European Journal of Psychiatry最新文献

{"title":"Digital mental health and employment - Lessons from the Australian experience","authors":"Sebastian Rosenberg ,&nbsp;Luis Salvador-Carulla ,&nbsp;Sue Lukersmith ,&nbsp;Nasser Bagheri ,&nbsp;The EMPOWER Consortium","doi":"10.1016/j.ejpsy.2022.08.001","DOIUrl":"https://doi.org/10.1016/j.ejpsy.2022.08.001","url":null,"abstract":"<div><h3>Background and objectives</h3><p>This paper reviews Australia's take-up of digital mental health interventions, including some specific reference to their application in relation to employment. Use of these interventions in Australia was already significant. Under COVID-19 they have exploded. The Australian experience offers useful lessons for European and other countries, and these are summarised.</p></div><div><h3>Methods</h3><p>This paper presents a narrative review of key texts, resources, policies and reports, from government and other sources. It also presents data reflecting the take-up of digital mental health services and the employment of people with a mental illness in Australia.</p></div><div><h3>Results</h3><p>We present data showing the explosion in uptake of digital mental health services. There is very limited evidence about the impact of these services in improving employment outcomes for people with a mental illness in Australia. The Government has moved to make them a permanent feature of mental health care, in addition to traditional face-to-face care.</p></div><div><h3>Conclusion</h3><p>Key lessons emerge from the Australian experience, including the need for target clarity; the importance of blending digital services into broader frameworks of mental health care; the need for quality and safety standards to be developed and applied to digital services; and the need for better evaluation of the outcomes of digital interventions in the workplace.</p><p>The digital mental health genie is out of the bottle. New capacity for evaluation of the outcomes of digital mental health services is vital to ensure value and quality of such investments.</p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"37 1","pages":"Pages 36-43"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50204117","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":"Perceived stigma and discrimination among persons with mood and anxiety disorders: Results from the WHO World Mental Health Survey Portugal","authors":"Ana Antunes ,&nbsp;Manuela Silva ,&nbsp;Sofia Azeredo-Lopes ,&nbsp;Graça Cardoso ,&nbsp;José Miguel Caldas-de-Almeida","doi":"10.1016/j.ejpsy.2022.06.001","DOIUrl":"https://doi.org/10.1016/j.ejpsy.2022.06.001","url":null,"abstract":"<div><h3>Background and objectives</h3><p><span>The stigma attached to mental disorders remains a </span>public health challenge, represents an important barrier to healthcare and widens existing social inequalities.</p><p>This study aimed to characterize the association between perceived stigma and mental disorders. The two main objectives were to estimate the association between perceived stigma and 12-month anxiety and mood disorders, and to assess the factors associated with perceived stigma among persons with these mental disorders.</p></div><div><h3>Methods</h3><p>A nationally representative sample of the Portuguese population was used. Participants were Portuguese-speaking adults, aged 18 or above and residing in permanent dwellings in the country's mainland. The survey was administered by trained lay interviewers using a computer assisted personal interview (CAPI) on a face-to-face setting.</p></div><div><h3>Results</h3><p>The results showed a two-fold increase in the likelihood of experiencing stigma among individuals with 12-month anxiety and mood disorders, slightly higher in the latter, when compared with individuals without. Among the sub-sample with these mental disorders, participants retired (or others), with psychiatric comorbidity and with co-occurrence of psychiatric and physical disorders had higher odds of reporting perceived stigma.</p></div><div><h3>Conclusions</h3><p>The findings of this study highlight the need to consider stigma as a public health priority in Portugal and to develop policies to create awareness and promote the social inclusion of persons with mental disorders.