Pub Date : 2022-12-01DOI: 10.33091/amj.2022.176303
N. Rezaieg
I ndeed, the prehistoric period was associated with chronic malnutrition, which was a fundamental rule of human history. Because of this, natural selection favored genetic patterns that could survive in these harsh conditions by storing fat. This is because the main function of body fat is to store food reserves for the body [1]. Feeding behavior could be an interaction of a physiologic need for food with the reward system that powerfully encourages excessive eating in some people. Neuroadaptations in the reward system happens when people eat too many tasty foods. This disconnects eating behavior from caloric needs and leads to uncontrollable overeating [2]. Over time, body fat became a major issue. However, the negative effects of being overweight were not recognized in medical literature until as late as the 18th century. Then, technological advancement and economic prosperity resulted in the comfortable availability and simple cost of high-calorie foods, which are palatable to a large segment of the population [3]. Many factors that were formed as a result of this technological development have become major contributors to the increase in the obesity epidemic, including the increased use of sugar substitutes, the addition of preservatives to foods, sugar-sweetened beverages, changing eating patterns, as well as the promotion of sedentary lifestyles [4]. Excess calories taken in comparison to calories burned from any source result in the accumulation of these calories as body fat. Obesity may be characterized in many ways: For starters, it is a condition in which excess body fat interferes with normal activity and health. Second, the weight is more than 20% greater than the ideal height and body size. Third, a body mass index (BMI) is over 30 [5]. By dividing the body weight in kilograms by the height in square meters and using the equation below, the body mass
{"title":"Reward Systems and Ultra-processed Foods.","authors":"N. Rezaieg","doi":"10.33091/amj.2022.176303","DOIUrl":"https://doi.org/10.33091/amj.2022.176303","url":null,"abstract":"I ndeed, the prehistoric period was associated with chronic malnutrition, which was a fundamental rule of human history. Because of this, natural selection favored genetic patterns that could survive in these harsh conditions by storing fat. This is because the main function of body fat is to store food reserves for the body [1]. Feeding behavior could be an interaction of a physiologic need for food with the reward system that powerfully encourages excessive eating in some people. Neuroadaptations in the reward system happens when people eat too many tasty foods. This disconnects eating behavior from caloric needs and leads to uncontrollable overeating [2]. Over time, body fat became a major issue. However, the negative effects of being overweight were not recognized in medical literature until as late as the 18th century. Then, technological advancement and economic prosperity resulted in the comfortable availability and simple cost of high-calorie foods, which are palatable to a large segment of the population [3]. Many factors that were formed as a result of this technological development have become major contributors to the increase in the obesity epidemic, including the increased use of sugar substitutes, the addition of preservatives to foods, sugar-sweetened beverages, changing eating patterns, as well as the promotion of sedentary lifestyles [4]. Excess calories taken in comparison to calories burned from any source result in the accumulation of these calories as body fat. Obesity may be characterized in many ways: For starters, it is a condition in which excess body fat interferes with normal activity and health. Second, the weight is more than 20% greater than the ideal height and body size. Third, a body mass index (BMI) is over 30 [5]. By dividing the body weight in kilograms by the height in square meters and using the equation below, the body mass","PeriodicalId":378741,"journal":{"name":"Al- Anbar Medical Journal","volume":"26 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132653720","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}
Pub Date : 2022-12-01DOI: 10.33091/amj.2022.176309
C. Saeed, S. Shareef, Pshtiwan Majeed
Background: Smoking is the foremost public health problem affecting the world and it has a crucial implication in causing many common diseases due to Helicobacter pylori infection which is globally distributed. Smoking is considered a critical risk factor that accelerates infection with this bacterium. Objectives: The study’s goal was to find out how common Helicobacter pylori infections were among male cigarette and nargileh smokers. Materials and methods: A case-control study was performed between August and December 2021in Erbil Teaching Hospital in Erbil City, Kurdistan Region, Iraq. Blood samples were collected and used for detection of anti- Helicobacter pylori IgG Ab for 80 males who were smokers and 80 who were non-smoker. Results: The prevalence of Helicobacter pylori positivity was 64.9% in smokers and 45.5% in nonsmokers (P-Value = 0.03). The highest percentage (54.1%) was found in the young age group (25-34) years (P-Value = 0.05), and 89.2% of Helicobacter pylori -positive individuals exhibited stomach symptoms (P-Value = 0.01). Fifty percent of Helicobacter pylori -infected individuals were nargileh smokers. Conclusion: The prevalence of Helicobacter pylori showed significant value in nargileh smoking males. Therefore, smoking was a key factor in the seroprevalence of Helicobacter pylori and had a substantial impact on it.
