医学最新文献

{"title":"Health and health management among motorcycle-based food delivery workers in South Korea: a qualitative interview study.","authors":"Sookyung Kim, Min Soo Woo, Soyun Hong","doi":"10.1080/17482631.2026.2613971","DOIUrl":"10.1080/17482631.2026.2613971","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to qualitatively examine the daily lives of motorcycle-based food delivery workers, focusing on how they experience, perceive, and interpret their health-related issues.</p><p><strong>Methods: </strong>Semi-structured in-depth interviews were conducted with nine MFDWs in South Korea between July and September 2024 to explore their perceptions of health. Participants were recruited through purposive and snowball sampling, and data were analyzed using thematic analysis.</p><p><strong>Results: </strong>Thematic analysis revealed the following key findings: MFDWs' challenging working conditions posed physical and emotional stressors, which contributed to negligent driving and unhealthy habits. Although they recognized traffic accidents as the most critical health risk, they exhibited a tendency toward risky driving behaviors. Unhealthy lifestyles were linked to further health deterioration. While the majority showed a passive attitude toward health management, a few adopted individual strategies to maintain their health.</p><p><strong>Conclusions: </strong>The findings suggest the need for policy-level attention to mitigate traffic accident risk factors among MFDWs. Larger and more diverse studies are required to confirm these findings and to provide a stronger evidence base for policy recommendations. In addition, delivery applications could be further refined to help reduce occupational risks, and the development of tailored health promotion interventions may support their health and well-being.</p>","PeriodicalId":51468,"journal":{"name":"International Journal of Qualitative Studies on Health and Well-Being","volume":"21 1","pages":"2613971"},"PeriodicalIF":2.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12794690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IgA Vasculitis with necrotizing arteritis: a multicenter retrospective study from the French Vasculitis Study Group and systematic review of the literature.","authors":"Emmanuel Ribereau-Gayon, Amélie Carbonnelle-Puscian, Marie Ottavi, Marie Donzel, Xavier Puéchal, Cord Sundekötter, Alexandra Audemard-Verger, Julien Rohmer, Brigitte Balme, Alice Fauquier, Natacha Grienay-Poletto, Etienne Novel-Catin, Anne-Laure Liegeon, Alexandre Chollat-Namy, Benjamin Terrier, Cécile-Audrey Durel","doi":"10.1080/08916934.2026.2677546","DOIUrl":"10.1080/08916934.2026.2677546","url":null,"abstract":"<p><p>IgA vasculitis (IgAV) primarily affects small vessels, but rare cases with necrotizing arteritis (NA) raise questions about overlap with polyarteritis nodosa (PAN). To characterize IgAV with necrotizing arteritis (IgAV-NA) and compare its phenotype with classical IgAV and PAN. We performed a multicenter retrospective study combined with a systematic literature review (1990-2025). Patients fulfilled EULAR/PRINTO/PRES IgAV criteria, had pathological or imaging evidence of NA in small or medium arteries, and were ANCA-negative. Thirty patients were included (7 from databases, 23 from the literature). NA was confirmed by biopsy (<i>n</i> = 16) or vascular imaging (<i>n</i> = 14). Clinical features, treatments, remission, and mortality were compared with 257 adult IgAV and 196 PAN patients. Median age was 54.5 years. IgAV-NA was characterized by severe manifestations, including gastrointestinal bleeding, perforation, surgical abdomen, neuropathy, pancreatitis, and livedo. Compared with classical IgAV, IgAV-NA showed significantly higher rates of multi-organ involvement and mortality. Compared with PAN, IgAV-NA shared vascular complications but had less fever and neuropathy. Despite arterial involvement, patients did not fulfil PAN criteria. IgAV-NA represents a rare, severe IgAV phenotype with life-threatening complications rather than an IgAV-PAN overlap. Severe or atypical IgAV presentations should prompt vascular imaging and intensified immunosuppression.</p>","PeriodicalId":8688,"journal":{"name":"Autoimmunity","volume":"59 1","pages":"2677546"},"PeriodicalIF":3.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148026288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of Concern: Insulin Sensitiser Agents Alone and in Co-Treatment with r-FSH for Ovulation Induction in PCOS Women.","authors":"","doi":"10.1080/09513590.2026.2687275","DOIUrl":"https://doi.org/10.1080/09513590.2026.2687275","url":null,"abstract":"","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"42 1","pages":"2687275"},"PeriodicalIF":3.0,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Professional identity formation among participants in a longitudinal pediatric program for final year medical students: a qualitative case study.","authors":"Hillary Anderson, Amara Heard Stittum, Lisa Grefe, Molly Rideout","doi":"10.1080/10872981.2026.2694913","DOIUrl":"https://doi.org/10.1080/10872981.2026.2694913","url":null,"abstract":"<p><strong>Objective: </strong>To explore aspects of professional identity formation in participants of a longitudinal pediatric program for final-year medical students in the US.