Irish Journal of Medical Science最新文献

{"title":"A scoping review of historical and contemporary management strategies for paediatric scrotal trauma.","authors":"Kenneth Patterson, Derek B Hennessey, Fardod O'Kelly","doi":"10.1007/s11845-025-03929-0","DOIUrl":"https://doi.org/10.1007/s11845-025-03929-0","url":null,"abstract":"<p><strong>Objective: </strong>To perform a scoping review of the literature pertaining to paediatric scrotal trauma and to contrast operative with conservative management in this cohort of patients using available data.</p><p><strong>Methods: </strong>A search of Cochrane, SCOPUS, and EMBASE databases was performed using methods pre-published on PROSPERO. Reporting followed Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Eligible studies were articles or abstracts published in English describing the management of paediatric scrotal trauma, which reported at least one secondary outcome. The intended primary analysis is to report the management of paediatric scrotal trauma and the outcome based on management.</p><p><strong>Results: </strong>Thirty-six studies were identified, totaling 253 patients. Then, 91.7% of cases presented with unilateral testicular injury and 94.5% of cases resulted from blunt trauma. Then, 86% of patients presenting with scrotal trauma underwent ultrasound imaging of the scrotum. One hundred twenty-three cases underwent conservative management, 116 cases underwent acute surgical management, and 14 underwent delayed surgical management, with a mean time to an intervention of 3 days. Thirty patients were found to have testicular atrophy, with a mean follow-up of 14 months, of these 30 patients, 63% (n = 19) were conservatively managed, 20% (n = 6) were managed with acute surgical repair, and 17% (n = 5) were managed with delayed surgical repair.</p><p><strong>Conclusion: </strong>Paediatric testicular trauma is a rare presentation. A high level of suspicion is mandatory when testicular rupture is suspected. Early exploration is warranted in the setting of high risk and provides an excellent chance of testicular salvage.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633949","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":"Microbiologic features of prosthetic joint infections at a tertiary referral orthopaedic unit.","authors":"Stephen Christopher Murphy, Shane P Russell, James A Harty, Padhraig O'Loughlin","doi":"10.1007/s11845-025-03933-4","DOIUrl":"https://doi.org/10.1007/s11845-025-03933-4","url":null,"abstract":"<p><strong>Background: </strong>Prosthetic joint infections (PJI) are a potential devasting consequence of arthroplasty surgery. Knowledge of the causative organism and antimicrobial sensitivity increases eradication success rates for PJI.</p><p><strong>Aims: </strong>This study aimed to: 1) Observe the PJI microbiome at a tertiary referral arthroplasty unit; 2) Make comparison to similar published observations; and; 3) Establish empiric local antibiotic PJI guidelines.</p><p><strong>Methods: </strong>All patients with positive tissue cultures for PJIs over a 4 year period were included. An electronic microbiology laboratory database search was performed to identify isolated microorganisms, sensitivities and resistances. Time from index procedure to PJI onset was recorded. The identified PJI microbiome was compared to current literature.</p><p><strong>Results: </strong>86 patients involving 88 joints were included. 56% (n = 49) related to hip, 42% (n = 37) to knee and 2% (2) to shoulder arthroplasty procedures. Coagulase Negative Staphylococci (CoNS) were isolated in 32% of cases, Staphylococcus aureus (SA) in 23%, Enterococcus species and Streptococcus species in 9.0%. 19% of case occurred within 3 months of index surgery, 17% from 3-12 months and 64% after 12 months. The microbiome identified varied comparable studies.</p><p><strong>Conclusion: </strong>This study describes a local PJI microbiome with contrasting results from comparable studies. Empiric antibiotic guidelines have been established to target treatment and a local PJI register has since been established to improve patient outcomes and antimicrobial stewardship in an era of antibiotic resistance.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624809","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":"Impact of changes in gestational diabetes mellitus diagnostic criteria during the COVID-19 pandemic.","authors":"Jessica Neville, Kelly Foley, Seán Lacey, Antoinette Tuthill, Oratile Kgosidialwa, Mairead O'Riordan, Fiona O'Halloran, Seán J Costelloe","doi":"10.1007/s11845-025-03926-3","DOIUrl":"https://doi.org/10.1007/s11845-025-03926-3","url":null,"abstract":"<p><strong>Background/aims: </strong>During the COVID-19 pandemic, the Health Service Executive (HSE) and Royal College of Obstetricians and Gynaecologists (RCOG) recommended fasting and random plasma glucose (FPG/RPG) alongside glycated haemoglobin (HbA_1c) to replace the oral glucose tolerance test (OGTT) for diagnosing Gestational Diabetes Mellitus (GDM).