{"title":"Prevalence of Helicobacter pylori Infection in Cigarette and Nargileh Smoking Males in Erbil City, Iraq","authors":"C. Saeed, S. Shareef, Pshtiwan Majeed","doi":"10.33091/amj.2022.176309","DOIUrl":"https://doi.org/10.33091/amj.2022.176309","url":null,"abstract":"Background: Smoking is the foremost public health problem affecting the world and it has a crucial implication in causing many common diseases due to Helicobacter pylori infection which is globally distributed. Smoking is considered a critical risk factor that accelerates infection with this bacterium. Objectives: The study’s goal was to find out how common Helicobacter pylori infections were among male cigarette and nargileh smokers. Materials and methods: A case-control study was performed between August and December 2021in Erbil Teaching Hospital in Erbil City, Kurdistan Region, Iraq. Blood samples were collected and used for detection of anti- Helicobacter pylori IgG Ab for 80 males who were smokers and 80 who were non-smoker. Results: The prevalence of Helicobacter pylori positivity was 64.9% in smokers and 45.5% in nonsmokers (P-Value = 0.03). The highest percentage (54.1%) was found in the young age group (25-34) years (P-Value = 0.05), and 89.2% of Helicobacter pylori -positive individuals exhibited stomach symptoms (P-Value = 0.01). Fifty percent of Helicobacter pylori -infected individuals were nargileh smokers. Conclusion: The prevalence of Helicobacter pylori showed significant value in nargileh smoking males. Therefore, smoking was a key factor in the seroprevalence of Helicobacter pylori and had a substantial impact on it.","PeriodicalId":378741,"journal":{"name":"Al- Anbar Medical Journal","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124839149","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}
Pub Date : 2022-06-01DOI: 10.33091/amj.2021.174524
A. Othman, Nabeel M Al-Hamamy
{"title":"Effect of Preoperative Alpha-Blocker in Ureteroscopy for Ureteral Stones: A Case-Control Study","authors":"A. Othman, Nabeel M Al-Hamamy","doi":"10.33091/amj.2021.174524","DOIUrl":"https://doi.org/10.33091/amj.2021.174524","url":null,"abstract":"","PeriodicalId":378741,"journal":{"name":"Al- Anbar Medical Journal","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131878274","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}
Pub Date : 2022-06-01DOI: 10.33091/amj.2021.174526
M. Kadhim, Noor Abed
Background: Breast cancer is the second cause of cancer death in women. Shear wave elastography (SWE) is an ultrasound (US) procedure that can improves the sensitivity and the specificity in the diagnosis of breast lesions. Objectives: To evaluate the value of SWE to discriminate benign from malignant Breast Imaging-Reporting and Data System (BI-RADS) IV breast lesions. Materials and methods: A cross sectional analytic study was done in the Radiology Department, Oncology Teaching Hospital, Baghdad Medical City, Baghdad, Iraq. The study period was one year (February 2020 to January 2021). The study included 42 female patients with suspicious breast lesions in the group BI-RAD 4 by mammography and US. Shear wave elastography was done for all patients. The final diagnosis of all breast lesions were done by fine needle aspiration cytology or true cut biopsy or excisional biopsy. Results: The final histological diagnosis showed that 23 (54.8%) of study patients were with benign breast lesions. There was a statistically significant association between the quality of SWE and histopathological diagnosis as the proportion of malignant breast lesions was significantly higher among the patients with score 5 (homogenous dark blue) images (85.7%, P= 0.004). Subjectts with malignant lesions had a significantly higher mean of E-mean SWV than those with benign lesions (133.8 versus 75.47 kPa, P = 0.001). The best cut point of E-mean SWV was 83 kPa (E-mean SWV > 83 kPa is predictive for malignant lesion of breast) with 89.5% sensitivity, 60.9% specificity, and 73.8% accuracy. Conclusion: SWE have a significant diagnostic value in differentiation of BI-RADS IV breast lesions into benign and malignant in both qualitative and quantitative patterns. The best cut off value in SWE is 83 KPa for E-mean.
