Archives of Pediatric Neurosurgery最新文献

{"title":"Paediatric Neurosurgical emergency operations:Clinical spectrum, Presentation-Intervention Interval and Early operative outcome in Regional Neurosurgical center, Nigeria","authors":"A. Koko, A. Lasseini, Usman Daibu, Muhammad Mansur Idris","doi":"10.46900/apn.v6i2.240","DOIUrl":"https://doi.org/10.46900/apn.v6i2.240","url":null,"abstract":"BACKGROUND: Pediatric neurosurgical emergencies are prevalent worldwide, often triggered by acute, life-threatening conditions that necessitate immediate surgery to prevent disability and death. Managing these conditions perioperatively poses significant challenges for neurosurgeons and anesthetists due to potential complications like anemia, seizures, electrolyte imbalances, intracranial hypertension, and vision threats, alongside the primary neurosurgical issues. Proper correction and optimization of these physiological derangements before surgery are crucial for favorable postoperative outcomes.\u0000PATIENTS AND METHODS: This retrospective study analyzes emergency neurosurgical operations performed on children aged sixteen and under at a neurosurgical center in Sokoto, Nigeria, from January 2018 to December 2021. The center caters to a population of approximately twenty million people from three north-western and one north-central Nigerian states, as well as neighboring Niger and Benin republics. The area features a mostly arid climate with limited seasonal rainfall and experiences the Sahara’s harmattan winds.\u0000RESULTS A total of 131 children underwent emergency neurosurgical procedures during the study period. The majority were males (71%), with an average age of 5.6 years. Hydrocephalus was the most frequent emergency condition, leading to 44.3% of surgeries, primarily through ventriculoperitoneal shunt procedures, which accounted for 42.7% of interventions. Anemia was the most common comorbid condition. The mean time from presentation to intervention was 10 days. Postoperatively, 17.9% of patients suffered from surgical site infections, yet 67.9% had favorable outcomes with a mortality rate of 7.1%.\u0000CONCLUSION: This study underscores the importance of timely surgical interventions and highlights the predominance of ventriculoperitoneal shunts in treating pediatric hydrocephalus in the region, with generally positive outcomes despite delays","PeriodicalId":491452,"journal":{"name":"Archives of Pediatric Neurosurgery","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141025841","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":"Concordance factors in craniosynostosis twins: a meta-analysis and case report","authors":"Artur Henrique Galvão Bruno Da Cunha, P. Guerra, R. R. M. Cysneiros, Inaê Carolline Silveira Da Silva","doi":"10.46900/apn.v6i2.245","DOIUrl":"https://doi.org/10.46900/apn.v6i2.245","url":null,"abstract":"Introductions: \u0000Craniosynostosis is a condition where the cranial sutures close prematurely. It is influenced by both genetics and environment. This paper focuses on craniosynostosis in twins, which is an understudied area. It presents a case report of male identical twins and conducts a meta-analysis based on 34 articles to understand the factors affecting concordance in twins who have craniosynostosis. The study considers factors such as zygosity, gender, genetic syndromes, and the type of synostosis.\u0000Material and methods: A meta-analysis was conducted on 105 twin pairs (210 patients) identified from studies carried out between 1963 to 2023. The eligible studies, based on PICO criteria, included case reports and case series focusing on twins with craniosynostosis. A systematic literature search was conducted on PUBMED and Mendeley platforms to gather data on gestational age, zygosity, genetic syndromes, affected sutures, and concordance.\u0000Results: The report is about two identical twin brothers who had sagittal and metopic suture synostosis. They were treated successfully with cranial remodeling surgery. In a meta-analysis of 105 twin pairs (210 patients) , a total of 25.9% showed concordance. The study found a significant difference in concordance between monozygotic (45.3%) and dizygotic (7.3%) twins. The analysis also revealed that twins with scaphocephaly had a higher degree of concordance than those with trigonocephaly (46.7% vs. 18.9%, respectively). The study did not find any significant correlation between gender, the presence of genetic syndromes, and concordance.