eNeurologicalSci最新文献

{"title":"Dandy-Walker syndrome associated with a giant occipital meningocele: A case report and a literature review","authors":"Ahmed Dheyaa Al-Obaidi ,&nbsp;Ali Tarik Abdulwahid ,&nbsp;Mustafa Najah Al-Obaidi ,&nbsp;Abeer Mundher Ali ,&nbsp;Hashim Talib Hashim","doi":"10.1016/j.ensci.2023.100486","DOIUrl":"https://doi.org/10.1016/j.ensci.2023.100486","url":null,"abstract":"<div><h3>Background</h3><p>Dandy-Walker malformation or syndrome is the most common posterior fossa malformation. It is commonly associated with other congenital anomalies such as cardiac defects; however, association with a giant occipital meningocele is extremely rare, as only around 34 cases have been described.</p></div><div><h3>Case description</h3><p>We report a case of a 2-month-old female infant who presented with a midline, gigantic mass in the back of the head. It was first discovered on a prenatal ultrasound. The mass measured about 15 × 5 cm, extending to the midback, not changing in size with crying, not attached to the back, and with a positive transillumination test. The diagnosis was confirmed after doing a brain computed tomography, which revealed hypoplasia of the vermis with an enlarged posterior fossa as well as cystic dilation of both ventricles with herniation through a bone defect.</p></div><div><h3>Conclusion</h3><p>Our case highlights a rare association between giant occipital meningocele and Dandy-Walker syndrome that is rarely discussed or reported in the medical literature. By reporting this extremely rare case of Dandy-Walker syndrome associated with a giant occipital meningocele, we hope to contribute to the creation of a database for future research so that a management protocol can be established for use by clinicians and neurosurgeons for better management of the condition.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"33 ","pages":"Article 100486"},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405650223000448/pdfft?md5=d37f48d5dcaa9395468d3f063403ef63&pid=1-s2.0-S2405650223000448-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136695596","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":"Neurological complications after COVID-19: A narrative review","authors":"Ghazale Molaverdi ,&nbsp;Zahra Kamal ,&nbsp;Mahshid Safavi ,&nbsp;Arman Shafiee ,&nbsp;Sayed-Hamidreza Mozhgani ,&nbsp;Mohadeseh Zarei Ghobadi ,&nbsp;Mahdi Goudarzvand","doi":"10.1016/j.ensci.2023.100485","DOIUrl":"https://doi.org/10.1016/j.ensci.2023.100485","url":null,"abstract":"<div><p>COVID-19 is primarily classified as a respiratory disorder; however, various neurological symptoms have been reported in COVID-19 patients. Neurological manifestations may be the initial signs of COVID-19 and can develop in patients of different age groups and with or without underlying disease. COVID-19 causes a broad range of complications in the central nervous system. These include headaches, altered mental status, dizziness, seizures, cerebrovascular events, encephalitis, and other encephalopathies. Moreover, a broad spectrum of peripheral nervous system symptoms such as olfactory and gustatory dysfunctions, neuropathy, visual impairments, neuralgia, cranial nerves palsy, and muscle involvement could manifest as symptoms. Despite various efforts, the exact pathogenesis of the COVID-19 neurological complications has not been clarified yet. Moreover, the reason for the development of neurological manifestation in only some COVID-19 patients has not been determined. This review focuses on the different neurological symptoms associated with COVID-19 and the possible pathological mechanisms hoping to provide new insights for diagnosis, therapies, or other forms of intervention.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"33 ","pages":"Article 100485"},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405650223000436/pdfft?md5=bfb4e61b386836425c719cc09ca0deb9&pid=1-s2.0-S2405650223000436-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138423348","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":"Clinical characteristics of motor functional neurological disorder manifesting as limb weakness after vaccination against coronavirus disease 2019: A case series","authors":"Masayuki Ohira ,&nbsp;Takashi Osada ,&nbsp;Hiroaki Kimura ,&nbsp;Terunori Sano ,&nbsp;Masaki Takao","doi":"10.1016/j.ensci.2023.100487","DOIUrl":"https://doi.org/10.1016/j.ensci.2023.100487","url":null,"abstract":"<div><h3>Background</h3><p>The characteristics of functional limb weakness (FLW) as one of the manifestations of functional neurological disorder after vaccination against coronavirus disease 2019 (COVID-19) remain controversial.