Hossam Alslaim, Sreeja Sanampudi, Driss Raissi, Weibo Fu, Amanda Y Behr, Mohamed Issa, Mary B Sheppard, Neal L Weintraub, Michael Winkler
{"title":"A Comprehensive Research Schema for the Characterization of Aortic Aneurysms.","authors":"Hossam Alslaim, Sreeja Sanampudi, Driss Raissi, Weibo Fu, Amanda Y Behr, Mohamed Issa, Mary B Sheppard, Neal L Weintraub, Michael Winkler","doi":"10.1055/s-0042-1744275","DOIUrl":"10.1055/s-0042-1744275","url":null,"abstract":"<p><p>A robust, accurate, and standardized approach to measurement of the aorta is critical to improve the predictive accuracy of these aortic measurements, and to investigate other aortic imaging biomarkers. Developing a comprehensive and generic schema for characterization of the aorta to enable investigators to standardize data that are collected across all aorta research. A systematic review of the literature was conducted to identify and assess schemata of aortic measurement and description. The schemata were reported and discussed to guide the synthesis of a comprehensive schema. We propose the International College of Angiology Aortic Research Schema as a comprehensive design that fills the gaps left behind by previously reported schemata. It is intended to be applicable for all clinically relevant purposes, including endograft development for aneurysm repair and for the accurate characterization of the aortic anatomy. This schema divides the aorta into 14 segments and 2 sections (thoracic and abdominal aortas). The segmentation proposed can be used in addition to specific measurements taken for any aneurysm including the neck, and maximal and minimal diameters of the aneurysm.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"32 1","pages":"34-42"},"PeriodicalIF":0.6,"publicationDate":"2022-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9886451/pdf/10-1055-s-0042-1744275.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9703159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gagan Kaur, Patrick Baghdasaryan, Balaji Natarajan, Prabhdeep Sethi, Ashis Mukherjee, Padmini Varadarajan, Ramdas G Pai
{"title":"Pathophysiology, Diagnosis, and Management of Coronary No-Reflow Phenomenon.","authors":"Gagan Kaur, Patrick Baghdasaryan, Balaji Natarajan, Prabhdeep Sethi, Ashis Mukherjee, Padmini Varadarajan, Ramdas G Pai","doi":"10.1055/s-0041-1735949","DOIUrl":"https://doi.org/10.1055/s-0041-1735949","url":null,"abstract":"<p><p>Coronary no-reflow phenomenon is a lethal mechanism of ongoing myocardial injury following successful revascularization of an infarct-related coronary artery. Incidence of this phenomenon is high following percutaneous intervention and is associated with adverse in-hospital and long-term outcomes. Several mechanisms such as ischemia-reperfusion injury and distal microthromboembolism in genetically susceptible patients and those with preexisting endothelial dysfunction have been implicated. However, the exact mechanism in humans is still poorly understood. Several investigative and treatment strategies within and outside the cardiac catheterization laboratory have been proposed, but they have not uniformly shown success in reducing mortality or in preventing adverse left ventricular remodeling resulting from this condition. The aim of this article is to provide a brief and concise review of the current understanding of the pathophysiology, clinical predictors, and investigations and management of coronary no-reflow phenomenon.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 2","pages":"107-112"},"PeriodicalIF":0.6,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9296268/pdf/10-1055-s-0041-1735949.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10531524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Assessment of the CHIVA and the ASVAL Method.","authors":"Cestmir Recek","doi":"10.1055/s-0041-1741469","DOIUrl":"https://doi.org/10.1055/s-0041-1741469","url":null,"abstract":"<p><p>In this article, the CHIVA and ASVAL methods are assessed from the hemodynamic point of view. The CHIVA method comprises complicated, unusual terminology and new perceptions, such as closed and open shunts, fractionation of the hydrostatic pressure, subdivision of the venous network. The principal part of the CHIVA theory is the drainage of venous blood from the thigh saphenous system into the deep lower leg veins through the preserved saphenous trunk after high ligation at the saphenofemoral junction, which is considered as a beneficial, physiological phenomenon. In reality, this is recurrent reflux producing ambulatory venous hypertension. The main impact of the CHIVA procedure is the elimination of the saphenous reflux by high ligation at the saphenofemoral junction; thus it can be presumed that the CHIVA procedure yields similar results like the crossectomy. The ASVAL procedure is de facto the modification of the old Madelung method that was the prevalent surgical procedure before the Trendelenburg era in the 19th century. The results after ASVAL were not checked by plethysmography; there is a good case to suppose that the results after the ASVAL method would comply with those after sclerotherapy.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 2","pages":"83-87"},"PeriodicalIF":0.6,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9272252/pdf/10-1055-s-0041-1741469.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10681549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ashima Mahajan, Syed T Fazal, Sanjay Mehta, Narender S Kataria, Vipul Nanda
