no gold standard for measuring fragility. The use of such assessment methods in pre-operative frailty screening as a risk-stratification instrument has been shown to be effective in older persons undergoing general surgery. The use of frailty assessment tools to determine the level of frailty together with evidence-based treatment and management should be supported by collaborative decision making. In this narrative review, we discussed the four commonly used frailty assessment tools with a particular emphasis on the need for additional research to refine these models and enhance their predictive accuracy in surgical settings.","PeriodicalId":373451,"journal":{"name":"Annals of Medicine &amp; Surgery","volume":"44 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141343827","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":"Clinical efficacy of TEVAR utilizing fenestrated stent-grafts for zone 0 in an elderly frail patient with giant aortic arch aneurysm","authors":"H. Kurobe, T. Hori, Hiroshi Fujita, Tomohide Higaki, Takuma Fukunishi, H. Sogabe, H. Izutani","doi":"10.1097/ms9.0000000000002268","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002268","url":null,"abstract":"\u0000 \u0000 Elderly and frail patients with thoracic aortic aneurysms (TAAs) near to origins of cervical arteries present facing challenges with aortic arch replacement with cardiopulmonary bypass, and traditional tube-type stent-grafts are also inadequate for transcatheter endovascular aortic repair (TEVAR). Thus, necessitating precise treatment with fenestrated stent-grafts from zone 0. This approach is crucial for achieving favorable postoperative outcomes without compromising activities of daily living (ADL).\u0000 \u0000 \u0000 \u0000 An 85-year-old-man admitted to the hospital for treatment of a large TAA. While arch replacement is a definitive procedure, it is highly invasive, and the postoperative ADL are expected to be significantly lower than preoperative levels. Therefore, we performed a debranching TEVAR from Zone 0 with fenestrated stent-graft. The patient was discharged from the hospital on the 11th postoperative day.\u0000 \u0000 \u0000 \u0000 In frail and elderly patients for whom conventional surgery may not be viable, TEVAR emerges as a preferred alternative. However, TEVAR of TAA proximal to the aortic arch continues to pose challenges, necessitating meticulous attention to the cervical branches in the intervention strategy. While surgical intervention in these patients necessitates careful consideration of its suitability, including the potential for postoperative enhancement in ADL, the use of fenestrated stent-grafts from Zone 0 emerges as one of the treatment modalities.\u0000 \u0000 \u0000 \u0000 We present a very elderly case in which fenestrated stent-grafts were used to avoid aortic arch replacement for a large aortic arch aneurysm, resulting in a good postoperative course with no decline in ADL.\u0000","PeriodicalId":373451,"journal":{"name":"Annals of Medicine &amp; Surgery","volume":"63 36","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141347005","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":"Correlation between fetal ventricular echogenic foci in pregnancy and fetus chromosomal anomaly, a case-control study in bandar abbas city","authors":"Mazyar Rastegar, Shahrokh Rajaei, Negin Yazdian Anari, Seyyed Mohammad Hashemi, Amir Entezar Baghiatallah, Arezoo Ghazalgoo, Sholes Namazi, Saman Soltani Moghadam, M. Aleali, M. Keivanlou, Ehsan Amini-Salehi","doi":"10.1097/ms9.0000000000002260","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002260","url":null,"abstract":"\u0000 \u0000 Ventricular echogenic foci are small structures within the hearts of some fetuses. These small areas result from increased echogenicity in the ventricles of fetuses located near the papillary muscles. An association between these foci and chromosomal abnormalities in fetuses has been reported. Considering that chromosomal abnormalities are a major cause of prenatal death, this study aimed to determine the value of fetal echogenic foci as markers for chromosomal abnormalities.\u0000 \u0000 \u0000 \u0000 Fetal echocardiography was performed by an experienced cardiologist on 149 pregnant women in the second trimester. Of these, 75 were reported to have positive echogenic foci, and 74 were reported to have no echogenic foci. Subsequently, the three chromosomal anomalies including trisomies 21, 18, and 13 were examined. The information of the individuals, including gestational age and echogenic foci, was recorded.\u0000 \u0000 \u0000 \u0000 Based on the findings of the present study, seven infants (4.7%) had trisomy 21, four infants (2.7%) had trisomy 13, and six infants (4.1%) had trisomy 18. The mean gestational age of pregnant women with positive and negative echogenic foci was 21.07±3.23 and 21.03±3.09, respectively. No significant relationship was found between ventricular echogenic foci and trisomy 21, 18, or 13.