Acta otorrinolaringologica espanola最新文献

{"title":"Prevalence of obstructive sleep apnea in obese patients candidates for bariatric surgery and predictive questionnaires","authors":"Silvia Matarredona Quiles ,&nbsp;Marina Carrasco Llatas ,&nbsp;Paula Martínez Ruíz de Apodaca ,&nbsp;Jose Ángel Díez Ares ,&nbsp;Sergio Navarro Martínez ,&nbsp;José Dalmau Galofre","doi":"10.1016/j.otoeng.2024.06.001","DOIUrl":"10.1016/j.otoeng.2024.06.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Obstructive sleep apnea (OSA) is a prevalent condition among electable to bariatric surgery obese patients, often remaining underdiagnosed, thereby increasing surgical risk. The main purpose was to determine prevalence of OSA among candidates for bariatric surgery and to assess the rate of underdiagnosis of this condition. Additionally, the study aimed to evaluate the specific performance of three sleep questionnaires and scales (Excessive Daytime Sleepiness Scale (EDSS), Epworth Sleepiness Scale (ESS), and STOP-Bang) in these patients.</div></div><div><h3>Methods</h3><div>A longitudinal, prospective, single-cohort study, with consecutive sampling including patients aged 18–65 years with obesity grade II (body mass index (BMI) ≥ 35 kg/m²) and hypertension, type 2 diabetes, metabolic syndrome or OSA or obesity grade III or IV (BMI ≥ 40 kg/m²) elective for bariatric surgery. Patients were evaluated at the Otorhinolaryngology department with an anamnesis regarding OSA including the administration of three sleep questionnaires (EDSS, ESS, and STOP-Bang), followed by cardiorespiratory polygraphy (CRP) for sleep evaluation.</div></div><div><h3>Results</h3><div>124 patients were included in this study. While 74.2% of the sample exhibited OSA on CRP, only 28.2% had a prior diagnosis. The STOP-Bang questionnaire demonstrated the highest sensitivity (93.3%) for detecting moderate to severe OSA, although with low specificity (33.8%). EDSS and ESS did not show a significant association with the presence of OSA.</div></div><div><h3>Conclusions</h3><div>OSA screening is crucial in candidates for bariatric surgery due to its high prevalence and low diagnosis rate. The STOP-Bang questionnaire may serve as a useful tool for identifying patients at risk of moderate to severe OSA and optimizing sleep assessments. However, further research is necessary to validate its utility in this specific population.</div></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"75 6","pages":"Pages 354-360"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141441219","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":"The current situation of tutoring in specialised training in otorhinolaryngology-head and neck surgery in Spain. Where are we? Where do we want to go?","authors":"Pedro Díaz de Cerio Canduela ,&nbsp;Francesc Xavier Avilés Jurado ,&nbsp;Julia de Juan Beltrán ,&nbsp;Carlos Magri Ruiz ,&nbsp;Alfonso Santamaría Gadea ,&nbsp;Fernando López","doi":"10.1016/j.otoeng.2024.03.002","DOIUrl":"10.1016/j.otoeng.2024.03.002","url":null,"abstract":"<div><h3>Background and objective</h3><div>There is great heterogeneity in the methodology and evaluation in specialized health training (SHT) in otorhinolaryngology in our country. The figure of the resident tutor is the cornerstone on which the ESF system is based and the regulation and recognition of this figure varies. This article aims to take a snapshot of the current situation of the ESF in Spain and to describe the activity of tutors.</div></div><div><h3>Materials and methods</h3><div>During the month of September 2023, a survey was sent in a Google Forms® format through the Spanish Society of Otolaryngology and Head and Neck Surgery. The survey consisted of 8 multiple-choice questions and 4 questions in which they were asked to rank a series of 5 weaknesses, threats, opportunities and strengths selected by the authors, in order to perform a SWOT analysis.</div></div><div><h3>Results</h3><div>A total of 103 responses were obtained, of which 81 corresponded to accredited tutors. 63% of the tutors indicated that they did not have enough time to carry out their teaching work and 48% did not carry out a regular assessment of their residents. 64% of the tutors believe that the quality of otorhinolaryngology training in Spain is good and 61% are satisfied with their job as tutors. The main weakness was the short duration of the training programme, and the pressure of care was found to be the main threat. An experienced training system was considered the main strength and the creation of a national network of tutors was seen as an opportunity for improvement.</div></div><div><h3>Conclusions</h3><div>The creation of a common and transversal otorhinolaryngology training pathway for all accredited centres and the creation of a network of mentors and residents are necessary to address the problems of SHT. The role of the tutor must be recognised and reinforced to improve specialist training.