The Laryngoscope最新文献

{"title":"In Response to Treatment Outcome in Head and Neck Cancer with Distant Metastasis at Initial Diagnosis.","authors":"Joe Omata, Yushi Ueki, Yuto Takahashi, Ryoko Tanaka, Yusuke Yokoyama, Takeshi Takahashi, R. Shodo, K. Yamazaki, Takafumi Togashi, Hiroshi Matsuyama, Nao Takahashi, Ryuichi Okabe, A. Horii","doi":"10.1002/lary.31519","DOIUrl":"https://doi.org/10.1002/lary.31519","url":null,"abstract":"","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":"63 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140964786","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":"Hearing Preservation After Cochlear Reimplantation Using Electrocochleography: A Case Report.","authors":"Amit Walia,&nbsp;Matthew A Shew,&nbsp;Amanda J Ortmann,&nbsp;Craig A Buchman,&nbsp;Jacques A Herzog","doi":"10.1002/lary.29734","DOIUrl":"https://doi.org/10.1002/lary.29734","url":null,"abstract":"<p><p>Studies have shown that hearing preservation is possible in the context of reimplantation, but residual hearing could not be predicted or expected in these cases. We describe a case in which a patient with mild to profound sensorineural hearing loss who underwent cochlear implantation with a lateral wall array and had hearing preserved postoperatively. She developed facial nerve stimulation which was unresponsive to reprogramming. Using electrocochleography to measure intracochlear trauma during the insertion process, the patient underwent reimplantation with a perimodiolar electrode and hearing was preserved postoperatively. This case demonstrates the potential to use electrocochleography for hearing preservation during reimplantation. Laryngoscope, 131:2348-2351, 2021.</p>","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":" ","pages":"2348-2351"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lary.29734","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39143472","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":"In Reference to How to Reduce the Risk of Adverse Events After COVID-19 Nasopharyngeal Swab.","authors":"Fabio Piazza","doi":"10.1002/lary.29775","DOIUrl":"https://doi.org/10.1002/lary.29775","url":null,"abstract":"I read the paper “CSF Leak After COVID-19 Nasopharyngeal Swab: A Case Report” by Paquin et al. and I think some recommendations can be added to optimize the procedural technique of nasopharyngeal swab to reduce the risk of adverse events: 1) to facilitate non-otolaryngologists, the floor of the nasal fossa (i.e., a line running from the nasal ala to the earlobe) should be parallel to the floor of the room; 2) slowly insert the swab down and posteriorly, following the direction of the floor of the nasal fossa; 3) the patient should be reminded not to move during collection of specimens; 4) ask the patient from which nostril she breathes best to understand which nostril is probably easier to pass through; 5) If the patient has a history of severe coagulopathy, ask her if she has had epistaxis and, if so, which side to obtain a nasopharyngeal swab specimen passing through the contralateral nasal cavity or, as an alternative, to obtain an oropharyngeal swab. In conclusion, I would like to thank Paquin for highlighting the need for educational of proper nasopharyngeal swab technique. I believe combining their recommendations with the tips I suggested may be useful to the readers and reduce the risk of adverse events.","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":" ","pages":"E2639"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lary.29775","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39216473","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":"Surgeon-performed Transoral Ultrasound-Guided Aspiration of Peritonsillar Abscess.","authors":"Tobias Todsen,&nbsp;Mads Georg Stage,&nbsp;Christoffer Holst Hahn","doi":"10.1002/lary.29525","DOIUrl":"https://doi.org/10.1002/lary.29525","url":null,"abstract":"INTRODUCTION Peritonsillar abscess is a common deep head and neck infection requiring early treatment to avoid a potentially dangerous spread of pus into the surrounding tissue. However, it can be challenging to distinguish peritonsillar cellulitis from an abscess by clinical examination. Many patients receive unnecessary needle aspiration attempts or exposure to ionizing radiation from a computed tomography (CT) scan with contrast to ensure a correct diagnosis. Instead, otolaryngologists can use ultrasound as a dynamic, radiation-free, and point-of-care imaging technique. Previously described transoral ultrasound techniques have limitations in clinical implementation due to transducer size and lack of real-time guidance of the needle. Therefore, we have improved the transoral technique using a small transducer to perform ultrasound-guided needle aspiration of patients with peritonsillar abscess. In this article, we will describe the method and present our initial results.","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":" ","pages":"2241-2245"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lary.29525","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25497448","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":"Multi-Institutional