\u0000Conclusion: This investigation highlights the complex interplay of genetic and environmental factors in craniosynostosis in twins. The higher concordance in monozygotic twins emphasizes the genetic basis. These findings validate existing literature and provide new insights.","PeriodicalId":491452,"journal":{"name":"Archives of Pediatric Neurosurgery","volume":"49 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141040975","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":"Celebrating 20 Years of Excellence: Latin American Pediatric Neurosurgery Course LACPN (2004-2024)","authors":"Ricardo Santos de Oliveira, M. Ballestero","doi":"10.46900/apn.v6i2.257","DOIUrl":"https://doi.org/10.46900/apn.v6i2.257","url":null,"abstract":"Two decades ago, a visionary initiative was launched in Latin America with the aim of advancing pediatric neurosurgery education and expertise across the region. Today, as we mark the 20th anniversary of the Latin American Pediatric Neurosurgery Course (LACPN), it is an opportune moment to reflect on its journey, celebrate its achievements, and chart a course for its continued success. \u0000The LACPN was established with a clear mission: to provide a platform for knowledge exchange, skill development, and collaboration among neurosurgeons dedicated to caring for children with neurological conditions. \u0000Designed to cover the major fields in Pediatric Neurosurgery, the scientific program is divided into annual courses over a 3-year cycle, with each biannual course is based on a four-day program divided in the morning sessions; lectures and case discussion an afternoon session; lectures, video session, \"hand-on\", and \"solve a case\". Following the ESPN post-graduate course and Asian-Australasian Course in Pediatric Neurosurgery program. \u0000At the heart of the LACPN's success lies its unwavering commitment to education and training, a culture of continuous learning and mentorship, the LACPN has not only raised the standard of care but also inspired a new generation of neurosurgeons dedicated to pediatric neurosurgery in the past 20 years. \u0000Over the past 18 years of LACPC more than 350 different trainees (from Brazil, Argentina, Chile, Colombia, Uruguay, Mexico, Venezuela, Bolivia, Cuba, Paraguay, and others) and 73 faculty invitees (from Brazil, Argentina, Chile, Mexico, USA, France, Italy, Costa Rica, Colombia, Turkish, Singapore, Spain, UK, and Australia, South Africa) have attended the course. \u0000In 2024, the LACPN become an official course of the Latin American Association for Pediatric Neurosurgery (ASOLANPED). This year the course was held in Pilar, Buenos Aires, Argentina, with the brilliant direction of Dr. Ramiro delRio and Dr. Sebastian G. Jaimovich. \u0000As we reflect on the past 20 years, it is evident that the LAPNC has made a profound impact on the field of pediatric neurosurgery in Latin America. Its legacy extends far beyond the confines of the operating room, encompassing a legacy of excellence, collaboration, and compassion that will continue to shape the future of pediatric neurosurgery for generations to come. \u0000As we celebrate this significant milestone, we are reminded that our work is far from complete. Challenges remain, ranging from disparities in access to care to the need for continued innovation and research. As we look ahead to the next 20 years and beyond, let us recommit ourselves to the pursuit of excellence, the advancement of knowledge, and the relentless pursuit of better outcomes for the children and families we serve.LACPN is a unique course! Friendship, collaboration and opportunities for everyone are the pillars of this course. \u0000In closing, we extend our heartfelt gratitude to all those who have contributed to the success of t","PeriodicalId":491452,"journal":{"name":"Archives of Pediatric Neurosurgery","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141032822","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":"Spinal cord diffuse midline glioma with H3K27M mutation: case report in a pediatric patient","authors":"Vitor Bonk Rizzo, Michelle Arrata Ramos, André Leonardo Bacellar Mota, Samya Hamad Mehanna, Julia Costa Linhares, Marcela Santos Cavalcanti","doi":"10.46900/apn.v6i2.246","DOIUrl":"https://doi.org/10.46900/apn.v6i2.246","url":null,"abstract":"Introduction/Background: Pediatric diffuse midline gliomas are predominantly localized within the brainstem, pons, or are bi-thalamic, while in adolescents and adults, they predominantly arise unilaterally in the thalamus or spinal cord. Epidemiological data remain scarce for this recently described entity. They represent 10-15% of all pediatric brain tumors and 75% of all pediatric brainstem tumors.