{"title":"Cephalic Vein Aneurysm in the Distal Forearm Managed with Sclerotherapy-A Rare Case Report and Literature Review.","authors":"Ashima Mahajan, Syed T Fazal, Sanjay Mehta, Narender S Kataria, Vipul Nanda","doi":"10.1055/s-0042-1743252","DOIUrl":"https://doi.org/10.1055/s-0042-1743252","url":null,"abstract":"<p><p>Venous aneurysm of upper extremities is rare entity. We report a rare case of large cephalic vein (CV) aneurysm in a 41-year-old man who presented as slowly growing painless swelling at distal forearm along the lateral aspect. Duplex ultrasound showed aneurysm originating from the anterior wall of the CV with venous waveform pattern on Doppler. It was managed successfully with percutaneous sclerotherapy.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 2","pages":"92-96"},"PeriodicalIF":0.6,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9296263/pdf/10-1055-s-0042-1743252.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10258604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alberto Garavello, Stefania Gilardi, Paola Fiamma, Valentina Toti, Massimo Tozzi, Pietro Fransvea
{"title":"Deep Venous Thrombosis and Ulcers of Lower Limbs: Ultrasound Findings in 156 Patients.","authors":"Alberto Garavello, Stefania Gilardi, Paola Fiamma, Valentina Toti, Massimo Tozzi, Pietro Fransvea","doi":"10.1055/s-0042-1743408","DOIUrl":"https://doi.org/10.1055/s-0042-1743408","url":null,"abstract":"<p><p>Venous ulcers (VUs) of lower limbs affect 1% of Western population. In most cases, ultrasounds show only superficial venous insufficiency (SVI), but a deep venous insufficiency (DVI) may also be present without a history of deep vein thrombosis (DVT). To assess SVI and DVI in DVT-positive and DVT-negative patients with VU, a retrospective cohort of 123 patients entered the study (50 male and 73 female, minimum age 29 years and maximum age 90 years, and mean 70.6 years). In 56 patients (45.5%), ulcer was on the right leg, in 52 (42.3%) on the left leg, and in 15 patients (12.2%), ulcer was bilateral, resulting in a total number of 138 limbs in the study. Sixty-six patients suffered DVT, while in 72 anamnesis was negative. Color duplex ultrasound was performed on both limbs, which revealed insufficiencies of superficial and/or deep veins in 18 limbs which had not been affected by an ulcer or a previous DVT. So the study was on 156 limbs. SVI were substantially overlapping in two groups ( <i>p</i> -value = 0.593), while combined SVI and DVI was 72.5% in DVT positive limbs ( <i>p</i> -value = 0.001). In 70% of cases with a femoral vein insufficiency ( <i>p</i> -value = 0.036) or popliteal vein insufficiency (PVI) ( <i>p</i> -value 0,003), a DVT history was present. Of 18 limbs, although not affected by ulcer or previous DVT, eight were positive for DVI (two femoral veins and six popliteal veins). In the patient with VU, the history of DVT is a strong predictor of DVI insufficiency. In DVT-positive patients with ulcer, the number of \"combined superficial and deep insufficiencies\" appears to be particularly significant and surgical treatment must take this into account. A previous DVT has a low impact on great and small saphenous insufficiencies in ulcer patients; these were substantially overlapping in DVT-positive and DVT-negative patients. The 18 limbs with DVI and SVI without ulcer and DVT history were unexpected result. We think these patients must have a close follow-up to avoid the onset of a VU.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 2","pages":"113-119"},"PeriodicalIF":0.6,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9272312/pdf/10-1055-s-0042-1743408.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9452222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mikołaj Kamiński, Michał Kulecki, Paweł Lachowski, Dominika Kasprzak, Ania Kulczycka, Maria Kozłowska, Daria Klause, Aleksandra Uruska, Mateusz Michalski, Dorota Zozulińska-Ziółkiewicz