Analysis of Outcomes in Supraglottic Jet Ventilation with a Team-Based Approach.","authors":"Jennifer P Rodney,&nbsp;Justin R Shinn,&nbsp;Shaunak N Amin,&nbsp;David S Portney,&nbsp;Margaret B Mitchell,&nbsp;Zoey Chopra,&nbsp;Andrew B Rees,&nbsp;Robbi A Kupfer,&nbsp;Norman D Hogikyan,&nbsp;Keith A Casper,&nbsp;Alan Tate,&nbsp;Kimberly N Vinson,&nbsp;Kenneth C Fletcher,&nbsp;Alexander Gelbard,&nbsp;Paul J St Jacques,&nbsp;Michael S Higgins,&nbsp;Robert J Morrison,&nbsp;C Gaelyn Garrett","doi":"10.1002/lary.29431","DOIUrl":"https://doi.org/10.1002/lary.29431","url":null,"abstract":"<p><strong>Objectives/hypothesis: </strong>To evaluate the safety and complications of endoscopic airway surgery using supraglottic jet ventilation with a team-based approach.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>Subjects at two academic institutions diagnosed with laryngotracheal stenosis who underwent endoscopic airway surgery with jet ventilation between January 2008 and December 2018 were identified. Patient characteristics (age, gender, race, follow-up duration) and comorbidities were extracted from the electronic health record. Records were reviewed for treatment approach, intraoperative data, and complications (intraoperative, acute postoperative, and delayed postoperative).</p><p><strong>Results: </strong>Eight hundred and ninety-four patient encounters from 371 patients were identified. Intraoperative complications (unplanned tracheotomy, profound or severe hypoxic events, barotrauma, laryngospasm) occurred in fewer than 1% of patient encounters. Acute postoperative complications (postoperative recovery unit [PACU] rapid response, PACU intubation, return to the emergency department [ED] within 24 hours of surgery) were rare, occurring in fewer than 3% of patient encounters. Delayed postoperative complications (return to the ED or admission for respiratory complaints within 30 days of surgery) occurred in fewer than 1% of patient encounters. Diabetes mellitus, active smoking, and history of previous tracheotomy were independently associated with intraoperative, acute, and delayed complications.</p><p><strong>Conclusions: </strong>Employing a team-based approach, jet ventilation during endoscopic airway surgery demonstrates a low rate of complications and provides for safe and successful surgery.</p><p><strong>Level of evidence: </strong>4 Laryngoscope, 131:2292-2297, 2021.</p>","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":" ","pages":"2292-2297"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lary.29431","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25392128","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":"In Reference to Beethoven's Deafness.","authors":"Michael H Stevens,&nbsp;Teemarie Jorgensen,&nbsp;Alicia Kay Crofts","doi":"10.1002/lary.29493","DOIUrl":"https://doi.org/10.1002/lary.29493","url":null,"abstract":"Dear Editor: There have been many theories proposed to explain the deafness of Ludwig van Beethoven. One reason is because his history is complex. Brotto supports the theory by Stevens by presenting a progressive hearing loss in a living person where lead poisoning was found to be the cause. In this illuminating patient, lead came from a pan with a worn ceramic surface with which the patient used to cook her food for many years. Although lead poisoning has been considered previously, it has been dismissed because wrist drop, a common finding in lead poisoning, was not found in Beethoven. Brottosuggests that lead poisoning causes a variety of symptoms that, depending on the time of exposure and healthcare support, are extremely variable from person to person. However, Reubens indicates there is another explanation for Beethoven’s lack of wrist drop. Chronic low-level lead exposure results in sensory and autonomic rather than motor neuropathy. This is due to an alternate mechanism of metabolism than that found in high levels of acute lead exposure. Brotto substantiates Beethoven’s alcohol dependence problem and further confirms that the most likely cause of Beethoven’s deafness was his consumption of wine tainted with lead. Beethoven particularly liked inexpensive Hungarian wine to which lead had been added to improve the flavor. We therefore congratulate the authors on what is not an obscure diagnosis, but what is the most likely to be correct. Although we do not have the advantage of audiograms and blood lead levels, Beethoven did have high levels of lead in his hair and deep in the bone. The latter indicates a history of lead exposure recurring over a period of many years. Michael H. Stevens, MD Emeritus Professor of Otolaryngology, University of Utah School of Medicine, Salt Lake City, Utah, U.S.A.","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":" ","pages":"E2696"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lary.29493","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25415031","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":"Characteristics of the Dual Board-Certified Sleep Otolaryngology Workforce.","authors":"Phoebe K Yu,&nbsp;Shekhar K Gadkaree,&nbsp;Joanna Li,&nbsp;Justin C McCarty,&nbsp;Phillip Huyett,&nbsp;Regan W Bergmark","doi":"10.1002/lary.29725","DOIUrl":"https://doi.org/10.1002/lary.29725","url":null,"abstract":"<p><strong>Objective: </strong>Sleep medicine is a multidisciplinary field that includes otolaryngology. After 2011, sleep medicine board eligibility required completion of a dedicated sleep medicine fellowship. The objective of our study is to describe the characteristics and geographic distribution of the dual board-certified sleep otolaryngology workforce and to assess the impact of the 2011 change.