\u0000 \u0000 \u0000 \u0000 The present study suggests no significant relation between the presence of echogenic foci and chromosomal trisomies. This finding indicates that additional tests are required to confirm chromosomal abnormalities when echogenic intracardiac foci are present, especially in high-risk fetuses. Moreover, the absence of echogenic focus does not rule out chromosomal disorders.\u0000","PeriodicalId":373451,"journal":{"name":"Annals of Medicine &amp; Surgery","volume":"52 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141345664","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":"Patterns of substance use and initiation timing in adults with substance abuse: A comparison between those with and without ADHD","authors":"Roya Vaziri-harami, M. Khademi, Anahita Zolfaghari, Saharnaz Vaziri-harami","doi":"10.1097/ms9.0000000000002272","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002272","url":null,"abstract":"\u0000 \u0000 Attention deficit hyperactivity disorder (ADHD) is a prevalent psychiatric disorder in childhood and adolescence, persisting into adulthood in 60% of cases, with an adult age prevalence rate of 4%. Substance use disorder (SUD) is a recognized comorbidity with significant social and financial implications, necessitating detailed investigation.\u0000 \u0000 \u0000 \u0000 This longitudinal study focused on adults with SUD in addiction detention in two camps including Toska and Chitgar in the west and south of Tehran during 2021-2022. Participants underwent assessment using the Structured Clinical Interview for DSM Disorders (SCID) to identify individuals with SUD, excluding those with major mental problems. The remaining subjects were assessed by Conner’s questionnaire. and positive cases underwent a comprehensive ADHD interview. The study comprised 50 individuals with ADHD and 90 without ADHD, allowing for a comparative analysis of the onset age of substance use and patterns across both groups. The substances examined included alcohol, cannabis, crack, methamphetamine, tramadol, methadone, opium, ecstasy, morphine, and hypnotics.\u0000 \u0000 \u0000 \u0000 The study revealed a lower age of onset of substance use in the ADHD group. Furthermore, individuals with ADHD exhibited higher rates of alcohol, cannabis, methamphetamine, and tramadol use, while the non-ADHD group showed elevated usage of Ritalin, methadone, ecstasy, morphine, and hypnotics.\u0000 \u0000 \u0000 \u0000 Prompt diagnosis and treatment of ADHD regarding the lower onset age of substance use and a further range of high-risk substances, such as alcohol, methamphetamine, and crack, would be crucial. Additionally, based on these findings, policy recommendations should emphasize early ADHD screening and intervention strategies to mitigate the risk of substance use disorders, thereby addressing the associated social and financial burdens.\u0000","PeriodicalId":373451,"journal":{"name":"Annals of Medicine &amp; Surgery","volume":"62 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141346732","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":"Aortic ulcerated plaque discovery following mesenteric infarction in a 60-year-old patient: A case report","authors":"Ahmad Almohamed, Saleh Takkem, Saja Karaja, Sliman Marina, Sham Zoukar, Rema Rahhal","doi":"10.1097/ms9.0000000000002262","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002262","url":null,"abstract":"\u0000 \u0000 A penetrating aortic ulcer (PAU), which accounts for 2%-7% of all acute aortic syndromes, is the ulceration of an aortic atherosclerotic plaque that passes through the internal elastic lamina and into the aortic medium. Although PAUs are frequently seen in the middle and lower descending thoracic aortas, it is rare for them to arise in the ascending aorta. Atherosclerotic vascular illnesses and isolated peripheral arterial illnesses are associated with similar risk factors, such as male gender, advanced age, a history of tobacco use, hypertension, hyperlipidemia, and coronary artery disease. Just 20–54% of people with PAU first exhibit symptoms, suggesting that the condition might sometimes present as an asymptomatic phenomenon.\u0000 \u0000 \u0000 \u0000 A 60-year-old male came to the emergency department due to severe abdominal pain and abdominal contractures, which were diagnosed as mesenteric infarction with a relatively small infarcted intestinal segment. A part of the intestine was resected. Then he was referred to request a cardiac consultation to search for the source of the mesenteric infarction, which turned out to be an embolus.\u0000 \u0000 \u0000 \u0000 the patient was referred to cardiac surgery to perform aortic grafting.\u0000 \u0000 \u0000 \u0000 Aortic ulcer and mesenteric infarction together provide a challenging clinical picture that has to be recognized and treated right away. A high index of suspicion is necessary due to the possibility of fast deterioration, particularly in individuals who have risk factors like arteriosclerosis. Improving outcomes depends critically on early diagnostic imaging and intervention.