{"title":"Erectile Dysfunction in Individuals with Type 1 Diabetes is Associated with Long-term Metabolic Control and Diabetic Complications: A Cross-Sectional Study.","authors":"Mikołaj Kamiński, Michał Kulecki, Paweł Lachowski, Dominika Kasprzak, Ania Kulczycka, Maria Kozłowska, Daria Klause, Aleksandra Uruska, Mateusz Michalski, Dorota Zozulińska-Ziółkiewicz","doi":"10.1055/s-0041-1735209","DOIUrl":"https://doi.org/10.1055/s-0041-1735209","url":null,"abstract":"<p><p><b>Background</b> Erectile dysfunction (ED) affects approximately 38% of individuals with type 1 diabetes (T1DM). Skin autofluorescence (AF) reflects skin advanced glycation end product (AGE) deposits and is a marker of long-term glycemia control. <b>Objective</b> The study investigates the relationship between ED and diabetes control in patients with T1DM. <b>Methods</b> Adult patients with T1DM visiting the Diabetology Department were cross-sectionally investigated. Medical history, anthropometric features, and laboratory findings were collected. All individuals filled the International Index of Erectile Function (IIEF-5). IIEF-5 total score < 22 represented the presence of ED. AF was measured on the volar aspect of the forearm using AGE Reader. Insulin resistance (IR) was assessed by the estimated glucose disposal rate. Descriptive statistics and multivariate logistic regression analyses were performed. The adjusted covariates were general risk factors of ED. <b>Results</b> Of a total of <i>n</i> = 70 patients, <i>n</i> = 30 (42.9%) suffered from ED. The presence of ED was associated with higher glycated hemoglobin level (OR, 95% CI; 1.62, 1.02-2.60; <i>p</i> = 0.043), presence of at least one diabetic complication (3.49, 1.10-11.03; <i>p</i> = 0.03), and skin AF (9.20, 1.60-52.94; <i>p</i> = 0.01), but not with IR (0.78, 0.57-2.60; <i>p</i> = 0.12). Skin AF values ≥ 2.2 indicates presence of ED with a sensitivity of 70.0% and a specificity of 77.5%. Area under the curve was equal to 0.72 (95% CI: 0.60-0.85). <b>Conclusions</b> The presence of ED in individuals with T1DM is associated with HbA1c, the presence of at least one diabetic complication, and skin AF.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 2","pages":"97-106"},"PeriodicalIF":0.6,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9272316/pdf/10-1055-s-0041-1735209.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9074318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thomas Kotsis, Panagitsa Christoforou, Dorothea Tsekoura, Konstantinos Nastos
{"title":"Eversion Carotid Endarterectomy: Cardiac Troponin Assessment.","authors":"Thomas Kotsis, Panagitsa Christoforou, Dorothea Tsekoura, Konstantinos Nastos","doi":"10.1055/s-0042-1743254","DOIUrl":"10.1055/s-0042-1743254","url":null,"abstract":"<p><p>Myocardial infarction (MI) is an eversion carotid endarterectomy (eCEA) complication, but most events are unknown, and true incidence and correlation remain controversial. Routine cardiac troponin measurement is a commonly used method for assessing early identification and treatment of MI and stratifying high-risk patients. The aim of the present study is to evaluate the effect of troponin elevation levels following eCEA and to investigate a possible correlation between adverse cardiovascular events and the incidence of postoperative myocardial infarction following emergent vascular surgery. The study included 54 patients who underwent eCEA. High-sensitive troponin I (hsTnI) levels were routinely monitored pre- and postoperatively, with an upper reference range of 34.5 pg/mL for men and 15.6 pg/mL for women. Increases were correlated with demographic and clinical risk factors, as well as clinical or subclinical cardiovascular events. hsTnI was increased in percentage (13%) postoperatively, and non-ST segment elevation MI was diagnosed in eight patients. No patient had clinical symptoms of MI and only two of them presented with simultaneous electrocardiographic changes. Increased levels did not correlate with comorbidities or other surgical risk factors. hsTnI elevation may occur in patients after eCEA and mostly correlates with silent non-ST segment elevation MI that occurred in the early postoperative phase, indicating a possible value as a tool for cardiovascular event diagnosis during the patient's hospitalization.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"32 2","pages":"100-105"},"PeriodicalIF":0.5,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10191692/pdf/10-1055-s-0042-1743254.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9499842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Surya Dharma, William Kamarullah, Adelia Putri Sabrina