</p></div><div><h3>Methods</h3><p>In this descriptive case series, we aimed to elucidate the characteristics of Japanese patients with FLW who claimed muscle weakness after COVID-19 vaccination among patients who visited our outpatient clinic between 1 June 2021 and 31 December 2022.</p></div><div><h3>Results</h3><p>Nine patients were diagnosed with FLW (mean age: 30.8 years), including two men and seven women. Seven patients were vaccinated with the BioNTech/Pfizer vaccine and two with the mRNA-1273 Moderna vaccine. All patients demonstrated various positive signs for FLW. Magnetic resonance imaging or computed tomography indicated no abnormality that could explain their symptoms. At the time of the clinic visit, five patients were treated for psychiatric disorders, including depression, insomnia, attention-deficit hyperactivity disorder, and Asperger's syndrome. Muscle weakness spread to the limbs beyond the vaccinated arm in seven patients.</p></div><div><h3>Conclusions</h3><p>We describe the basic characteristics of FLW in Japanese patients after COVID-19 vaccination. Further recognition of these characteristics could aid the diagnosis of FLW by physicians allowing them to support these patients effectively.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"33 ","pages":"Article 100487"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S240565022300045X/pdfft?md5=7d59b81bb9345123f114001e07040a49&pid=1-s2.0-S240565022300045X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134832068","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":"High acceptability, convenience and reduced carbon emissions of tele-neurology outpatient services at a regional referral centre in Kenya","authors":"Fazal Abdulaziz Yakub ,&nbsp;Jasmit Shah ,&nbsp;Dilraj Singh Sokhi","doi":"10.1016/j.ensci.2023.100484","DOIUrl":"10.1016/j.ensci.2023.100484","url":null,"abstract":"<div><h3>Background</h3><p>There is severe shortage of neurologists in sub-Saharan Africa. Tele-neurology consultations (TNC) can bridge this service gap, but there is very little published evidence on TNC in our setting, which we addressed through our study.</p></div><div><h3>Methods</h3><p>We prospectively enrolled patients at our neurology outpatients from October 2020 to October 2021. We administered a post-TNC questionnaire which captured satisfaction/acceptability using Likert scales. A sub-group of participants who also did in-person consultations (IPC) were additionally administered post-IPC questionnaires. Statistical comparisons were made using the paired student <em>t</em>-test, and descriptive data expressed as median (inter-quartile range).</p></div><div><h3>Results</h3><p>From 219 enrolled patients, 66.7% participants responded: 74.0% had both IPC and TNC; 63.0% were female; age was 40.9 (30.6–55.2) years; and 2.7% were from neighbouring countries. The commonest presentations were headache (30.8%), seizures (26.0%) and neurodegenerative disorders (15.1%). For TNC, &gt;90% found it: (i) as comfortable as IPC (<em>p</em> = 0.35); (ii) didn't violate their privacy; (iii) saved time [3.0 (2.0–4.0) hours], travel [11.0 (7.2–21.1) km] and cost [$9.09 (4.55–18.18)]; and (iv) addressed their concerns satisfactorily such that they would use TNC again. Conversely, 15.1% didn't agree with TNC being as effective as IPC, and felt the neurologist did not satisfactorily identify all of their health problems (<em>p</em> = 0.03). In total, our TNC service saved our patients $6167, 1143 h, and 25,506 km of travel, translating to 3.5 t (equivalent to 21 newly-planted trees) of carbon dioxide emissions.</p></div><div><h3>Conclusions</h3><p>Our study demonstrates that TNC is an acceptable, efficient, effective, and environmentally-sustainable care delivery model.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"33 ","pages":"Article 100484"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405650223000424/pdfft?md5=921be3f233c78a51fbb538f6f9607f04&pid=1-s2.0-S2405650223000424-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135610547","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":"Population-based stroke risk profile from a West-African community","authors":"Ifeoma Uchenna Onwuakagba ,&nbsp;Emmanuel Chiebuka Okoye ,&nbsp;Favour Chidera Kanu ,&nbsp;Chukwuemeka Michael Kalu ,&nbsp;Daniel Chidubem Akaeme ,&nbsp;Ogochukwu Charity Obaji ,&nbsp;Christopher Olusanjo Akosile","doi":"10.1016/j.ensci.2023.100483","DOIUrl":"https://doi.org/10.1016/j.ensci.2023.100483","url":null,"abstract":"<div><h3>Objectives</h3><p>To determine the stroke risk profile of dwellers of Nnewi community in Nigeria.</p></div><div><h3>Methods</h3><p>This was a cross-sectional survey involving consecutively recruited community-dwelling adults without a previous history of stroke. The Modified Framingham Stroke Risk Score (MFSRS) was used to evaluate the stroke risk profile of the participants. Data was analysed using descriptive and inferential statistics at an alpha level of 0.05.