\u0000 Case presentation: Herein we report a case of Diffuse Midline Glioma in a 10-year-old male pediatric patient, with an unusual location in the spinal cord, presenting with atypical clinical features. Histopathological and immunohistochemical analysis confirmed the diagnosis and the presence of K27M (lysine to methionine at codon 27) mutations in the histone 3 gene.\u0000Conclusions: Early and differential diagnosis of atypical spinal cord tumors is crucial to avoid dismal consequences for the patient and provide them with a better quality of life. Highlighting rare cases with fatal outcomes is essential for emphasizing the importance of understanding this pathological entity within the medical community.","PeriodicalId":491452,"journal":{"name":"Archives of Pediatric Neurosurgery","volume":"18 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141051074","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":"Complication of the use of bleomycin in the management of cystic craniopharyngioma: case report","authors":"Jose Roberto Tude Melo, Verônica Aline de Oliveira Barbosa, Leonardo Conrado Silva Lima, P. Azi, José Henrique Silva Barreto","doi":"10.46900/apn.v6i2.243","DOIUrl":"https://doi.org/10.46900/apn.v6i2.243","url":null,"abstract":"Introduction: Craniopharyngiomas are the most common neoplasms of the central nervous system of non-glial origin in childhood. Therapeutic options for proper management include total surgical resection, partial surgical resection associated with radiotherapy, and use of drugs such as bleomycin and alpha interferon (INFa) via Ommaya reservoir. \u0000Objective: The scope of this article is to report the case of a child with successive recurrence of craniopharyngioma who progressed to endocrine and neurological complications after bleomycin administration. \u0000Method/case presentation: A 9-year-old boy underwent partial resections of craniopharyngioma followed by radiotherapy. Due to the increase in the cystic portion of the lesion, he underwent a complete treatment protocol with INFa. Two years after finishing the treatment, a new increase in the cystic portion of the craniopharyngioma was detected and bleomycin was administered in an attempt to control the disease. The boy was hospitalized on an urgent basis due to decreased level of consciousness, drowsiness, ataxia, and hyponatremia. Magnetic resonance imaging findings of the brain showed edema in the vicinity of the tumor suggestive of injury due to pharmacological toxicity. The child presented complete remission of symptoms with the use of systemic corticosteroids. \u0000Conclusion: Neurotoxicity is a complication following bleomycin administration via Ommaya reservoir. Immediate discontinuation associated with the introduction of systemic corticosteroids and support in a specialized care unit can reverse the initial clinical picture.","PeriodicalId":491452,"journal":{"name":"Archives of Pediatric Neurosurgery","volume":"7 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141038016","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 Overcorrective Modification of Cranial Vault Reconstruction for Non-Syndromic Metopic Suture Synostosis: Shiraz Technique","authors":"M. Masoudi, Sina Zoghi, Ali Ansari, Sanaz Taherpour, Reza Shahriarirad, Reza Taheri","doi":"10.46900/apn.v6i2.231","DOIUrl":"https://doi.org/10.46900/apn.v6i2.231","url":null,"abstract":"Objective: Growth restriction of frontal bones due to premature closure of metopic suture leads to the “Trigonon” shape of the skull, introduced by Welcker in 1862. Paul Tessier introduced cranial vault reconstruction (CVR), a common craniofacial procedure for treating this condition. The present study aims to introduce a modified version of this procedure. \u0000Methods: In this study, we present our experience with a modified version of CVR, named the Shiraz technique, used as a single-stage overcorrective reconstructive method for isolated metopic suture synostosis with limited unique threesome osteotomies. We also report 35 cases treated with this technique. \u0000Results: The patient population comprised 26 males (74.3%) and 9 females (25.7%) with a mean age of 8.4 months (range: 3-13). The mean duration of the operation and anesthesia was 175.0 minutes (range: 60-300). The mean intraoperative bleeding and blood transfusion volumes were 95.6 ml (range: 20-250) and 75.3 ml (range: 0-320), respectively. The main complications