</p><p><strong>Methods: </strong>The study compared testing patterns and diagnostic rates for GDM before and after implementing the RCOG guidelines (01/05/2020) in pregnancies beginning 01/11/2018 to 31/03/2021. Trends were inspected using Cochrane-Armitage tests. Differences between General Practice (GP) and Secondary Care (SCare) were assessed by chi-square analysis. A significance level of p < 0.05 was used for all analyses. Information on maternal and pregnancy characteristics was accessed where available.</p><p><strong>Results: </strong>Data indicated a significant reduction in OGTTs requested by GPs and SCare. Conversely, HbA_1c, FPG and RPG test requests increased significantly in both locations. The overall GDM positivity rate increased significantly from 7.4% to 22.0% in GP and 16.9% to 39.0% in SCare following RCOG guideline implementation.</p><p><strong>Conclusions: </strong>The RCOG guidelines appear to have been well adopted by GPs and SCare, with greater adherence in SCare. Using FPG, RPG and HbA_1c to a greater extent than the OGTT corresponded with increased GDM diagnostic rates. Given the difficulties with interpreting HbA_1c in pregnancy, its routine use in diagnosing GDM requires further careful consideration. Relaying changes in diagnostic protocol during pandemics requires strong communication with all requesting clinicians, including GPs. Comparisons between GP and SCare indicated significant differences in test-requesting practices and GDM positivity rates.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615595","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":"Let-7a microRNA modulates caspase-3-dependent apoptosis in melanoma cells treated with dabrafenib and trametinib combination.","authors":"Murat Keser, Harika Atmaca","doi":"10.1007/s11845-025-03923-6","DOIUrl":"https://doi.org/10.1007/s11845-025-03923-6","url":null,"abstract":"<p><strong>Background: </strong>Malignant melanoma is an aggressive tumor with high resistance to therapy. The emergence of RAS-driven secondary cancers and BRAF-inhibitor resistance has led to the development of combination therapies targeting both BRAF and MEK.</p><p><strong>Aims: </strong>This study explored the mechanisms underlying the synergistic effects of dabrafenib (DAB) and trametinib (TM) in drug-resistant A375 and RPMI 7951 melanoma cells.</p><p><strong>Methods: </strong>Cytotoxicity was assessed via MTT assay and combination effects were evaluated via combination index analysis. Apoptosis was analyzed by DNA fragmentation ELISA, while ectopic let-7a miRNA expression and inhibition were performed using lipofection. Gene expression levels were quantified by qRT-PCR, and protein expression was assessed via Western blot.</p><p><strong>Results: </strong>The combination of 0.7 μM DAB and 5.0 μM TM exhibited synergistic cytotoxicity by inhibiting the pERK1/2 signaling pathway and inducing MITF expression. This resulted in mitochondria-mediated apoptosis, characterized by a decrease in anti-apoptotic Bcl-2 and an increase in pro-apoptotic Bax, caspase-9, and caspase-3 levels. Additionally, Let-7a was identified as a crucial regulator of apoptosis sensitivity by targeting caspase-3, the key executor of apoptosis.</p><p><strong>Conclusions: </strong>These findings provide new insights into overcoming melanoma drug resistance through combined BRAF/MEK inhibition.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597084","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":"Comparative evaluation of microleakage of four restorative materials using confocal laser scanning microscopy: an in vitro study.","authors":"Annapoorna Kini, Kavana M G, Shubhashini N, Nithin Shetty, Venkata Suresh Venkataiah, Mohammad Fareed, Mohmed Isaqali Karobari","doi":"10.1007/s11845-025-03927-2","DOIUrl":"https://doi.org/10.1007/s11845-025-03927-2","url":null,"abstract":"<p><strong>Objective: </strong>Understanding the sealing ability of restorative materials to prevent microleakage and its consequent complications-such as secondary caries, postoperative sensitivity, and restoration failure-is imperative in clinical dentistry. This study aims to compare the microleakage performance of four restorative materials-bioactive composite resin (Activa Pronto), alkasite restorative (Cention N), compomer (Dyract Flow), and glass ionomer cement (Type 2 GIC)-in Class V cavities of extracted premolar teeth.</p><p><strong>Materials and methods: </strong>Forty non-carious, intact premolar teeth were selected and prepared with standardized Class V cavities. The teeth were randomly assigned to one of four groups (n = 10) and restored with the respective materials. The restorations underwent thermocycling, followed by microleakage testing using rhodamine dye. Confocal laser scanning microscopy (CLSM), a technique that provides superior depth resolution and three-dimensional visualization of microleakage, was used to assess dye penetration at the tooth-restoration interface. Microleakage was then scored using a standardized grading system.