{"title":"Incidence of intrauterine infections in neonatal intensive care unit: a long-term epidemiological analysis","authors":"O. Kuznetsova, A. Marchenko","doi":"10.23946/2500-0764-2022-7-3-31-39","DOIUrl":"https://doi.org/10.23946/2500-0764-2022-7-3-31-39","url":null,"abstract":"Aim. To improve epidemiological surveillance in the neonatal intensive care unit.Materials and Methods. We retrospectively examine case histories of 646 newborns delivered in Tyumen Perinatal Center and admitted to neonatal intensive care unit (310 with intrauterine infection and 336 without intrauterine infection). Predictors of intrauterine infection (odds ratio and 95% confidence interval) were determined by means of multivariate analysis and logistic regression analysis.Results. According to the multivariate analysis, past medical history of abortions, urinary tract infections, preterm birth during previous pregnancy, colpitis, vaginitis, leukocytosis, elevated C-reactive protein, anemia, and impaired fetal blood supply were among the predictors of intrauterine infection. Stepwise logistic regression identified 7 significant features associated with intrauterine infection: leukocytosis, anemia, pathological alterations in amniotic fluid, preterm birth, impaired fetal blood supply, newborn respiratory distress syndrome, and injury of the newborn central nervous system. Sensitivity and specificity of the prognostic model were 87.7% and 83.9%.Conclusion. Our prognostic model might be applicable for the prediction and verification of intrauterine infection during the prenatal and perinatal observation.","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74038917","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}
A. V. Shulepov, M. I. Shperling, Yu. V. Yurkevich, N. V. Shperling, L. V. Minaeva
{"title":"Systemic inflammatory response in rats with explosive wound","authors":"A. V. Shulepov, M. I. Shperling, Yu. V. Yurkevich, N. V. Shperling, L. V. Minaeva","doi":"10.23946/2500-0764-2022-7-3-8-16","DOIUrl":"https://doi.org/10.23946/2500-0764-2022-7-3-8-16","url":null,"abstract":"Aim. To evaluate the temporal changes in circulating cytokines rallying systemic inflammatory response after a blast injury.Material and Methods. Experiments were performed on 60 male Wistar rats (50 rats with blast-related soft tissue injury of the thigh and 10 intact rats). Blast injury was modeled under general anaesthesia using grater firecrackers stuffed with a pyrotechnic mixture. After 3, 7, 14 and 28 days post injury, we carried out a gross examination of the wound and its drainage, measured wound area, assessed local oedema severity, and evaluated serum potassium, myoglobin TNF-α, IL-1β, IL-6, and IL-10.Results. Three to seven days post injury, therewas abundant serous and purulent exudate and pronounced local edema without considerable changes in the wound area. Serum myoglobin and potassium were raised 2.2-2.6-fold and 1.3-fold, respectively (p < 0.05); in addition, we documented the elevation of a major pro-inflammatory cytokine IL-1β. Fourteen days post injury, wound area reduced by 24%, (p < 0.05) along with the decreased wound drainage and local edema of the injured area. Although the levels of serum myoglobin and pro-inflammatory cytokines (in particularIL-6) lowered, they were still significantly higher as compared with the intact rats. Twenty eight days post injury, fibrosis has been completed, epithelialization occurred and only a small scab remained on the wound surface. Yet, serum IL-1β still was 1.3-fold higher than in the intact animals (p < 0.05), albeit IL-6 and TNF-α returned to the reference values. The concentration of anti-inflammatory cytokine IL-10 reached its maximum values relative to the control (3.9-fold, p < 0.05) to the 14th day post injury that was followed by a considerable reduction (though not reaching the reference values) by the period of scar formation.Conclusion. Blast injury in rats is accompanied by a dysregulated balance between pro-inflammatory and anti-inflammatory cytokines throughout all regeneration phases.","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86606812","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}
L. A. Levanova, Y. Zakharova, A. Markovskaya, L. Otdushkina