</p><p><strong>Methods: </strong>A cross-sectional analysis of sleep-certified otolaryngologists registered with the American Board of Otolaryngology-Head and Neck Surgery in 2019 was performed to characterize the sleep otolaryngology workforce. County and regional analysis of provider density was conducted by comparing provider characteristics with county-level data from the United States Census Bureau.</p><p><strong>Results: </strong>There were 275 active dual board-certified sleep otolaryngologists, or approximately 1 for every 1.12 million Americans. 77.8% were in private practice and 2.9% had American Society of Pediatric Otolaryngology membership. Eighty-eight percent were male, with females more likely than males to be in an academic setting (36.4% for females compared to 20.2% for males; P = .045). The South Atlantic and South Central regions had the highest number of sleep board-certified otolaryngologists per capita. Before 2011, an average of 75.7 otolaryngologists took the sleep board exam per 2-year cycle, compared to 14.3 otolaryngologists after 2011 (P = .029).</p><p><strong>Conclusion: </strong>There are few dual board-certified sleep otolaryngologists across the country, which may affect care for patients with sleep-disordered breathing. Increased resident exposure and otolaryngology training in sleep medicine can strengthen the otolaryngology contribution to the multidisciplinary care of these patients.</p><p><strong>Level of evidence: </strong>4 Laryngoscope, 131:E2712-E2717, 2021.</p>","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":" ","pages":"E2712-E2717"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lary.29725","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39077588","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":"Anesthetic Management for Awake Tubeless Suspension Microlaryngoscopy.","authors":"Jean Selim,&nbsp;Charles Maquet,&nbsp;Zoubir Djerada,&nbsp;Emmanuel Besnier,&nbsp;Vincent Compère,&nbsp;Frédéric Crampon,&nbsp;Thomas Clavier,&nbsp;Jean-Paul Marie","doi":"10.1002/lary.29565","DOIUrl":"https://doi.org/10.1002/lary.29565","url":null,"abstract":"<p><strong>Objectives/hypothesis: </strong>Patients' eligibility for bilateral selective laryngeal reinnervation surgery is evaluated by suspension microlaryngoscopy (SML) examination with laryngeal electromyography (LEMG). Maintaining spontaneous ventilation, with remifentanil sedation/analgesia without endotracheal tube, to allow the patient to phonate with the surgeon during awake, LEMG is a major challenge for the anesthesiologist and the otorhinololaryngologist. The objective of this study was to evaluate the safety and efficacy of a novel anesthesia protocol to manage airway access during awake tubeless SML.</p><p><strong>Study design: </strong>Retrospective study.</p><p><strong>Methods: </strong>Anesthesia records of patients undergoing awake SML with LEMG were retrospectively analyzed. Procedures were performed with remifentanil sedation/analgesia with targeted controlled infusion (TCI) in combination with local anesthesia. The main outcome was the failure rate of the anesthesia protocol during the procedure. Secondary outcomes were as follows: rate of apnea requiring ventilation, airway bleeding, regurgitation, hemodynamic data as well as vasopressor use, complications, and surgeon satisfaction with the procedure.</p><p><strong>Results: </strong>Data were obtained for 39 patients between November 2017 and September 2019, the mean age was 52 years and 29 (74%) were female. All procedures were completed without complications (0% [0-9]). Three patients (8% [1.6-20.8]) had an intraoperative episode of hypoxemia requiring mask reventilation. There was no airway bleeding, no regurgitation, and no hypotensive episode. Three patients (8% [1.6-20.8]) had noninvasive ventilation for respiratory distress after the end of the procedure.</p><p><strong>Conclusions: </strong>Our results show that awake tubeless SML allowing phonation during LEMG can be realized under sedation and local anesthesia. However, further data are needed concerning the intraoperative and postoperative safety of the procedure.</p><p><strong>Level of evidence: </strong>4 Laryngoscope, 131:E2669-E2675, 2021.