{"title":"Value of Shear Wave Elastography in Discriminating Category IV Breast Lesions According to Breast Imaging-Reporting and Data System","authors":"M. Kadhim, Noor Abed","doi":"10.33091/amj.2021.174526","DOIUrl":"https://doi.org/10.33091/amj.2021.174526","url":null,"abstract":"Background: Breast cancer is the second cause of cancer death in women. Shear wave elastography (SWE) is an ultrasound (US) procedure that can improves the sensitivity and the specificity in the diagnosis of breast lesions. Objectives: To evaluate the value of SWE to discriminate benign from malignant Breast Imaging-Reporting and Data System (BI-RADS) IV breast lesions. Materials and methods: A cross sectional analytic study was done in the Radiology Department, Oncology Teaching Hospital, Baghdad Medical City, Baghdad, Iraq. The study period was one year (February 2020 to January 2021). The study included 42 female patients with suspicious breast lesions in the group BI-RAD 4 by mammography and US. Shear wave elastography was done for all patients. The final diagnosis of all breast lesions were done by fine needle aspiration cytology or true cut biopsy or excisional biopsy. Results: The final histological diagnosis showed that 23 (54.8%) of study patients were with benign breast lesions. There was a statistically significant association between the quality of SWE and histopathological diagnosis as the proportion of malignant breast lesions was significantly higher among the patients with score 5 (homogenous dark blue) images (85.7%, P= 0.004). Subjectts with malignant lesions had a significantly higher mean of E-mean SWV than those with benign lesions (133.8 versus 75.47 kPa, P = 0.001). The best cut point of E-mean SWV was 83 kPa (E-mean SWV > 83 kPa is predictive for malignant lesion of breast) with 89.5% sensitivity, 60.9% specificity, and 73.8% accuracy. Conclusion: SWE have a significant diagnostic value in differentiation of BI-RADS IV breast lesions into benign and malignant in both qualitative and quantitative patterns. The best cut off value in SWE is 83 KPa for E-mean.","PeriodicalId":378741,"journal":{"name":"Al- Anbar Medical Journal","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124845643","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}
Pub Date : 2022-06-01DOI: 10.33091/amj.2022.174523
Hani Danhash, R. Al-Ani, Maher Khaleel
Background: Brucellosis is a common and endemic disease in the Anbar governorate. Besides, the Brucella microorganism has different ways of transmission. Objectives: The study aimed to determine the ways of transmission of Brucella organisms to human beings in the Al-Anbar governorate. Materials and methods: A retrospective study was carried out on patients visiting the two main Ramadi Teaching Hospitals in Ramadi city, Iraq for the diagnosis and treatment of Brucellosis. Patients with blood-culture-positive brucellae were enrolled in the study. The study included the period between February 2002 and March 2005. Data were collected and recorded regarding age, gender, and residence. The possible ways of acquiring the disease were recorded too. These included ingestion of possibly contaminated foods, butchering of animals, meat cutting, keeping animals in homes or nearby their livings, cleaning animal places, caring for, milking of them, aiding in their delivery and if they wear gloves, blowing in the mouth of delivered fetuses, their work, and possible laboratory worker exposure. Results: A total of 312 patients with brucellosis were enrolled in the study. The disease appears to be more common in rural areas (P-value < 0.001). More cases were females in all age groups, and it was more common in the age group 31-40 years. The main mode of transmission is direct or indirect contact with infected domestic animals (P-value < 0.001). Lab workers and ingestion of raw milk and unsafe milk products were the least recorded expected risk for infection. Three risky behaviors for acquiring brucellosis were also recognized in this study: milking animals, aiding domestic animals in delivery, and blowing in the mouth of delivered fetuses to promote breathing of the newly delivered animals. Conclusion: Direct or indirect animal contact was the main way of Brucella transmission in the Al-Anbar governorate.