during the follow-up were epidural hematoma (n=3, 8.6%; one case needed reoperation), temporal hollowing (n=2, 5.7%), raised intracranial pressure (n=2, 5.7%), wound infection (n=2, 5.7%), and mortality in one of the cases, which was presumed to be due to air emboli. \u0000Conclusions: The Shiraz technique, as a novel modified version of CVR, is a safe and effective technique for the treatment of non-syndromic metopic suture synostosis with low mean intraoperative blood loss and transfusion. In the long-term follow-up, the occurrence of temporal hollowing was decreased, and the outcome showed a smooth anterior skull base. ","PeriodicalId":491452,"journal":{"name":"Archives of Pediatric Neurosurgery","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141047943","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":"Posterior fossa hemangioblastoma in children: literature review","authors":"Aline Rabelo Rodrigues, Pedro Lucas Bessa Dos Reis, Gabriel Bagarolo Petronilho, Caio Araujo De Souza, Pamela Lopes Carvalho, Ricardo Santos de Oliveira, Rodrigo Inácio Pongeluppi, Matheus Ballestero","doi":"10.46900/apn.v5i3.216","DOIUrl":"https://doi.org/10.46900/apn.v5i3.216","url":null,"abstract":"Introduction: Posterior fossa hemangioblastomas (HBs) are uncommon benign neoplasms, comprising 1.5-2.5% of intracranial tumors and 7-8% of posterior cranial fossa tumors. They predominantly impact the central nervous system, often localizing within the cerebellar hemispheres of individuals aged 50-60 years, with higher prevalence among adults and limited occurrence in the pediatric population. This review sheds light on the distinctive clinical characteristics of pediatric HBs Methods: Employing the PRISMA guidelines, databases like SciELO, Lilacs, and PubMed were meticulously searched, deploying keywords \"hemangioblastoma\" and \"posterior fossa.\" Inclusion criteria spanned articles published from 2003-2023 in English or Portuguese, focusing on pediatric cases. Results: The search yielded 16 relevant articles from PubMed and 72 from Lilacs, with SciELO yielding no relevant results. Rigorous assessment against the predetermined criteria identified 10 pertinent articles from Lilacs discussing pediatric posterior fossa HBs, encompassing topics like imaging, pathophysiology, immunohistochemistry, and therapeutic modalities. Diverse themes were explored, including pregnancy-related manifestations, tumor growth patterns, and treatment approaches such as surgical resection, radiotherapy, neuronavigation, and presurgical embolization. Advanced imaging techniques, like high-resolution 3D multifusion medical imaging, were also explored. Conclusion: Early diagnosis and a comprehensive multidisciplinary strategy are essential in managing pediatric posterior fossa HBs. Genetic insights and advanced imaging techniques, coupled with precise surgical interventions, play a pivotal role in improving prognosis and elevating the quality of life for patients. The genetic context of VHL mutations, the centrality of MRI in early detection, and the prominence of complete surgical resection underscore the multifaceted comprehension indispensable for effective management.","PeriodicalId":491452,"journal":{"name":"Archives of Pediatric Neurosurgery","volume":"172 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135461883","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":"Intraoperative Neurophysiological Monitoring in Posterior Fossa Surgeries","authors":"Denise Pinheiro, Sergio Cavalheiro","doi":"10.46900/apn.v5i3.215","DOIUrl":"https://doi.org/10.46900/apn.v5i3.215","url":null,"abstract":"review article","PeriodicalId":491452,"journal":{"name":"Archives of Pediatric Neurosurgery","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135618393","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":"Differential diagnosis of bulging scalp: beyond cephalohematoma and subgaleal hematoma","authors":"Lillian Gonçalves Campos, Tassia Andrea Duraes Prioste, Jorge Wladimir Junqueira Bizzi","doi":"10.46900/apn.v5i3.218","DOIUrl":"https://doi.org/10.46900/apn.v5i3.218","url":null,"abstract":"A 30-day-old infant was brought to the pediatric emergency room with a bulge in the scalp in the parieto-occipital region, mobile and without associated phlogistic signs. He had no history of fever or any other complaints. The mother reported that the bulge appeared at 20 days of life and showed progressive growth. There was no history of trauma. The boy was born at term by cesarean delivery due to cephalopelvic disproportion.