{"title":"Bacteriophage sensitivity of opportunistic microbiota in children with gut dysbiosis","authors":"L. A. Levanova, Y. Zakharova, A. Markovskaya, L. Otdushkina","doi":"10.23946/2500-0764-2022-7-3-40-45","DOIUrl":"https://doi.org/10.23946/2500-0764-2022-7-3-40-45","url":null,"abstract":"Aim. As the activity of bacteriophages is species- and strain-specific, it is necessary to study bacteriophage sensitivity in distinct geographic regions with various disease patterns. Here, we aimed to study the lytic activity of specific commercially available bacteriophages against Klebsiella spp., Proteus spp., and Staphylococcus aureus isolated from the intestines of children with gut dysbiosis.Materials and Methods. Bacteriophage sensitivity was assessed in 315 opportunistic microorganisms (125 Staphylococcus aureus strains, 120 Klebsiella spp. strains, 70 Proteus spp. strains) isolated from the intestinal microbiota of 300 children < 4 years of age with gut dysbiosis. Bacteriophage preparations were produced by Microgen (Russian Federation). The lytic activity of bacteriophages was studied by a drip method on a Muller-Hinton medium by calculating the area of bacterial culture lysis.Results. We found low sensitivity of Klebsiella spp. (37.5% sensitive strains) and Proteus spp. (41.4% sensitive strains) to specific bacteriophages, albeit there were considerable differences between distinct Klebsiella species (Klebsiella pneumoniae, 56.7% sensitive strains; Klebsiella oxytoca, 18.3% sensitive strains, p = 0.03) and Proteus species (Proteus vulgaris, 52.0% strains; Proteus mirabilis, 35.6% strains, p = 0.04). Nevertheless, sensitivity to Staphylococcus aureus was considerably higher (78.4%). In addition, lytic activity of bacteriophages reduced along with the increasing severity of gut dysbiosis.Conclusion. Klebsiella spp. and Proteus spp. isolated from children with dysbiosis have low sensitivity to commercially available bacteriophages. Bacteriophage sensitivity positively correlated with gut dysbiosis.","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88291972","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":"Hormonal and immunological features of women with cervical insuffciency","authors":"D. Beglov, N. Artymuk, O. Novikova","doi":"10.23946/2500-0764-2022-7-2-38-44","DOIUrl":"https://doi.org/10.23946/2500-0764-2022-7-2-38-44","url":null,"abstract":"Aim. To determine the level of estradiol, progesterone, IgA and IgG to these hormones, and IgA/IgG to benzo[a]pyrene in women with cervical weakness.Materials and Methods. We retrospectively analysed case histories of 200 women, including 100 patients with cervical weakness defned by an ultrasound examination at 18-21 weeks of gestation and 100 patients without cervical weakness. Serum estradiol, progesterone, IgA and IgG to these hormones, and IgA/IgG to benzo[a]pyrene were measured at 18-21 weeks of gestation using enzyme-linked immunosorbent assay.Results. Patients with cervical weakness had a higher level of serum estradiol [12477 (1000; 31600) pg/mL], IgA to progesterone [2.15 (0.6; 8.3) a.u.] and benzo[a]pyrene [4.74 (0.4; 13.9) a.u.], IgG to estradiol [8.64 (1.2; 23.5) a.u.], progesterone [5.29 (0.2; 20.1) a.u.], and benzo[a] pyrene [11.89 (1.1; 28.5) a.u.] as compared with those without [10946 (2999; 19480) pg/mL, p = 0.034]; [1.42 (0.6; 2.6) a.u., p = 0.034]; [3.22 (0.7; 5.7) a.u., p = 0.032]; [4.78 (0.7; 8.7) a.u., p < 0.0001]; [2.55 (0.2; 5.1) a.u., p < 0.0001]; [4.72 (0.4; 10.1) a.u., p < 0.0001]. An association between the preterm birth and levels of IgA to progesterone (p = 0.00017) and benzo[a]pyrene (p = 0.0003) was established.Conclusion. Patients with cervical weakness were characterized by higher levels of IgA and IgG to estradiol, progesterone, and benzo[a]pyrene; notably, increased IgA to progesterone and benzo[a] pyrene correlated with a higher risk of preterm birth.","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90870522","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":"Patients with metabolic syndrome and premature atrial contractions: predicting the atrial fbrillation onset","authors":"A. I. Olesin, I. Konstantinova, V. Ivanov","doi":"10.23946/2500-0764-2022-7-2-75-83","DOIUrl":"https://doi.org/10.23946/2500-0764-2022-7-2-75-83","url":null,"abstract":"","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78655146","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}
A. B. Priymak, O. V. Korpacheva, A. N. Zolotov, E. I. Kluchnikova