</div></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"75 6","pages":"Pages 347-353"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141138159","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":"Enhancing the coverage and rotation of anterior ethmoidal artery flap for septal perforation closure: Insights from a flap design study","authors":"Octavio Garaycochea ,&nbsp;Lina Piñeros ,&nbsp;Camilo Rodríguez-Van Strahlen ,&nbsp;María Jesús Rojas-Lechuga ,&nbsp;Isam Alobid","doi":"10.1016/j.otoeng.2024.06.002","DOIUrl":"10.1016/j.otoeng.2024.06.002","url":null,"abstract":"<div><h3>Background and objectives</h3><div>The anterior ethmoidal artery flap (AEA) is a pedicle endonasal flap frequently used to repair septal perforations (SP). The posterior incision is the most complex to perform. The primary objective was to determine the minimum height of the posterior incision (PI) of an AEA completely cover an anterior septal perforation.</div></div><div><h3>Materials and methods</h3><div>A cadaveric specimen was sectioned in the sagittal plane and a SP of 1 cm was created anteriorly. The PI of the AEA flap was made progressively at a height of 10, 20, 30, and 40 mm. The complete closure of the SP and the angle of rotation (AR) of the flap were assessed.</div></div><div><h3>Results</h3><div>According to the length of the PI the following results were obtained: PI = 10 mm: The SP was covered partially, and the AR was 45º. PI = 20 mm: The SP was fully covered, and the AR was 63º.</div><div>PI = 30 mm and 40 mm: The SP was fully covered with redundant tissue.</div><div>This study shows that an anterior ethmoidal artery flap that includes the nasal floor and the inferior meatus mucosa combined with a posterior incision of 20 mm could result in adequate coverage of all margins of an anterior SP up to area 1a of the septum.</div></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"75 6","pages":"Pages 367-372"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303152","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":"Intraoral ultrasonography: an adjunct in oral onco-surgery","authors":"","doi":"10.1016/j.otoeng.2024.01.008","DOIUrl":"10.1016/j.otoeng.2024.01.008","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the precision and accuracy of intraoral sonography in assessing the depth of invasion in oral cancer.</p></div><div><h3>Material and methods</h3><p>A prospective study was conducted in 30 cases of oral cancer. Subjects were subjected to computerised tomography and intraoral sonography before surgery. The depth of invasion assessed through clinical palpation and radiological tools was compared with surgical histopathology.</p></div><div><h3>Results</h3><p>The depth of invasion assessed on clinical palpation and computerized tomography had statistically significant difference with histopathology whereas intraoral sonography didn’t show any difference. The intraoral sonography and computerised tomography had comparable precision and accuracy, with a slight dominance of the computerised tomography in assessing the tumor's depth of invasion greater than 4 mm. However, intraoral sonography was more precise and accurate than computerised tomography in assessing the depth of invasion beyond 10 mm.</p></div><div><h3>Conclusion</h3><p>Intraoral sonography was found to be a reliable tool in the assessment of the depth of invasion in oral cancer. It can prove beneficial during surgery in achieving tumour-free surgical margins.</p></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"75 5","pages":"Pages 273-280"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736916","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":"Comparison of Proliferating Cell Nuclear Antigen (PCNA) Expression among Nasal Polyp and Chronic Rhinosinusitis","authors":"","doi":"10.1016/j.otoeng.2024.02.003","DOIUrl":"10.1016/j.otoeng.2024.02.003","url":null,"abstract":"<div><h3>Background and objective</h3><p>Chronic rhinosinusitis is a common inflammatory disorder in sinonasal mucosa that could be developed with or without nasal polyps. Cellular proliferation is suggested as a possible mechanism of nasal polyp development. However, conducted studies in this context are limited. So, the present study's aim is the comparison of proliferating cell nuclear antigen (PCNA) expression in nasal polyps and chronic rhinosinusitis.</p></div><div><h3>Materials and methods</h3><p>In this cross-sectional study, 70 nasal polyp and 60 chronic rhinosinusitis samples from patients referred to Mostafa Khomeini Hospital, Tehran from 2017 to 2022 were immunohistochemically stained by PCNA marker. The percentage of PCNA nuclear expression was determined in two groups and its association with the type of pathological lesion and the patient's age and sex was analyzed by SPSS statistic software version 24 statistical software (IBM Statistics, USA).</p></div><div><h3>Results</h3><p>The mean percentage expression of PCNA in nasal polyp and chronic rhinosinusitis samples was 16.55 ± 13.66 and 17.58 ± 12.68 respectively (ranging from 0 to 57 in both groups) however, there was no significant statistical difference between the two groups (p = 0.479). No relationship was found between PCNA expression with age and sex in none of the chronic rhinosinusitis and nasal polyp groups.