</p><p><strong>Results: </strong>Significant differences in microleakage were observed among the groups (χ² = 45.69; p < 0.001). Group 1 (bioactive composite resin) demonstrated the lowest microleakage, with predominantly Grade 0 and Grade 1 scores, while Group 4 (GIC) exhibited the highest microleakage, characterized mainly by Grade 3 scores. Bioactive composite resin exhibited significantly lower microleakage than alkasite, compomer, and GIC (p < 0.05). No significant difference was observed between alkasite and compomer.</p><p><strong>Conclusions: </strong>Bioactive composite resin (Activa Pronto) provided the most effective seal against microleakage, followed by alkasite and compomer, with glass ionomer cement showing the least effective sealing properties.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597081","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":"Correction to: Age‑related volume decrease in subcortical gray matter is a part of healthy brain aging in men.","authors":"Radmila Peric, Igor Romčević, Milica Mastilović, Ivana Starčević, Jasmina Boban","doi":"10.1007/s11845-025-03925-4","DOIUrl":"https://doi.org/10.1007/s11845-025-03925-4","url":null,"abstract":"","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572847","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":"Frequency of post-traumatic stress disorder among orthopedic trauma patients and its association with personal parameters.","authors":"Fareeha Qamar, Amna Mehboob, Amna Rehman, Ali Afzal, Muhammad Babar Khawar","doi":"10.1007/s11845-025-03914-7","DOIUrl":"https://doi.org/10.1007/s11845-025-03914-7","url":null,"abstract":"<p><strong>Background and objectives: </strong>Post-traumatic stress disorder (PTSD) is a common psychological condition following traumatic events, including physical trauma. In this study, we aimed to determine the prevalence and demographic correlates of PTSD among orthopedic trauma patients.</p><p><strong>Methods: </strong>We used a cross-sectional survey design and assessed 200 orthopedic trauma patients, using a self-administered questionnaire. The questionnaire consisted of demographic information and the PTSD Checklist-Civilian Version to determine the prevalence of PTSD.</p><p><strong>Results: </strong>The results showed that the prevalence of PTSD was 39%. Females had a higher incidence rate (63%) than males (26%). Females were 1.16 times more likely to suffer from PTSD following trauma as compared to males, with a statistically significant association found between PTSD and female gender. However, the study found no significant association between PTSD and age. Additionally, a high proportion of PTSD participants had comorbid depression.</p><p><strong>Conclusion: </strong>Future studies should further explore the demographic and psychological risk factors associated with PTSD following physical trauma.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566601","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":"John Stearne (1624-1669). Founder of the Royal College of Physicians of Ireland and first Professor of Medicine in Trinity College Dublin.","authors":"Joseph Harbison","doi":"10.1007/s11845-025-03921-8","DOIUrl":"https://doi.org/10.1007/s11845-025-03921-8","url":null,"abstract":"<p><p>John Stearne was the first Regius Professor of Medicine in Trinity College Dublin and founded the Fraternity of Physicians of Trinity Hall that later became the Royal College of Physicians in Ireland. He was born in Ardbraccan, County Meath in 1624 and was a great nephew of the Archbishop of Armagh and renowned scholar James Ussher who was his patron. He entered Trinity College in 1639 and was elected Scholar in 1641, before fleeing Dublin at the outbreak of the Confederate Wars later that year. He moved to Cambridge and studied medicine in Sidney Sussex College. After a short period practicing medicine in Bedfordshire, he returned to Trinity in 1651 and was appointed Professor of Medicine and College medicus. He later also became Professor of Hebrew and Professor of Law. He wrote six books and became a Senior Fellow of the College. In 1654, he established the Fraternity of Physicians with some other Dublin physicians in a disused building on Trinity Street. Stearne resigned his Fellowship and Professorship in 1659 but had them restored by 1662 following the Restoration of the King Charles II. The Royal College of Physicians of Ireland received its first royal charter in 1667. Stearne died in 1669 at the age of 44. This paper, written to celebrate the quatercentenary of his birth, discusses Stearne's life and achievements in more detail particularly in the context of the political turmoil of the age and the important role of his extended family in the important events that occurred.