{"title":"Modes of Transmission of Brucellosis in Anbar Governorate, Iraq","authors":"Hani Danhash, R. Al-Ani, Maher Khaleel","doi":"10.33091/amj.2022.174523","DOIUrl":"https://doi.org/10.33091/amj.2022.174523","url":null,"abstract":"Background: Brucellosis is a common and endemic disease in the Anbar governorate. Besides, the Brucella microorganism has different ways of transmission. Objectives: The study aimed to determine the ways of transmission of Brucella organisms to human beings in the Al-Anbar governorate. Materials and methods: A retrospective study was carried out on patients visiting the two main Ramadi Teaching Hospitals in Ramadi city, Iraq for the diagnosis and treatment of Brucellosis. Patients with blood-culture-positive brucellae were enrolled in the study. The study included the period between February 2002 and March 2005. Data were collected and recorded regarding age, gender, and residence. The possible ways of acquiring the disease were recorded too. These included ingestion of possibly contaminated foods, butchering of animals, meat cutting, keeping animals in homes or nearby their livings, cleaning animal places, caring for, milking of them, aiding in their delivery and if they wear gloves, blowing in the mouth of delivered fetuses, their work, and possible laboratory worker exposure. Results: A total of 312 patients with brucellosis were enrolled in the study. The disease appears to be more common in rural areas (P-value < 0.001). More cases were females in all age groups, and it was more common in the age group 31-40 years. The main mode of transmission is direct or indirect contact with infected domestic animals (P-value < 0.001). Lab workers and ingestion of raw milk and unsafe milk products were the least recorded expected risk for infection. Three risky behaviors for acquiring brucellosis were also recognized in this study: milking animals, aiding domestic animals in delivery, and blowing in the mouth of delivered fetuses to promote breathing of the newly delivered animals. Conclusion: Direct or indirect animal contact was the main way of Brucella transmission in the Al-Anbar governorate.","PeriodicalId":378741,"journal":{"name":"Al- Anbar Medical Journal","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128102525","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}
Pub Date : 2022-06-01DOI: 10.33091/amj.2022.174527
Shaimaa Jubair, S. Shihab, Naqaa Mousa
Background: Gout is the most common type of inflammatory arthritis in men and postmenopausal women. The incidence and prevalence of hyperuricemia and gout were increased all over the world even among developed countries. Materials and methods: A cross-sectional study was conducted at the Rheumatology Unit of Baghdad Teaching Hospital in Medical City, Baghdad, Iraq from October 2020 to April 2021. A total of 247 subjects were included in the study. Data were collected using a pre-constructed data collection sheet by face-to-face individual interviews. The sheet includes demographic characteristics, gout-related questions regarding the etiology, suspected predisposing agents, complications, diagnostic methods, food-related, clinical manifestations among studied cases, and attitudes of the gout patients among the study sample. Results: Of 247 subjects, there were 67.2% (n = 166) males, 27.9 (n = 69) from the age group 40-49 years, 36.4% (n = 90) from Baghdad city, 25.5% (n = 63) university graduates, 19.9% with good income, 70.5 (174) employed, 221 (89.5%) married, 85% (n = 210) non-smokers, and 8.9% (n = 22) with family history of gout. Overall, 59 (23.9%) of the participants had a high level of awareness whereas low awareness levels accounted for 41.3% (n = 102). The awareness level showed a statistically significant association with education level, occupation, economic status, smoking habit, family history of gout, and patients with gout (P-value < 0.05). Conclusion: There was a high proportion (41.3%) of the participants with a low level of awareness about gout and hyperuricemia. The awareness level among the participants was related to the education level, occupation, economic status, smoking habit, family history of gout, and patients with gout.