</p><p><strong>Introduction: </strong>Many institutions have specialty-specific courses focused on the transition to residency, typically at the end of medical school. This study examines professional identity formation among participants of a longitudinal fourth-year Pediatric Concentration.</p><p><strong>Methods: </strong>Authors used a case study design for this qualitative research study using semi-structured interview questions based on a conceptual model of professional identity formation. Authors used purposeful sampling to identify study participants who were randomly selected from former students who completed the program between 2019 and 2021. Three interviewers independently conducted interviews with individual program participants. Thematic analysis with coder reliability was utilized for data analysis; two investigators independently coded and performed inter-rater reliability (IRR) on three sets of questions from transcriptions. After ensuring acceptable IRR, investigators coded the remaining questions and subsequently identified themes and sub-themes.</p><p><strong>Findings: </strong>Eleven former students completed interviews. Following initial independent coding, IRR for three questions was 80%. After coding the 11 interviews, investigators determined that code saturation was achieved. They subsequently identified six main themes: career development, interpersonal connection, personal growth, positive role models, skill-building, and supportive learning environment. Two cross-cutting themes were recognized throughout the data: sense of belonging and gaining confidence toward starting residency.</p><p><strong>Conclusions: </strong>Participants in a longitudinal specialty-specific program in the final year of medical school experienced professional identity formation through a supportive learning environment fostering connection and personal growth while building skills, surrounded by positive role models. This community of practice cultivated a sense of belonging and helped participants gain confidence toward their residency and career. This longitudinal, specialty-specific approach to the final year of medical school may enhance professional identity formation for students entering all specialties and could facilitate transition to internship.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2694913"},"PeriodicalIF":4.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing hope and uncertainty: family perspectives on lung transplantation in cystic fibrosis - a qualitative study.","authors":"Ulrika Skogeland, Isabelle de Monestrol, Tove Godskesen","doi":"10.1080/17482631.2026.2620417","DOIUrl":"10.1080/17482631.2026.2620417","url":null,"abstract":"<p><strong>Purpose: </strong>Cystic fibrosis (CF) is a genetic disease primarily affecting the lungs and digestive system. Individuals with advanced CF lung disease may require transplantation to survive. Family members often take on significant caregiving roles, facing both emotional and practical challenges throughout the transplantation process. This study explores the experiences of such family members to inform and improve supportive care practices.</p><p><strong>Method: </strong>Employing a naturalistic, exploratory design, this qualitative study used purposive sampling to recruit 19 family members of lung transplant recipients with CF. Data were collected through semi-structured interviews and analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>The analysis identified three main themes and eight subthemes: (I) balancing hope and despair on the waiting list, (II) navigating challenges and finding relief after the transplantation, and (III) unmet support and informational needs before and after transplantation.</p><p><strong>Conclusion: </strong>This study highlights the emotional burden and caregiving responsibilities shouldered by family members of individuals with CF who have undergone lung transplantation. The findings emphasise the importance of person- and family-centred interventions, including support for palliative care discussions. A more structured and inclusive framework is essential to address the often-overlooked needs of families throughout the transplantation process.</p>","PeriodicalId":51468,"journal":{"name":"International Journal of Qualitative Studies on Health and Well-Being","volume":"21 1","pages":"2620417"},"PeriodicalIF":2.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12833888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccination status of children with special health-care needs visiting a vaccination consultation clinic of a pediatric hospital in Wuxi, China, from 2020 to 2023: A cross-sectional study.","authors":"Lingling Wang, Xiaojuan Zhang, Xuwen Wang, Hongxia Xiang, Yuan Shen, Shixin Xiu","doi":"10.1080/21645515.2026.2613562","DOIUrl":"10.1080/21645515.2026.2613562","url":null,"abstract":"<p><p>There has been a considerable controversy about vaccination practices of children with special health-care needs (CSHCNs) in China. We aim to describe current vaccination recommendations, immunization status, and vaccination safety of CSHCNs in Wuxi. We conducted a cross-sectional study of CSHCNs aged <18 y visiting the vaccination consultation clinic (VCC) at Wuxi Children's Hospital in 2020-2023. Demographic information was collected from Electronic Medical Records, vaccination data was obtained from Vaccination Integrated Service Management Information System of Jiangsu Province, China. Safety monitoring data was acquired from China National Adverse Events Following Immunization Information System (CNAEFIS). Descriptive data were presented as percentages, and Poisson test was used to compare the cumulative incidence of AEFIs between groups. Four thousand one hundred and twenty-two participants were included and the majority (73.0%) were under 12 months. The top three diseases consulted were those relating to the certain conditions originating in the perinatal period, developmental anomalies, and diseases of the blood or blood-forming organs. Only 6.1% had previously received all age-eligible vaccine doses before seeking evaluation. According to the vaccination guidance issued by the VCC, 59.9% were recommended to continue vaccine normally, partial vaccination was recommended for 37.2%, and 4.1% were advised to delay. A total of 3927 CSHCNs received 62,744 vaccine doses after consultation. None had serious adverse events and the cumulative incidence of AEFIs was higher than the general population of children. Specialist consultation is helpful to improve the vaccine uptake. Further research on strategies to improve the vaccination coverage of CSHCNs is warranted.</p>","PeriodicalId":49067,"journal":{"name":"Human Vaccines & Immunotherapeutics","volume":"22 1","pages":"2613562"},"PeriodicalIF":4.2,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12826754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Confronting fear and uncertainty: adults' experiences of undergoing a food challenge test for food allergy.","authors":"Melina Makatsori, Anne Miles","doi":"10.1080/17482631.2026.2626841","DOIUrl":"10.1080/17482631.2026.2626841","url":null,"abstract":"<p><strong>Background: </strong>Oral food challenges are indicated when food allergies cannot be confirmed by clinical history or investigations, such as blood or skin-prick tests. However, few studies have examined adults' experiences of oral food challenges.</p><p><strong>Methods: </strong>Semi-structured, individual interviews were conducted with 18 adults who had undergone an oral food challenge at a UK hospital.</p><p><strong>Results: </strong>Three main themes were identified using thematic analysis, describing experiences before, during, and after testing: \"A limited and scared life,\" \"facing fear and uncertainty in a safe environment,\" and \"living with revised boundaries.\" Prior to the test, participants described a life characterized by fear of reactions, hypervigilance, planning and restrictive diets, limiting social participation. During testing, participants experienced an emotional rollercoaster, confronting something previously avoided, which could potentially cause a severe reaction. After testing, participants reported reduced fear and uncertainty following clarification of their allergies, leading to greater freedom, and for those who tested negative, a return to viewing food as a source of pleasure, rather than fear.</p><p><strong>Conclusions: </strong>Oral food challenges reduce fear and uncertainty surrounding allergies, providing clarity about which foods trigger reactions. Greater availability of oral food challenges would enable adults with suspected allergies to live less restricted and more enjoyable lives.</p>","PeriodicalId":51468,"journal":{"name":"International Journal of Qualitative Studies on Health and Well-Being","volume":"21 1","pages":"2626841"},"PeriodicalIF":2.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12884989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"QuantiFERON-TB gold plus in people living with HIV: independence from CD4+ T-cell counts in a low TB-burden setting.","authors":"Erika Asperges, Roberto Gulminetti, Laura Maiocchi, Stefano Novati, Layla Pagnucco, Paolo Sacchi, Valentina Zuccaro, Angelo Tavano, Francesco Siviero, Pietro Guidicini, Enrica Bono, Giuseppe Albi, Patrizia Cambieri, Bianca V Mariani, Raffaele Bruno","doi":"10.1080/25787489.2026.2624947","DOIUrl":"10.1080/25787489.2026.2624947","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis screening is recommended for people living with HIV. The QuantiFERON-TB test measures the cell-mediated response against <i>M. Tuberculosis</i>. The Gold-In-Tube measures the response of CD4+ T-cells, often leading to indeterminate results. The new Gold-Plus (QFT-GP) also measures CD8+ T-cells response, thus reducing uncertainties. However, studies on people living with HIV, that would benefit from a test independent from CD4+ T-cells, are scarce.</p><p><strong>Objective: </strong>This study addresses this gap by evaluating the performance of QFT-GP specifically in a large cohort of people living with HIV in a low TB-endemic setting.</p><p><strong>Methods: </strong>We retrospectively evaluated the frequency of indeterminate QFT-GP tests in a cohort of people living with HIV with at least one test. We collected demographic data, CD4+ and CD8+ T-cell count at nadir and at the time of testing, and history of prior TB infection or treatment. We correlated the QFT-GP results to the CD4+ T-cell count.