 For initial evaluation, skull X-ray and cerebral ultrasound were performed (Figure 1). A magnetic resonance imaging and tomography of the brain were also performed (Figure 1). 
 Faced with the diagnostic challenge, neurosurgery proceeded with drainage of the collection and biopsy of the galea. No malignant cells were found and the biopsy only found an inflammatory change. Given these findings, the diagnosis of delayed subaponeurotic fluid collection (DSFD) was made. There was no recurrence of the collection and the patient had a good evolution.
 DSFD are a rare condition, which occurs spontaneously between the 4th and 18th week of life, and makes the differential diagnosis with cephalohematoma, caput succedeneum and subgaleal hematoma [1]. Its pathophysiology is not fully elucidated; however, most reports share a similar history of prolonged or instrumented delivery [1,2]. Patients are otherwise healthy and with no history of trauma [2].
 The management of DSFD is conservative and the natural history is spontaneous resolution within 1 to 2 months [1,2].","PeriodicalId":491452,"journal":{"name":"Archives of Pediatric Neurosurgery","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135618392","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":"Parasitic Craniopagus with Cervical Myelomeningocele and Hydrocephalus: Reporting the rarely Reported","authors":"Aliyu Muhammad Koko, Ali Lasseini, Nasiru Jinjiri Isma, Bello Bala Shehu","doi":"10.46900/apn.v5i3.194","DOIUrl":"https://doi.org/10.46900/apn.v5i3.194","url":null,"abstract":"Objective: parasitic craniopagus is an extremely rare neurosurgical condition globally, additional anomalies such as hydrocephalus and myelomeningocele make it even more uncommon and complex to manage. The objective of this report was to describe successful management of a child with triad of craniopagus parasiticus, congenital hydrocephalus and cervical myelomeningocele
 Case presentation: we successfully managed a five-month-old female infant with parasitic craniopagus, cervical myelomeningocele and congenital hydrocephalus.
 Conclusion: parasitic craniopagus remains an uncommon neurosurgical condition and can be associated with many congenital anomalies such as hydrocephalus and myelomeningocele, careful evaluation and management will confer favourable outcome.
 Objective: parasitic craniopagus is an extremely rare neurosurgical condition globally, additional anomalies such as hydrocephalus and myelomeningocele make it even more uncommon and complex to manage. The objective of this report was to describe successful management of a child with triad of craniopagus parasiticus, congenital hydrocephalus and cervical myelomeningocele
 Case presentation: we successfully managed a five-month-old female infant with parasitic craniopagus, cervical myelomeningocele and congenital hydrocephalus.
 Conclusion: parasitic craniopagus remains an uncommon neurosurgical condition and can be associated with many congenital anomalies such as hydrocephalus and myelomeningocele, careful evaluation and management will confer favourable outcome.","PeriodicalId":491452,"journal":{"name":"Archives of Pediatric Neurosurgery","volume":"166 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135547444","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}