</p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"36 4","pages":"Pages 280-287"},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71732011","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":"Activity of energy, glutamate, and glutathione metabolism enzymes in blood cells of elderly patients with depression","authors":"Olga Savushkina ,&nbsp;Irina Boksha ,&nbsp;Tatyana Prokhorova ,&nbsp;Elena Tereshkina ,&nbsp;Tatyana Safarova ,&nbsp;Olga Yakovleva ,&nbsp;Vladimir Kornilov ,&nbsp;Elena Shipilova ,&nbsp;Elena Vorobyeva ,&nbsp;Gulnur Burbaeva","doi":"10.1016/j.ejpsy.2022.05.001","DOIUrl":"https://doi.org/10.1016/j.ejpsy.2022.05.001","url":null,"abstract":"<div><p><span><span>Heterogeneity of depression in older adults is a challenge for the development of person-centered treatment<span>. To address this, we studied glutamate and </span></span>glutathione metabolism enzymes in blood cells in 53 older adult patients with depression and 20 controls. Patients with depression had decreased platelet glutathione-S-transferase and erythrocyte </span>glutathione reductase<span>. The biochemical and clinical data contributed to three clinical clusters that are not linked to the onset of depression or its duration but were related to anxiety, cerebrovascular and cardiovascular comorbidities, including parkinsonian features such as tremor, akathisia, and rigidity. These findings could aid person-centered diagnosis and outcomes and timely successful treatment(s) of depression in older adults.</span></p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"36 4","pages":"Pages 288-293"},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71732012","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":"Endocrine biomarkers related to sleep-wake cycle and sleep disturbances in patients with bipolar disorder: A systematic review","authors":"Leticia González-Blanco ,&nbsp;Carlota Moya-Lacasa ,&nbsp;Sara Jiménez-Fernández ,&nbsp;Clara Martínez-Cao ,&nbsp;Mercedes Valtueña-García ,&nbsp;Francesco Dal Santo ,&nbsp;M. Paz García-Portilla ,&nbsp;Luis Gutiérrez-Rojas","doi":"10.1016/j.ejpsy.2022.04.004","DOIUrl":"https://doi.org/10.1016/j.ejpsy.2022.04.004","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Sleep and circadian disturbances have been widely studied in patients with bipolar disorder. However, there is no clear evidence about the role of peripheral biomarkers of the circadian cycle in this population. This systematic review aims to identify potential endocrine blood biomarkers of circadian rhythms and study their relationship with sleep problems in these patients.</p></div><div><h3>Methods</h3><p>An electronic search was performed of PubMed and PsycINFO databases. It included articles about the topic from 1991 through 2021. The search strategy was: (\"peripheral biomarkers\" OR \"biological markers\" OR biomarker OR cortisol OR melatonin OR orexin OR hypocretin) AND (blood OR serum OR plasma) AND (“sleep-wake” OR \"circadian rhythm\" OR sleep OR insomnia) AND \"bipolar.\"</p></div><div><h3>Results</h3><p>After excluding duplicates, 92 records were obtained. Only 5 studies met the inclusion criteria (n=499; bipolar disorder=125; unipolar depression=148; schizophrenia=80; controls=146). The endocrine parameters analyzed were: cortisol (3 studies), melatonin (1 study), and orexin-A (1 study). Overall, no significant associations were detected between these biomarkers and sleep disturbances, assessed with subjective (psychometric evaluation) and/or objective (polysomnography) measures.</p></div><div><h3>Conclusion</h3><p>This review highlights the lack of studies exploring the role of endocrine biomarkers related to circadian function in the pathophysiology of sleep disturbances in bipolar disorder.</p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"36 4","pages":"Pages 223-229"},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213616322000362/pdfft?md5=5b0cef2bba191818994f6adaf0af170b&pid=1-s2.0-S0213616322000362-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71732026","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":"Retinal nerve fiber layer decrease and choroidal layer increase after four weeks of buprenorphine/naloxone maintenance treatment in opioid use disorder","authors":"Mehmet Hamdi Orum ,&nbsp;Aysun Kalenderoglu ,&nbsp;Ayse Sevgi Karadag ,&nbsp;Cicek Hocaoglu","doi":"10.1016/j.ejpsy.2022.04.001","DOIUrl":"https://doi.org/10.1016/j.ejpsy.2022.04.001","url":null,"abstract":"<div><h3>Background and Objectives</h3><p><span>Spectral-domain optical coherence tomography (SD-OCT) findings in substance use disorders have been investigated in recent years. In this study, we compared the retinal nerve fiber layer (RNFL), the </span>ganglion cell layer<span> (GCL), the inner plexiform layer<span> (IPL), and the choroid thickness (CT) of OUD and control groups before and after buprenorphine/naloxone maintenance treatment (BN-MT).</span></span></p></div><div><h3>Methods</h3><p>The OUD group consisted of 46 male subjects and the control group consisted of 49 male subjects. Patients with chronic opioid use and opioid positivity in their urine during the initial SD-OCT application were included in the study. At the end of the fourth week of BN-MT, SD-OCT was repeated and BN positivity was detected in the urine of the patients at this time.