</p><p><strong>Results: </strong>Six hundred and ninety five patients were included (males/females 72.5/27.5%), median age was 51 ± 14 years. Only 1,2% of tests were indeterminate, and there was no association with the CD4+ or CD8+ T-cell count at the moment of the test or at the nadir.</p><p><strong>Conclusions: </strong>QFT-GP has few indeterminate results, even in patients with a low CD4+ T-cell count.</p>","PeriodicalId":13165,"journal":{"name":"HIV Research & Clinical Practice","volume":"27 1","pages":"2624947"},"PeriodicalIF":2.1,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetically engineered M13 phage-mediated H9N2 DNA vaccine with enhanced mucosal and systemic immune responses in mice.","authors":"Xiaohua Wang, Zhi Zhao, Mingze Shi, Shangen Xu, Xin Zhou, Kai Zhao","doi":"10.1080/10717544.2026.2629037","DOIUrl":"10.1080/10717544.2026.2629037","url":null,"abstract":"<p><p>Vaccine adjuvants and delivery systems have long been used in DNA vaccines to enhance immunogenicity. In this study, we developed a DNA vaccine delivery platform by combining <i>N</i>-2-hydroxypropyl trimethyl ammonium chloride chitosan/carboxymethyl chitosan nanoparticles (N-2-HACC/CMCS NPs) with a genetically engineered M13 phage containing the HA gene of H9N2 AIV (HA-M13). The composite NPs (HA-M13/N-2-HACC/CMCS) had an average particle size of 135.24 ± 4.36 nm, and the HA gene encapsulated in the composite NPs could be expressed <i>in vitro</i>. Additionally, the N-2-HACC/CMCS NPs exhibited high stability and effectively protected the HA gene and M13 phage from degradation while sustaining antigen release. Furthermore, the N-2-HACC/CMCS NPs promoted the maturation of DC2.4, enhanced MHC I and MHC II pathways and improved cellular, humoral, and mucosal immune responses. Mice immunized with HA-M13/N-2-HACC/CMCS via nasal and intramuscular injections presented higher anti-H9N2 AIV antibody titers than those given the commercial vaccine. Lymphocyte proliferation, as well as the levels of the cytokines IL-2, IL-4, IFN-<i>γ</i>, CD4⁺, and CD8⁺ T lymphocyte levels, also significantly increased. The nanovaccine provided effective protection against H9N2 AIV infection for 154 days postimmunization, surpassing the 120-day protection provided by the commercial vaccine. Consequently, the N-2-HACC/CMCS NPs loaded with M13 phages exhibit significant potential as vaccine adjuvants and mucosal immune delivery system.</p>","PeriodicalId":11679,"journal":{"name":"Drug Delivery","volume":"33 1","pages":"2629037"},"PeriodicalIF":8.0,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12895868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146156287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative safety assessment of measles-containing vaccination schedules in Jiangsu Province, China: A population-based pharmacovigilance study (2014-2024).","authors":"Yuanyuan Zhu, Jing Yu, Ran Hu, Zhiguo Wang, Xiang Sun","doi":"10.1080/21645515.2026.2686496","DOIUrl":"https://doi.org/10.1080/21645515.2026.2686496","url":null,"abstract":"<p><p>China's immunization policy was updated in 2020, replacing the sequence of MR (at 8-12 months) and MMR (at 18-24 months) with a comprehensive two-dose MMR schedule.This study aims to evaluate the safety of this policy shift by comparing the incidence of Adverse Events Following Immunization (AEFI) before and after the adjustment.Methods: A retrospective analysis was conducted using AEFI surveillance data from Jiangsu Province. The study compared two cohorts: the \"pre-adjustment\" group (MR at 8 months, MMR at 18 months) and the \"post-adjustment\" group (MMR at both 8 and 18 months). Incidence rates of non-serious reactions (fever, fatigue, local redness, and swelling) and serious reactions (allergic rash, febrile seizures, etc.) were analyzed using Chi-square tests and rate ratios (RR). Results: The transition to a two-dose MMR schedule was associated with an increase in reported mild AEFIs. Specifically, at the 8-month dose, the incidence of fever, fatigue, local redness, and swelling was significantly higher in the MMR8 group compared to the MR8 group (<i>P</i> < .001). The incidence of allergic rash also showed a 31% increase in the MMR8 group (45.39 per 100,000) compared to the MR8 group (34.71 per 100,000), though it remained below global safety thresholds. Crucially, there were no statistically significant differences in the incidence of serious AEFIs, such as thrombocytopenic purpura (<i>P</i> = .670) or febrile seizures (<i>P</i> = .915), between the two strategies. Furthermore, serious reactions as a whole category showed no statistically significant difference between MR8 and MMR8 (<i>P</i> = .710). The implementation of a two-dose MMR immunization schedule in Jiangsu Province is safe. While the shift was associated with an increase in mild, self-limiting reactions, it did not lead to an increase in serious adverse events. These findings support the continued use of the two-dose MMR strategy to provide broader protection against measles, mumps, and rubella without compromising vaccine safety.</p>","PeriodicalId":49067,"journal":{"name":"Human Vaccines & Immunotherapeutics","volume":"22 1","pages":"2686496"},"PeriodicalIF":4.2,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}