</p>","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":" ","pages":"E2669-E2675"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lary.29565","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38894016","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":"Speech Characteristics and Oromyofunctional Outcomes in Two Bimaxillary Face Transplantation Patients in Helsinki.","authors":"Atte A Manninen,&nbsp;Lotta-Maria Oksanen,&nbsp;Suvi Alaluusua,&nbsp;Ahmed Geneid,&nbsp;Andrew J Lindford,&nbsp;Pia Vuola,&nbsp;Remi Rousselle,&nbsp;Patrik Lassus","doi":"10.1002/lary.29601","DOIUrl":"https://doi.org/10.1002/lary.29601","url":null,"abstract":"<p><strong>Objectives/hypothesis: </strong>Facial functional restoration is one of the main goals in face transplantation. We report the oromyofacial function outcomes of two bimaxillary face transplantation (FT) patients in Helsinki.</p><p><strong>Study design: </strong>Outcome Study.</p><p><strong>Methods: </strong>Two male patients, aged 34 and 59, had severe functional facial disabilities following self-inflicted gunshot injuries sustained to their mid and lower faces several years earlier. Both underwent tooth-bearing maxillomandibular face transplantation in 2016 and 2018. We collected data regarding speech, swallowing, sensory recovery, motor recovery, and olfaction prior to transplantation. Patient charts were reviewed from the follow-up period of 4 and 2 years, respectively.</p><p><strong>Results: </strong>Speech intelligibility, acceptability, and articulation continued to improve during follow-up for both patients. Voice quality and resonance were mainly normal at last follow-up. Swallowing improved once lip occlusion was regained, with only minor aspiration evident on videofluorography. Both patients had significant improvement in facial mimic muscle function after FT. The first patient who only had buccal sensory nerves connected has only recovered protective facial sensation, whereas our second patient with buccal, infraorbital, and alveolar nerves connected has almost complete facial two-point discrimination.</p><p><strong>Conclusion: </strong>Both patients have regained satisfactory facial sensory and motor function. Sensory recovery seems to be faster and more precise if multiple sensory nerve coaptations are performed. Swallowing and speech have continued to improve over time although not reaching the level of the normal population. We demonstrate how speech-corrective surgery can safely be performed in a FT patient and can improve speech recovery.</p><p><strong>Level of evidence: </strong>4 Laryngoscope, 131:E2643-E2649, 2021.</p>","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":" ","pages":"E2643-E2649"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lary.29601","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38947335","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":"Discordant SARS-CoV-2 Detection in the Nasopharynx Versus Trachea for Patients With Tracheostomies.","authors":"Joshua D Smith,&nbsp;Jason A Correll,&nbsp;Jennifer L Stein,&nbsp;Robbi A Kupfer,&nbsp;Norman D Hogikyan,&nbsp;Robert J Morrison,&nbsp;Andrew P Stein","doi":"10.1002/lary.29617","DOIUrl":"https://doi.org/10.1002/lary.29617","url":null,"abstract":"<p><strong>Objectives/hypothesis: </strong>Patients with tracheostomies have an anatomically altered connection between their upper and lower airways that could impact SARS-CoV-2 testing. Our goal was to evaluate for discordance in SARS-CoV-2 detection in hospitalized patients with COVID-19 and tracheostomies based on the site analyzed.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Methods: </strong>This single-institution study evaluated hospitalized patients with COVID-19 who had tracheostomies placed during their treatment. We analyzed SARS-CoV-2 RNA nucleic acid amplification test (NAAT) results after tracheostomy. All included patients had nasopharyngeal (NP) and tracheal (TR) samples taken within a 48-hour period, allowing us to characterize rate of test concordance.</p><p><strong>Results: </strong>Forty-five patients met our inclusion criteria. Thirty-two (71.1%) patients had entirely concordant results after tracheostomy. However, 13 (28.9%) patients had at least one set of discordant results, the majority of which were NP negative and TR positive. There were no statistically significant differences in demographic or clinical variables, including time to tracheostomy and time to testing, among patients with concordant versus discordant SARS-CoV-2 results.</p><p><strong>Conclusion: </strong>This represents the first study to examine SARS-CoV-2 RNA NAAT concordance between NP and TR sites in hospitalized patients with COVID-19 and tracheostomies. One-third of patients demonstrated discordant testing when NP and TR specimens were collected within a 48-hour time period. Thus, patients with tracheostomies may have a higher false-negative rate if only one site is assessed for SARS-CoV-2. We recommend analyzing samples from both the nasopharynx and trachea for these patients until more prospective data exist.</p><p><strong>Level of evidence: </strong>4 Laryngoscope, 131:E2634-E2638, 2021.</p>","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":" ","pages":"E2634-E2638"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lary.29617","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38958747","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}