{"title":"Dalargin, a peripheral opiate receptor agonist, in the pathogenesis of myocardial contusion in rats with different stress tolerance","authors":"A. B. Priymak, O. V. Korpacheva, A. N. Zolotov, E. I. Kluchnikova","doi":"10.23946/2500-0764-2022-7-2-8-19","DOIUrl":"https://doi.org/10.23946/2500-0764-2022-7-2-8-19","url":null,"abstract":"Aim. To evaluate the effect of dalargin, a peripheral opiate receptor agonist, on the adaptive strategy of rats with different stress tolerance after the myocardial contusion.Materials and Methods. The experiment was performed on 216 male rats weighing 250-300 g which were ranked according to stress resistance using the forced-swim (Porsolt) test and the open feld test. Rats were divided into 3 groups: control animals and those with a blunt cardiac injury, with or without dalargin administration (100 µg/kg intramuscularly 2 hours before anesthesia, immediately before injury, and 2 hours post injury). Each group included 3 subgroups (n = 8 rats per each) with high, medium, and low stress tolerance. Myocardial contusion was simulated using an original device. Blood levels of glucose, lactic acid, triglycerides, corticosterone, total protein, albumin, white blood cell count, reduced glutathione and total antioxidant capacity were measured in all rats 24 hours post injury.Results. Myocardial contusion altered the metabolic profle to the stress-related pattern. The most signifcant increase in rectal temperature, white blood cell count, corticosterone, glucose, lactic acid, and triglyceride levels as well as maximum decrease in reduced glutathione and total myocardial antioxidant capacity were documented in animals with low stress tolerance. Administration of dalargin alleviated the stress response regardless of animal stress resistance.Conclusion. Blunt cardiac injury and myocardial contusion induce stress response characterised by hypercatabolism, systemic infammatory response syndrome, and myocardial oxidative stress in all rats, with a most signifcant response in animals with low stress tolerance. A peripheral opiate receptor agonist dalargin did not change the response pattern but curbed the stress response.","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78547324","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":"Trends of vaccination against COVID-19 among pregnant women in Siberia","authors":"N. Artymuk, Y. Parfenova, O. A. Tachkova","doi":"10.23946/2500-0764-2022-7-1-86-91","DOIUrl":"https://doi.org/10.23946/2500-0764-2022-7-1-86-91","url":null,"abstract":"Aim. To evaluate the trends of vaccination against COVID-19 among pregnant women in Siberia for the period from October 29, 2021 to November 26, 2021.Materials and Methods. The vaccination data have been collected from official records from October 29, 2021 (86,859 pregnant women) and November 26, 2021 (85,600 pregnant women) in 10 regions of Siberia.Results. Before the pregnancy onset, as of October 29, 2021, only 4,056 (4.7%) women had past medical history of COVID-19. These numbers have significantly increased to November 26, 2021 (5,656, 6.6%, p < 0.001). The number of vaccinated pregnant women increased from 4,185 (4.8%) to 8,318 (9.7%) (p < 0.001). As of November 26, 2021, we registered a reduced proportion of women vaccinated at the preconception stage (from 4.6% to 4.0%, p < 0.001), yet the number of vaccinated pregnant women raised both before (from 0.7% to 1.3 %, p < 0.001) and after 22 weeks of pregnancy (from 1.6% to 2.3%, p < 0.001). The highest proportion of pregnant women was documented in the Tyva Republic and the Irkutsk Region (p < 0.01). Major vaccination-associated adverse events have not been reported.Conclusions. The proportion of pregnant women recovered or vaccinated from COVID-19 increased from October 29, 2021 (16.4%) to November 26, 2021 (23.9%); however, this rate is clearly insufficient to reach herd immunity and reduce maternal mortality from COVID-19.","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"132 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77610718","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}
E. Polenok, S. Mun, L. Gordeeva, M. Kostyanko, A. Antonov, N. Verzhbitskaya, G. Kolpinskiy, A. Glushkov
{"title":"Associations of antibodies to benzo[a]pyrene, estradiol and progesterone with estrogen receptor phenotype in breast cancer tissue","authors":"E. Polenok, S. Mun, L. Gordeeva, M. Kostyanko, A. Antonov, N. Verzhbitskaya, G. Kolpinskiy, A. Glushkov","doi":"10.23946/2500-0764-2022-7-1-53-63","DOIUrl":"https://doi.org/10.23946/2500-0764-2022-7-1-53-63","url":null,"abstract":"Aim. To reveal the associations of IgA antibodies to benzo[a]pyrene, estradiol and progesterone (IgA-Bp, IgA-Es, IgA-Pg) with the conversion of estrogen-receptor positive (ER+) into estrogen-receptor negative (ER-) tumors during breast cancer progression.Materials and Methods. Having collected serum samples from 338 healthy volunteers and 1407 breast cancer patients, we have profiled them for IgA-Bp, IgA-Es, IgA-Pg by means of enzyme-linked immunosorbent assay. Conjugates of bovine serum albumin with Bp, Es and Pg were used as adsorbed antigens and anti-human IgA horseradish peroxidase-conjugated antibodies were used for the detection of specific antigen-bound antibodies. Individual IgA-Bp/IgA-Pg and IgA-Es/IgA-Pg ratios