</p></div><div><h3>Conclusion</h3><p>Proliferative activity of the nasal epithelial cell is similar in chronic rhinosinusitis with and without nasal polyps and it is considered that the increase of epithelial cell proliferative activity probably has no role in nasal polyp development in patients with chronic rhinosinusitis.</p></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"75 5","pages":"Pages 310-315"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900583","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":"Upper airway manifestations of anti-IgLON5 disease: Otorhinolaryngological point of view","authors":"","doi":"10.1016/j.otoeng.2024.04.001","DOIUrl":"10.1016/j.otoeng.2024.04.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Anti-IgLON5 disease is a recently described neurological disorder with multisystemic features. The disease is characterized by the presence of IgLON5 antibodies in serum and cerebrospinal fluid. Our objective is to describe in detail the otorhinolaryngological manifestations of this disease, which are frequent and may include dysphagia, dysarthria, vocal cord paralysis and laryngospasm.</p></div><div><h3>Methods</h3><p>In this study, we present a series of 9 patients with anti-IgLON5 disease and otolaryngological manifestations. Patients were evaluated between July 2012 and March 2022 by video-polysomnography, fiber-optic laryngoscopy, and functional endoscopic evaluation of swallowing.</p></div><div><h3>Results</h3><p>The median age was 71 years, and 5 (56%) were female. Video-polysomnography showed a NREM/REM parasomnia in 6 patients (67%), obstructive sleep apnea in 8 (88%), stridor during sleep in 7 (78%) and central apneas in 1 (11%). Six out of the 9 patients (67%) presented episodes of acute respiratory failure that required mechanical ventilation, 6 had vocal fold palsy with 4 of them requiring tracheostomy (3 had to be performed on an emergency basis). Dysphagia occurred in 8 patients (89%). Prominent upper airway secretion and sialorrhea was also present in 3 cases.</p></div><div><h3>Conclusion</h3><p>The anti-IgLON5 disease exhibits extensive otolaryngological symptoms, mainly affecting the upper airway. These symptoms affect the quality of life and can be life-threatening. Prompt acute management is essential for stridor, dyspnea, and dysphagia. Given the potential severity of the symptoms and rarity of the disease, it is important for otolaryngologists to be familiar with anti-IgLON5 disease.</p></div><div><h3>Level of evidence</h3><p>Level 4.</p></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"75 5","pages":"Pages 288-295"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140903824","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":"Utility of sialendoscopy in the management of juvenile recurrent parotitis. Retrospective study","authors":"Maider Andueza Guembe,&nbsp;Carlos Miguel Chiesa Estomba,&nbsp;Carlos Saga Gutiérrez,&nbsp;Izaskun Thomas Arrizabalaga,&nbsp;Marta Ábrego Olano,&nbsp;María Vázquez Quintano,&nbsp;Xabier Altuna Mariezcurren","doi":"10.1016/j.otoeng.2024.05.006","DOIUrl":"10.1016/j.otoeng.2024.05.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Juvenile recurrent parotitis is a rare disease characterized by repeated episodes of inflammation affecting, unilaterally or bilaterally, the parotid glands during childhood.</p></div><div><h3>Material and methods</h3><p>Retrospective study including patients diagnosed with juvenile recurrent parotitis between January 2010 and September 2020 at a tertiary level hospital, with the aim of evaluating the results of medical treatment and sialendoscopy.</p></div><div><h3>Results</h3><p>A total of 48 patients met the inclusion criteria and had a mean follow-up of 4 years (SD = 3; Min: 2/Max: 12). Regarding treatment, 34 (70.8%) patients received conservative treatment and had a mean of 5 episodes (SD = 3; Min: 2/Max: 13) until symptom resolution. Meanwhile, 14 (29.2%) patients underwent sialendoscopy, of which two (12%) required reintervention. In 100% (14) of the patients treated with sialendoscopy, the findings were consistent with JRP and, after sialendoscopy, a statistically significant reduction in episodes was observed, with a mean of 1 post-intervention episode (SD = 1.5; Min:0/Max: 6) (<em>P</em> &lt; .001).</p></div><div><h3>Conclusions</h3><p>The results obtained in this study suggest that sialendoscopy is a useful tool in the treatment of juvenile recurrent parotitis. However, new studies comparing the results of sialendoscopy with other therapeutic alternatives are necessary.</p></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"75 5","pages":"Pages 304-309"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749954","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 profile, otologic, and auditory outcomes in patients with Down syndrome","authors":"","doi":"10.1016/j.otoeng.2024.05.003","DOIUrl":"10.1016/j.otoeng.2024.05.003","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Even though the incidence has decreased in recent years, Down syndrome (DS) remains the most common chromosomal disorder today. Despite being a condition with multisystemic involvement, it often tends to affect the head and neck area, making it a frequent reason for consultation with pediatric otolaryngologists or otologists. The purpose of this work is to be one of the first in Spain to characterize and describe the pathology and therapeutic approach typically provided to these patients, analyzing the evolution from a clinical and auditory perspective.