{"title":"Awareness of Gout and Hyperuricemia in a Sample of the Adult Population in Iraq","authors":"Shaimaa Jubair, S. Shihab, Naqaa Mousa","doi":"10.33091/amj.2022.174527","DOIUrl":"https://doi.org/10.33091/amj.2022.174527","url":null,"abstract":"Background: Gout is the most common type of inflammatory arthritis in men and postmenopausal women. The incidence and prevalence of hyperuricemia and gout were increased all over the world even among developed countries. Materials and methods: A cross-sectional study was conducted at the Rheumatology Unit of Baghdad Teaching Hospital in Medical City, Baghdad, Iraq from October 2020 to April 2021. A total of 247 subjects were included in the study. Data were collected using a pre-constructed data collection sheet by face-to-face individual interviews. The sheet includes demographic characteristics, gout-related questions regarding the etiology, suspected predisposing agents, complications, diagnostic methods, food-related, clinical manifestations among studied cases, and attitudes of the gout patients among the study sample. Results: Of 247 subjects, there were 67.2% (n = 166) males, 27.9 (n = 69) from the age group 40-49 years, 36.4% (n = 90) from Baghdad city, 25.5% (n = 63) university graduates, 19.9% with good income, 70.5 (174) employed, 221 (89.5%) married, 85% (n = 210) non-smokers, and 8.9% (n = 22) with family history of gout. Overall, 59 (23.9%) of the participants had a high level of awareness whereas low awareness levels accounted for 41.3% (n = 102). The awareness level showed a statistically significant association with education level, occupation, economic status, smoking habit, family history of gout, and patients with gout (P-value < 0.05). Conclusion: There was a high proportion (41.3%) of the participants with a low level of awareness about gout and hyperuricemia. The awareness level among the participants was related to the education level, occupation, economic status, smoking habit, family history of gout, and patients with gout.","PeriodicalId":378741,"journal":{"name":"Al- Anbar Medical Journal","volume":"71 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131967354","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}
Pub Date : 2022-06-01DOI: 10.33091/amj.2021.174525
N. Rezaieg
Background: Food ingestion and energy spending are organized through a complicated neu-rological system that involves both hypothalamic centers and peripheral satiety regulation (gastrointestinal and pancreatic hormones). Objectives: To assess the effects of sugar addiction on appetite-related hormones and metabolic hormones. Materials and methods: The study was done in two main hospitals in Anbar governorate, Iraq from April 2020 to November 2020. Concentration of fasting blood glucose (FBG), insulin, hormone insulin resistance (HOMA-IR), leptin, ghrelin, lipid profile, TSH, T3, and T4 were measured in the 54 obese adolescents and were compared with 54 normal-weight adolescents. Results: There was a significant increase in the concentrations of FBG, insulin, HOMA-IR, leptin, total cholesterol (TC), triacylglycerol (TAG), low-density lipoprotein cholesterol (LDL-C), and TSH in obese adolescents as compared to normal-weight adolescents (P-value < 0.05). While there was a significant (P < 0.05) decreased in the concentrations of ghrelin, high-density lipoprotein cholesterol (HDL-C), T3, and T4 in obese adolescents compared with normal-weight adolescents. The results also showed that there is a significant positive correlation between the concentration of leptin and each of BMI, FBG, insulin, and HOMA-IR, while there was a significant negative association between leptin level with HDL-C and ghrelin. Conclusion: overeating and thus leads to obesity.
{"title":"The Effect of Sweet-tasting Foods Addiction on Appetite-related Hormones among Obese Adolescents","authors":"N. Rezaieg","doi":"10.33091/amj.2021.174525","DOIUrl":"https://doi.org/10.33091/amj.2021.174525","url":null,"abstract":"Background: Food ingestion and energy spending are organized through a complicated neu-rological system that involves both hypothalamic centers and peripheral satiety regulation (gastrointestinal and pancreatic hormones). Objectives: To assess the effects of sugar addiction on appetite-related hormones and metabolic hormones. Materials and methods: The study was done in two main hospitals in Anbar governorate, Iraq from April 2020 to November 2020. Concentration of fasting blood glucose (FBG), insulin, hormone insulin resistance (HOMA-IR), leptin, ghrelin, lipid profile, TSH, T3, and T4 were measured in the 54 obese adolescents and were compared with 54 normal-weight adolescents. Results: There was a significant increase in the concentrations of FBG, insulin, HOMA-IR, leptin, total cholesterol (TC), triacylglycerol (TAG), low-density lipoprotein cholesterol (LDL-C), and TSH in obese adolescents as compared to normal-weight adolescents (P-value < 0.05). While there was a significant (P < 0.05) decreased in the concentrations of ghrelin, high-density lipoprotein cholesterol (HDL-C), T3, and T4 in obese adolescents compared with normal-weight adolescents. The results also showed that there is a significant positive correlation between the concentration of leptin and each of BMI, FBG, insulin, and HOMA-IR, while there was a significant negative association between leptin level with HDL-C and ghrelin. Conclusion: overeating and thus leads to obesity.","PeriodicalId":378741,"journal":{"name":"Al- Anbar Medical Journal","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126190245","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}
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