</p></div><div><h3>Results</h3><p>There was a significant difference between OUD and control groups in terms of nasal superior and CT values of both eyes (p&lt;0.05) before BN use. The values of RNFL sectors and CT of both eyes before and after BN-MT differed significantly (p&lt;0.05); CT increased and RNFL sectors decreased. After BN-MT, psychometric scales differed significantly in favor of the patients (p&lt;0.05). The SD-OCT values of the OUD group after BN-MT were compared with the control group: the right IPL (p=0.003), the left IPL (p=0.023), the right N (p=0.001) and the left N (p&lt;0.001) values were significantly lower in the OUD group.</p></div><div><h3>Conclusion</h3><p>This is the first study to show the SD-OCT findings of patients with OUD before and after BN-MT. The findings of this study may indicate possible effects of chronic opioid use in patients<span> and/or possible effects of exogenous opioid or BN present in the body during SD-OCT applications. However, based on our findings, it is not possible to distinguish between the two possible outcomes. The fact that the use of BN acting through opioid receptors has different effects from exogenous opioids may be due to different receptor profiles.</span></p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"36 4","pages":"Pages 260-270"},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71794453","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":"The “GHU-Checkist”: Validity and acceptability of a 17-words checklist for rapid screening of depressive symptoms and anxiety","authors":"Fabienne El-Khoury ,&nbsp;Justine Lahaye ,&nbsp;Camille Oudinet ,&nbsp;Pierre Alexis Geoffroy ,&nbsp;Enrique Casalino ,&nbsp;Christophe Choquet ,&nbsp;Florence Perquier ,&nbsp;Michel Lejoyeux","doi":"10.1016/j.ejpsy.2022.03.002","DOIUrl":"https://doi.org/10.1016/j.ejpsy.2022.03.002","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Early detection of psychiatric disorders in general hospital settings could facilitate a systematic assessment of anxiety and depression, and lessen their non-detection, misdiagnoses and subsequent negative impacts. We built a new short screening tool with simple Yes/No questions on anxiety and depression and examined its diagnostic capacity and acceptability.</p></div><div><h3>Methods</h3><p>Our cross-sectional study included 608 patients examined in an emergency department at a Parisian general hospital. Their depressive and anxiety symptoms were assessed with the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder 7 (GAD-7). Participants also completed the ‘GHU-checklist’, a list of 17 words evoking moods or feelings. Sensitivity and specificity of the checklist were determined using receiver operating characteristic (ROC) analysis.</p></div><div><h3>Results</h3><p>22.7% of participants had depressive symptoms as measured by the PHQ-9, while 25.4% suffered from moderate or severe anxiety. Most participants perceived positively the GHU-checklist, which had a sensitivity of 81.5% in distinguishing patients with depressive symptoms. Sensitivity was 86.0% for moderate anxiety and 94.7% for severe anxiety. The specificity ranged from 64.3% to 71.1%.</p></div><div><h3>Conclusions</h3><p>A short 17-words checklist is able to ultra-rapidly screen for depressive and anxiety symptoms in non-psychiatric medical settings, and was perceived positively by patients. Its systematic use could facilitate a rapid and systematic assessment of these symptoms, especially in crowded and under-staffed settings such as the emergency department.</p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"36 4","pages":"Pages 238-245"},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213616322000271/pdfft?md5=713a27f1420b39ee6a21a7a9f05e1ed9&pid=1-s2.0-S0213616322000271-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71794858","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":"A letter to the editor: “The association between congenital heart disease and the risk of autism spectrum disorders or attention-deficit/hyperactivity disorder among children: a meta-analysis”","authors":"Aashraya Ramu ,&nbsp;Sushma Srinivas ,&nbsp;Alex Honest ,&nbsp;Zeeshan Mansuri ,&nbsp;Shailesh Jain","doi":"10.1016/j.ejpsy.2022.07.002","DOIUrl":"https://doi.org/10.1016/j.ejpsy.2022.07.002","url":null,"abstract":"","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"36 4","pages":"Pages 294-295"},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71794456","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":"Differential diagnosis of schizophrenia using decision tree analysis based on cognitive testing","authors":"Wentian Dong ,&nbsp;Yong He ,&nbsp;Jiuju Wang ,&nbsp;Chuan Shi ,&nbsp;Qihui Niu ,&nbsp;Haokui Yu ,&nbsp;Jun Ji ,&nbsp;Xin Yu","doi":"10.1016/j.ejpsy.2022.05.003","DOIUrl":"https://doi.org/10.1016/j.ejpsy.2022.05.003","url":null,"abstract":"<div><h3>Background and objectives</h3><p>To explore the discriminatory ability of a decision tree model based on cognitive testing data for the differential diagnosis of schizophrenia.