</p></div><div><h3>Material and methods</h3><p>We aim to analyze a sample of 16 pediatric patients recruited over the past 24 years, diagnosed with Down syndrome, and experiencing a wide range of diseases affecting the ear and its auditory function.</p></div><div><h3>Results</h3><p>62.50% of the patients were women, whose main reason for seeking specialist care was acute and serous otitis media, accounting for 31.25%. These patients have an indication for treatment for various entities within the otological sphere that usually do not differ from those of a healthy child. However, the evolution and response to treatments can take on a torpid character due to the anatomical characteristics of the ears of these patients.</p></div><div><h3>Conclusions</h3><p>Although the frequency of children with DS in the pediatric otolaryngologist's clinic is decreasing, these patients have a predisposition to ear diseases with auditory repercussions, with variable evolution depending on the disease and the child's intrinsic characteristics.</p></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"75 5","pages":"Pages 296-303"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141187124","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":"Update and validation of the early word perception test in the Spanish language","authors":"","doi":"10.1016/j.otoeng.2023.11.002","DOIUrl":"10.1016/j.otoeng.2023.11.002","url":null,"abstract":"<div><h3>Introduction</h3><p>It is extremely important to assess speech perception skills in children with hearing loss, since these skills are essential to guide the rehabilitation process.</p></div><div><h3>Objective</h3><p>Update and validate the Early Speech Perception test in Spanish in normal-hearing children.</p></div><div><h3>Method</h3><p>Different drawings were selected from children's books used daily in the work of teachers and speech therapists. 69 children aged between 3 and 8 years old participated in the study, divided into 6 groups by age (group 1, 3 years of age (<em>n</em> = 13); group 2, 4 years of age (<em>n</em> = 15); group 3, 5 years of age (<em>n</em> = 12); group 4, 6 years of age (<em>n</em> = 8); group 5, 7 years of age (<em>n</em> = 10); group 6, 8 years of age (<em>n</em> = 11)). For each category of the test, the children had to name and point to the corresponding drawing.</p></div><div><h3>Results</h3><p>The difference between age and gender groups was statistically evaluated. For the naming phase, a significant difference was observed between groups 1 and group 5; and between group 1 and group 6. For the pointing phase there was no difference between the groups, and in all groups, there was a score greater than 98%. In relation to gender, there was no difference between the groups.</p></div><div><h3>Conclusion</h3><p>The present study demonstrates that the material developed to assess auditory reception in normal-hearing children from 3 to 8 years old is appropriate.</p></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"75 5","pages":"Pages 281-287"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140023641","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":"Variants of posterior semicircular canal involvement in benign paroxysmal positional vertigo","authors":"","doi":"10.1016/j.otoeng.2024.01.013","DOIUrl":"10.1016/j.otoeng.2024.01.013","url":null,"abstract":"<div><p>Benign paroxysmal positional vertigo is the most common cause of peripheral vertigo. It is characterized by short and recurrent episodes of vertigo, trigged by specific head movements that displace otoconia within the semicircular canals. The movement of dislodge otoconia from the utricle cause abnormal positional endolymphatic currents. Primary treatment involves reposition maneuvers aimed at moving the displaced otoconia out the affected canal, therefore correct identification of the affected canal is essential for the diagnosis. The posterior semicircular canal (PSC) is the most frequently affected due to its spatial orientation and the force of gravity. Recent technological advances have allowed for better assessment of positional nystagmus during diagnostic and therapeutic maneuvers, revealing various possible scenarios of PSC involvement. Regarding the PSC, otoconia may be found in different parts of the canal, and not just in the expected location, floating in the long arm of the canal. The understanding of these variants is crucial, as the prognosis and the disease progression differ in such cases. This review aims to describe the six possible variants of PSC involvement described so far.</p></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"75 5","pages":"Pages 324-334"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029774","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}