</p></div><div><h3>Result</h3><p>310 individuals (mean age = 37.21 ± 15.84 years; 68.7% females) participated in this study. The mean MFSRS (6.79 ± 5.21) of the participants was minimal with 16% having a moderate-to-high risk. Dyslipidaemia (100.0%), meat (88.1%) and sugar (70.6%) consumption, hypertension (37.7%), physical inactivity (43.2%), and psychological stress (41.3%) were the most prevalent risk factors in the population. Participants' MFSRS significantly and positively correlated with their body mass index (BMI), waist circumference (WC), and waist-hip ratio (WHR) and significantly differed across their gender, educational, and occupational categories (<em>p</em> &lt; 0.05).</p></div><div><h3>Conclusion</h3><p>According to MFSRS, the risk of stroke among the sampled community was minimal and was significantly influenced by their BMI, WC, WHR, gender, education, and occupation. However, results revealed that stroke risk might be higher in the population than was depicted by the MFSRS. Enlightenment on the risk of stroke is needed in the community.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"33 ","pages":"Article 100483"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405650223000412/pdfft?md5=2117bd84ebb18b59b3994a37eafa2b47&pid=1-s2.0-S2405650223000412-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92043024","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":"MRI-negative myelitis associated with MOG-IgG antibody: A case report and literature reviews","authors":"Jiwon Yang,&nbsp;Yeong-Bae Lee,&nbsp;Hyeon-Mi Park","doi":"10.1016/j.ensci.2023.100481","DOIUrl":"https://doi.org/10.1016/j.ensci.2023.100481","url":null,"abstract":"<div><p>According to few case reports, myelin oligodendrocyte glycoprotein-associated disease (MOGAD) could present as myelitis subtype with normal spine MRI, though it is rare. Herein, we report a case of clinically myelitis but MRI was normal, with strongly positive anti-MOG-IgG antibody in the sera. The patient showed a rapid improvement following a high dose methylprednisolone treatment.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"33 ","pages":"Article 100481"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50201440","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":"Unveiling Dandy-Walker syndrome: A surprising twist in the tale of acute hydrocephalus and Down syndrome child","authors":"Elie Fahed ,&nbsp;Ali Msheik ,&nbsp;Mohamad Yazbeck ,&nbsp;Maya Rahal ,&nbsp;Stephanie Antoun ,&nbsp;Caroline Geagea ,&nbsp;Philippe Younes","doi":"10.1016/j.ensci.2023.100480","DOIUrl":"10.1016/j.ensci.2023.100480","url":null,"abstract":"<div><p>The correlation between Down syndrome and Dandy-Walker syndrome is an exceptionally uncommon occurrence. To date, only four cases have been documented. All previously reported cases involved individuals under the age of 37 months, with prenatal or birth diagnoses. Additionally, most of these cases displayed a limited life expectancy and experienced poor developmental outcomes. In this report, we present the first-ever instance of an 11-year-old male patient, previously undiagnosed with Dandy-Walker syndrome, who presented with acute intracranial hypertension. Magnetic Resonance Imaging revealed an active hydrocephalus caused by a Dandy-Walker malformation. The patient's condition was effectively managed through the implementation of a ventriculo-cysto-peritoneal shunt. This case highlights the coexistence of Dandy-Walker syndrome and Down syndrome in an asymptomatic young patient. Furthermore, it demonstrates that active hydrocephalus in such cases can be successfully addressed through either endoscopic third ventriculostomy or ventriculo-cysto-peritoneal shunt procedures.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"33 ","pages":"Article 100480"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10624568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487033","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":"Blood pressure variability and early neurological outcomes in acute and subacute stroke in Southwestern Uganda","authors":"Nicholas Kulaba ,&nbsp;Adrian Kayanja ,&nbsp;Denis Serubiri ,&nbsp;Mark Kaddu Mukasa ,&nbsp;Martin Kaddumukasa ,&nbsp;Jane Nakibuuka ,&nbsp;Shirley M. Moore ,&nbsp;Elly T. Katabira ,&nbsp;Martha Sajatovic ,&nbsp;Cumara B. O'Carroll ,&nbsp;Anthony Muyingo","doi":"10.1016/j.ensci.2023.100482","DOIUrl":"https://doi.org/10.1016/j.ensci.2023.100482","url":null,"abstract":"<div><h3>Background</h3><p>Greater blood pressure variability has detrimental effects on clinical outcome after a stroke; its effects are controversial and have not been evaluated in Sub-Saharan Africa (SSA).