</p></div><div><h3>Methods</h3><p>This study enrolled 82 patients with schizophrenia and 82 patients with affective disorders. The cognitive function of the two groups of participants was assessed based on learning, symbol coding, digital span, trail making, and category fluency tests. The logistic regression model in the sklearn package in Python was applied to discriminate and analyse the data for all 11 variables in the MATRICS Consensus Cognitive Battery (MCCB).</p></div><div><h3>Results</h3><p>The recognition rate for schizophrenia and affective disorder using all 11 variables of the MCCB was 82%.</p></div><div><h3>Conclusion</h3><p>The logistics model based on cognitive data distinguished patients with schizophrenia from those with affective disorder.</p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"36 4","pages":"Pages 246-251"},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71794857","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":"Translation and Psychometric Evaluation of the Turkish Version of the Motivation to Change Lifestyle for Dementia Risk Reduction Scale (T-MOCHAD-10)","authors":"Merve Aliye Akyol ,&nbsp;Özlem Küçükgüçlü ,&nbsp;Burcu Akpinar Söylemez ,&nbsp;Bilgehan ÖZKAYASAĞLAM ,&nbsp;Déborah Oliveira","doi":"10.1016/j.ejpsy.2022.03.004","DOIUrl":"https://doi.org/10.1016/j.ejpsy.2022.03.004","url":null,"abstract":"<div><h3>Background and Objectives</h3><p>The number of people living with dementia is increasing globally, particularly in middle-income countries like Turkey. To reduce risk of dementia, the implementation of lifestyle changes targeting modifiable risk factors are important. This study aimed to translate and validate the Turkish version of the Motivation to Change Lifestyle for Dementia Risk Reduction (T-MOCHAD-10).</p></div><div><h3>Methods</h3><p><span>Cross-sectional psychometric study design was used. After translation and back translation, we assessed face and content validity. For construct validation and reliability assessment, we conducted a survey with 601 individuals aged 40 and above using a socio-demographic form and the T-MOCHAD-10. We used Exploratory Principal Axis Factoring with </span>Oblimin rotation to explore the factor structure. We then confirmed the factor structure using fit indices. Reliability was established using test-re-test, Cronbach's alpha coefficient, item-total and item-subdimensions correlations, ceiling and floor effects, and the Hotelling's T-squared test.</p></div><div><h3>Results</h3><p>The T-MOCHAD-10 showed adequate face and content validity (Kendall W=0.09, p=0.60). As in the original scale, a two-factor solution was obtained. All fit indices were ≥0.95, and RMSEA was 0.06. A Cronbach's alpha of 0.79 was obtained and no significant differences were found between test and re-test measures (p&gt;0.05). We found no evidence of ceiling or floor effects, nor response bias (Hotelling's T-squared=4683.80, p&lt;0.001).</p></div><div><h3>Conclusion</h3><p>T-MOCHAD-10 is a short measurement tool which provides valid and reliable scores concerning the motivation to change lifestyle for reducing dementia risk among Turkish individuals aged 40 and over.</p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"36 4","pages":"Pages 252-259"},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71794446","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":"Are physicians aging well? Subjective successful aging, happiness, optimism, and resilience in a sample of Brazilian aging doctors","authors":"Rodrigo C.M. Silva ,&nbsp;Carla F. Zambaldi ,&nbsp;Sílvia Poliana G.A. Costa ,&nbsp;Philip A.C. Urquiza ,&nbsp;Leonardo Machado ,&nbsp;Amaury Cantilino","doi":"10.1016/j.ejpsy.2022.04.003","DOIUrl":"https://doi.org/10.1016/j.ejpsy.2022.04.003","url":null,"abstract":"<div><h3>Background and objectives</h3><p>The elderly physician population is increasing worldwide. Data on how doctors have aged are scarce. The purpose of this study is to evaluate subjective successful aging (SSA) and its correlations with resilience, happiness, and optimism in a sample of older physicians.</p></div><div><h3>Methods</h3><p>A cross-sectional study was carried out with physicians over 65, through face-to-face interviews. All the volunteers answered the following: Self-rate successful aging; CD-RISC 10; Subjective Happiness Scale; LOT-R; SF-36; and a socio-demographic questionnaire.</p></div><div><h3>Results</h3><p>The mean of self-rate successful aging in SSA was 8.65 (92.3% over or equal to 7), and significant and positive correlations were found between resilience (<em>r</em> = 0.33) and happiness (<em>r</em> = 0.68). No correlation was found between age subset (young-old x old) or physical limitations and evaluation of SSA.</p></div><div><h3>Conclusion</h3><p>Physicians evaluated aging as successful regardless of health and limitations. SSA had a positive correlation with resilience and happiness.</p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"36 4","pages":"Pages 271-279"},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71794455","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}