{"title":"Association of Admission Time and Mortality in STEMI Patients: A Systematic Review and Meta-analysis.","authors":"Surya Dharma, William Kamarullah, Adelia Putri Sabrina","doi":"10.1055/s-0042-1742610","DOIUrl":"10.1055/s-0042-1742610","url":null,"abstract":"<p><p>This systematic review and meta-analysis aimed to evaluate patients with acute ST-segment elevation myocardial infarction (STEMI) who were admitted during off-hours and treated with primary angioplasty associated with an increased risk of mortality compared with those admitted during regular working hours. We performed a systematic literature search using PubMed, SCOPUS, Europe PMC, and Cochrane CENTRAL databases that was finalized on March 15, 2021. The primary outcome was mortality comprising early (in-hospital), midterm (30 days to 1 year), and long-term mortality (>1 year). A total of 384,452 patients from 56 studies were included. The overall mortality of acute STEMI patients admitted during off-hours and regular hours were 6.1 and 6.7%, respectively. Patients admitted during off-hours had similar risk of early, midterm, and long-term mortality compared to those admitted during regular working hours ([relative risk or RR = 1.07, 95% confidence interval or CI, 1.00-1.14, <i>p</i> = 0.06; <i>I</i> <sup>2</sup> = 45%, <i>p</i> = 0.0009], [RR = 1.00, 95% CI, 0.95-1.05, <i>p</i> = 0.92; <i>I</i> <sup>2</sup> = 13%, <i>p</i> = 0.26], and [RR = 0.95, 95% CI, 0.86-1.04, <i>p</i> = 0.26; <i>I</i> <sup>2</sup> = 0%, <i>p</i> = 0.76], respectively). Subgroup analyses indicated that the results were consistent across all subgroups ([women vs. men], [age >65 years vs. ≤65 years], and [Killip classification II to IV vs. Killip I]). Funnel plot was asymmetrical. However, Egger's test suggests no significance of small-study effects ( <i>p</i> = 0.19). This meta-analysis showed that patients with acute STEMI who were admitted during off-hours and treated with primary angioplasty had similar risk of early, midterm, and long-term mortality compared with those admitted during regular working hours.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 4","pages":"273-283"},"PeriodicalIF":0.5,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9803553/pdf/10-1055-s-0042-1742610.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10814319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmad R Naga, Ali A Elemam, Nagib A Elaskary, Ashraf E Elsharkawy, Hassan Lotfy
{"title":"Conservative Approach is Safe for Perfused-Pulseless Hands Following Blunt Brachial Artery Injury in Children.","authors":"Ahmad R Naga, Ali A Elemam, Nagib A Elaskary, Ashraf E Elsharkawy, Hassan Lotfy","doi":"10.1055/s-0041-1742139","DOIUrl":"https://doi.org/10.1055/s-0041-1742139","url":null,"abstract":"<p><p>Blunt trauma of the brachial artery (BA) in pediatric age is often associated with neurological and orthopaedic injuries. Acute ischemic hands warrant immediate exploration, but the management of warm-pulseless hands following elbow trauma is controversial. This study evaluates the role of conservative treatment of blunt BA injuries in children with non-threatened hands. Eleven children with blunt trauma onto the BA having warm-pulseless hands were studied retrospectively. After a mean follow-up period of 2.5 ± 0.9 years, all cases had thorough clinical examination and duplex scan to assess the treatment outcomes. At the end of follow-up period, all subjects had well-perfused hands with intact wrist pulses. The duplex scan revealed those who had interposition grafts to be patent and one case had an aneurysmal dilatation. There was no statistical significance difference between affected and healthy forearms regarding the mean peak systolic velocity at the wrist, affected side was 62 ± 0.82 cm/s versus 68 ± 0.57 cm/s for opposite side ( <i>p</i> -value = 0.14). Patients with blunt BA trauma and warm-pulseless hands could be managed safely with conservative treatment, leaving surgical exploration for those who did not regain pulses after 48 hours. Duplex ultrasound can safely verify the patency of surgical repair and can be used for surveillance to detect future complications.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 1","pages":"48-51"},"PeriodicalIF":0.6,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881107/pdf/10-1055-s-0041-1742139.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10655204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lindsay Short, Van T La, Mandira Patel, Ramdas G Pai
{"title":"Primary and Secondary Prevention of CAD: A Review.","authors":"Lindsay Short, Van T La, Mandira Patel, Ramdas G Pai","doi":"10.1055/s-0041-1729925","DOIUrl":"https://doi.org/10.1055/s-0041-1729925","url":null,"abstract":"<p><p>Coronary artery disease is the leading cause of death in both men and women, yet adequate control of risk factors can largely reduce the incidence and recurrence of cardiac events. In this review, we discuss various life style and pharmacological measures for both the primary and secondary prevention of coronary artery disease. With a clear understanding of management options, health care providers have an excellent opportunity to educate patients and ameliorate a significant burden of morbidity and mortality.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"31 1","pages":"16-26"},"PeriodicalIF":0.6,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881111/pdf/10-1055-s-0041-1729925.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10428339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}