</p></div><div><h3>Methods</h3><p>We conducted a prospective study of patients with CT head confirmed ischemic and hemorrhagic strokes admitted to a tertiary hospital within 7 days of onset of unilateral neurological deficits. Blood pressure variability indices, standard deviation (SD) and coefficient of variation (CV) of systolic and diastolic blood pressure between day 0 and day 7, were calculated with a subsequent modified Rankin Scale (mRS) score on day 14 post-stroke. Linear regression was performed to determine the exponential coefficients of mortality at 14 days post- stroke.</p></div><div><h3>Results</h3><p>Out of 120 patients, 51.7% were female, 52.5% had ischemic stroke and the overall median age was 65 (IQR 54–80) years. Twenty (16.7%) patients died within a median survival time of 7 days, while 32 (26.7%) died by day 14 post-stroke. Patients with hemorrhagic stroke had an overall SDSBP of 16.44 mmHg while those with ischemic stroke had an overall SDSBP of 14.05 mmHg. In patients with ischemic stroke, SDSBP had adjusted coefficients of 1, <em>p</em> = 0.004 with C·I: 1.01–1.04 and NIHSS had adjusted coefficients of 1, <em>p</em> = 0.019 with C·I: 1.00–1.03 while in patients with hemorrhagic stroke, SDSBP had adjusted coefficients of 1, <em>p</em> = 0.045 with C·I: 1.00–1.04 and NIHSS had adjusted coefficients of 1, <em>p</em> ≤0.001 with C·I: 1.01–1.03.</p></div><div><h3>Conclusion</h3><p>Exponential increase in Blood Pressure Variability (BPV) and stroke severity scale were independently associated with early mortality among all stroke patients in our study. We recommend future studies to evaluate whether controlling BPV among patients with stroke in Sub-Saharan Africa can reduce mortality.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"33 ","pages":"Article 100482"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405650223000400/pdfft?md5=653e8643a2152efb97918351794b24c4&pid=1-s2.0-S2405650223000400-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91728700","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":"Nitrous oxide myelopathy: A pernicious contrast enhancement","authors":"Yachar Dawudi,&nbsp;Evangelia Pappa,&nbsp;Karolina Hankiewicz,&nbsp;Thomas De Broucker,&nbsp;Mickael Bonnan","doi":"10.1016/j.ensci.2023.100479","DOIUrl":"10.1016/j.ensci.2023.100479","url":null,"abstract":"","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"33 ","pages":"Article 100479"},"PeriodicalIF":0.0,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2b/05/main.PMC10585348.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49692841","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":"Adding a chapter to the literature: A rare encounter of unilateral Moyamoya disease with ipsilateral persistent trigeminal artery","authors":"Marilhia Cornejo,&nbsp;Ramit Singla,&nbsp;Savdeep Singh,&nbsp;Cheran Elangovan,&nbsp;Balaji Krishnaiah","doi":"10.1016/j.ensci.2023.100478","DOIUrl":"https://doi.org/10.1016/j.ensci.2023.100478","url":null,"abstract":"<div><h3>Background</h3><p>The coexistence of persistent trigeminal artery (PTA) and Moyamoya disease (MMD) has been reported. If their pathogenesis is related and if PTA is protective or harmful in MMD remains unknown as these are rare cerebrovascular anomalies.</p></div><div><h3>Case presentation</h3><p>A 35-year-old woman with sudden global aphasia whose CT head and CT angiography of head and neck showed a hypodensity in the left posterior middle cerebral artery (MCA), a possible left proximal internal carotid artery occlusion, and a left PTA with hypoplasia of vertebral and basilar arteries. Digital subtraction angiography showed chronic MMD in the left MCA with extensive pial collateralization from anterior cerebral artery (ACA). The patient was initiated on single antiplatelet therapy and later she underwent direct bypass surgical intervention and rehabilitation.</p></div><div><h3>Discussion</h3><p>Our case report brings attention to the infrequent coexistence of ipsilateral MMD and PTA suggesting a potential congenital pathogenesis based on embryologic development and hemodynamics. Also, we propose a protective role of PTA in MMD in case of large anterior vessel occlusion. This case contributes to the scarce literature on the intriguing relationship between MMD and PTA.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"33 ","pages":"Article 100478"},"PeriodicalIF":0.0,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405650223000369/pdfft?md5=c6c172ec9074281aff95bb794007c023&pid=1-s2.0-S2405650223000369-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90017200","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}