\u0000","PeriodicalId":373451,"journal":{"name":"Annals of Medicine &amp; Surgery","volume":" 40","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141366213","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":"Quality of life and depression in patients with Parkinson’s disease: effectiveness of group cognitive behavioral therapy: a randomized controlled study","authors":"Mohammad Delshadi, Hasan Arjmand, Shima Imannezhad, Maryam Mostafavi, Yasaman Mohammadi, Mahdi Naeim","doi":"10.1097/ms9.0000000000002254","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002254","url":null,"abstract":"\u0000 \u0000 Group cognitive behavioral therapy has demonstrated its effectiveness in treating various psychological disorders. Nevertheless, there is insufficient evidence supporting its application in enhancing both the quality of life and depression among Parkinson’s patients. Consequently, this study was undertaken to examine the efficacy of group cognitive-behavioral therapy in ameliorating depression symptoms and enhancing the quality of life in individuals afflicted with Parkinson’s disease.\u0000 \u0000 \u0000 \u0000 A randomized clinical trial with pre-test and post-test measurements, including a control group, was conducted. The sample consisted of individuals referred to Roozbeh Hospital in Tehran with Parkinson’s disease in 2023. 90 participants were selected using convenience sampling and randomly assigned to either an experimental or a control group, with 45 participants in each. The experimental group received a three-month cognitive-behavioral therapy intervention, consisting of 12 sessions of 90 minutes. Pre-test and post-test measures included the Beck Depression Questionnaire and the World Health Organization Quality of Life Questionnaire. Data analysis was performed using multivariate analysis of covariance (MANCOVA) in SPSS-25.\u0000 \u0000 \u0000 \u0000 The results revealed a significant difference between the experimental and control groups in terms of depression and quality of life. The cognitive-behavioral therapy intervention significantly reduced depression and significantly improved the quality of life in individuals with Parkinson’s disease (P≤0.01).\u0000 \u0000 \u0000 \u0000 Group cognitive-behavioral therapy can be an effective approach for reducing depression and improving the quality of life in individuals with Parkinson’s disease. Therefore, therapists and healthcare providers can utilize cognitive-behavioral therapy to enhance the well-being of individuals with Parkinson’s disease.\u0000","PeriodicalId":373451,"journal":{"name":"Annals of Medicine &amp; Surgery","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141366523","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":"Association between gallstone disease and carotid intima-media thickness: a prospective observational cross-sectional study in a tertiary care center","authors":"Lokendra Thapa, Shailendra Katwal, B. Thapa","doi":"10.1097/ms9.0000000000002269","DOIUrl":"https://doi.org/10.1097/ms9.0000000000002269","url":null,"abstract":"\u0000 \u0000 Gallstone disease (GD) is a prevalent health issue globally, particularly in developed nations, and has notable associations with cardiovascular disease (CVD). This prospective observational cross-sectional study aimed to investigate the association between gallstone disease and carotid intima-media thickness (CIMT), a marker of carotid atherosclerosis, in a tertiary care setting.\u0000 \u0000 \u0000 \u0000 Conducted at a Tertiary Care Center, the study included 96 participants (48 with gallstone disease and 48 age and sex-matched controls). Data collection involved demographic information, BMI calculation, abdominal ultrasonography for gallstone detection, and carotid ultrasonography for CIMT measurement. Statistical analysis was performed using SPSS version 26.\u0000 \u0000 \u0000 \u0000 The study revealed higher CIMT values in GD patients compared to controls (P<0.001). Additionally, a positive correlation was observed between CIMT and age (r=0.450, P<0.001) and Body mass index (BMI) (r=0.550, P<0.001). The Cohen’s d test indicated a clinically significant difference in CIMT between GD patients and controls (d=1.47).\u0000 \u0000 \u0000 \u0000 This study revealed a significant association between gallstone disease and elevated CIMT, correlating with higher BMI indicating a potential link between gallstone disease and increased risk of carotid atherosclerosis. These findings highlight the importance of assessing cardiovascular risk in patients with gallstone disease, highlighting the potential utility of carotid ultrasonography as a non-invasive screening tool. Early intervention strategies may be warranted to mitigate cardiovascular risks associated with gallstone disease.\u0000","PeriodicalId":373451,"journal":{"name":"Annals of Medicine &amp; Surgery","volume":" 85","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141365883","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}