were calculated. Estrogen receptor phenotype was determined using immunohistochemistry.Results. Low IgA-Bp/IgA-Pg ratios (≤ 1) in combination with low IgA-Es/IgA-Pg ratios (≤ 1) indicative of protective immunophenotype were more frequently revealed in healthy women (43.8%) in comparison with stage 1 breast cancer patients with ER+ (12.9%) and ER- (23.9%) tumors. High IgA-Bp/IgA-Pg ratios (>1) with high IgA-Es/IgA-Pg ratios (>1) suggestive of pro-carcinogenic immunological phenotype were less often detected in healthy women (27.5%) as compared with stage 1 breast cancer patients with ER+ (65.5%) and ER- (58.7%) tumors. Prevalence of protective and pro-carcinogenic phenotypes significantly differed in stage 1breast cancer patients with ER+ and ER- tumor phenotypes (p = 0.017). ER- tumor phenotype was more prevalent at II-IV tumor stages (25.6%) than at the stage 1 (16.3%). Conversion of ER+ to ER- tumors reflecting the breast cancer progression was characteristic for the patients with pro-carcinogenic immunological phenotype (p<0.0001).Conclusion. Detection of antibodies against Bp, Es and Pg may be applied as a risk marker of breast cancer development and progression.","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88710144","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}
А. V. Malyarchikov, K. Shapovalov, E. I. Morozova, S. Lukyanov, L. Kazantseva
{"title":"Inflammatory markers and organ dysfunction in patients with severe influenza A (H1N1) virus-associated pneumonia","authors":"А. V. Malyarchikov, K. Shapovalov, E. I. Morozova, S. Lukyanov, L. Kazantseva","doi":"10.23946/2500-0764-2022-7-1-70-77","DOIUrl":"https://doi.org/10.23946/2500-0764-2022-7-1-70-77","url":null,"abstract":"Aim. To assess inflammatory markers and organ dysfunction in patients with severe influenza A (H1N1) virus-associated pneumonia.Materials and Methods. The study included 50 patients (median age 47 (38-62) years, 24 males and 26 females) with severe influenza A (H1N1) virus-associated pneumonia. We analysed the clinicopathological data as well as complete blood count and biochemical profile. Organ dysfunction was assessed using SOFA and qSOFA scales.Results. The prevalence of multiple organ dysfunction syndrome in patients with severe influenza A (H1N1) virus-associated pneumonia was 46% (23/50 patients). Patients frequently suffered from insufficient oxygenation, impaired coagulation, altered haemodynamics, and central nervous system dysfunction. Out of 23 patients with multiple organ dysfunction syndrome, 10 (43.5%) suffered from reduced oxygenation and excessive coagulation, while 6 (26.0%) had all mentioned syndromes combined. Thrombocytopenia was detected as early as at day 1-2 of the disease and was further accompanied by an increase in the erythrocyte sedimentation rate and white blood cell count from day 2 to day 8. An increase in acute-phase proteins (C-reactive protein and fibrinogen) was noted at the day 5-6 of the disease.Conclusion. In patients with severe influenza A (H1N1) virus-associated pneumonia, an early systemic inflammatory response evolves into an uncontrolled multiple organ dysfunction syndrome by day 7-8 of infection.","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80850429","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}
I. Lebedeva, M. Shmakova, O. M. Drozdova, E. Brusina
{"title":"Mortality from COVID-19 in patients with tuberculosis: systematic review and meta-analysis","authors":"I. Lebedeva, M. Shmakova, O. M. Drozdova, E. Brusina","doi":"10.23946/2500-0764-2022-7-1-78-85","DOIUrl":"https://doi.org/10.23946/2500-0764-2022-7-1-78-85","url":null,"abstract":"Aim. To perform a systematic analysis of COVID-19 adverse outcomes in patients with tuberculosis.Materials and Methods. We queried PubMed, Cochrane Library, Embase, ClinicalTrials.gov, medRxiv, bioRxiv, and Elibrary databases for studies on COVID-19-related mortality in patients with tuberculosis published from 2020 to 2022. We considered open randomised controlled trials, cohort, and case-control studies. Pseudorandomisation and interventional studies have been excluded from the analysis as well as those without a clear comparison group (i.e., patients without tuberculosis) and duplicate studies.Results. Out of 23,296 hits, 10 studies were included in our review. The risk of death in patients with COVID-19 and tuberculosis was significantly higher (odds ratio = 2.24, 95% confidence interval = 1.46 – 3.43] as compared with the patients without tuberculosis.Conclusion. Tuberculosis is associated with COVID-19-related mortality.","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81251984","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}