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566760","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":"Correlation between serum C-peptide level and diabetic retinopathy according to estimated glomerular filtration rate in patients with type 2 diabetes.","authors":"Jaipal Makina, Moogaambiga S, Rangabashyam S R","doi":"10.1007/s11845-025-03919-2","DOIUrl":"https://doi.org/10.1007/s11845-025-03919-2","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic retinopathy is a common complication of diabetes and a leading cause of vision loss. The prevalence of DR increases with the duration of diabetes, poor glycemic control, and the presence of other systemic conditions such as hypertension and dyslipidemia. Serum C-peptide is a marker of endogenous insulin production and is commonly used to assess residual beta-cell function in patients with type 2 diabetes (T2D).</p><p><strong>Objectives: </strong>To examine the relationship between serum C-peptide levels and diabetic retinopathy in patients with type 2 diabetes, categorized according to their estimated glomerular filtration rate.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in VINAYAKA MISSION'S KIRUPANANDA VARIYAR MEDICAL COLLEGE AND HOSPITALS, VINAYAKA MISSION'S RESEARCH FOUNDATION, (DU), in the Department of General Medicine. The study was performed between September 2023 and July 2024. A total of 120 patients who had diabetes mellitus attending the OPD were included in the study. Blood samples were taken to measure serum C-peptide levels, fasting plasma glucose (FPG), and glycated hemoglobin (HbA1c). Serum C-peptide levels were measured using an electrochemiluminescence immunoassay. Also, eGFR was calculated using the CKD-EPI equation based on serum creatinine levels.</p><p><strong>Results: </strong>The majority of the participants had more than 10 years of diabetes (51.7%), while 48.3% had less than 10 years of diabetes. The mean HbA1c value was 8.2 ± 1.5, and the mean Serum C-peptide was 2.3 ± 1.1 ng/mL. The prevalence of diabetic retinopathy among the study participants was 45.0%.</p><p><strong>Conclusion: </strong>Serum C-peptide levels are significantly correlated with both diabetic retinopathy and kidney function. Lower C-peptide levels (reflecting worse beta-cell function) are associated with a higher risk of retinopathy and worse kidney function.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542017","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":"Role of abdominal aortic calcification score in predicting cardiovascular risk in the general population.","authors":"Yinze Ji, Naqiang Lv, Yingzhen Gu, Xiaorong Han, Aimin Dang","doi":"10.1007/s11845-025-03877-9","DOIUrl":"https://doi.org/10.1007/s11845-025-03877-9","url":null,"abstract":"<p><strong>Background: </strong>Abdominal aortic calcification (AAC) is closely related to cardiovascular disease. Although its clinical significances have primarily been investigated in patients with chronic kidney disease, its association with cardio-cerebrovascular mortality in the general middle-aged and elderly population has not been sufficiently investigated.</p><p><strong>Aims: </strong>To study the association of AAC and cardio-cerebrovascular mortality in both the entire general middle-aged and elderly populations and age subgroups.</p><p><strong>Methods: </strong>Data of participants of the National Health and Nutrition Examination Survey (NHANES) 2013-2014 were analyzed. This study included middle-aged and elderly (≥ 40 years old) individuals who underwent dual-energy X-ray absorptiometry. The severity of AAC was assessed by an AAC scoring system (AAC score) with a maximum possible value of 24. Participants were tracked for survival status and major cause of death till 31st December 2019. This study utilized AAC score = 6 as the optimal cut-off according to Harrell's c statistic. Based on AAC scores, participants were trichotomized (0, 0-6, and ≥ 6). Groupwise survival curves and cumulative incidence functions were plotted to reveal the association of AAC and cardio-cerebrovascular mortality. Given results under trichotomization, combination of participants with AAC scores 0 and 0-6 was conducted to reaffirm the association of AAC and adverse prognosis.</p><p><strong>Results: </strong>Correlation between increased AAC score and poorer survival, higher cumulative incidence of events was revealed. Cox models identified AAC score ≥ 6 as an independent risk factor of cardio-cerebrovascular mortality (AAC score ≥ 6 vs. AAC score = 0: Hazard ratio: 2.38, P = 0.008) after adjusting for cardiovascular risk factors. Results remained significant after regrouping (AAC score ≥ 6 vs. AAC score < 6: Hazard ratio: 2.06, P = 0.016). Subgroup analysis provided no evidence of unparallel change in hazard for the same amount of increase in AAC score among middle-aged (40-65 years old) and elderly (≥ 65 years old) individuals.</p><p><strong>Conclusions: </strong>AAC score ≥ 6 independently indicate increased risk of cardio-cerebrovascular death and would be effective in risk stratification among the general middle-aged and elderly population in clinical practice.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542019","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}