Journal of the International Association of Providers of AIDS Care最新文献

{"title":"HIV Patients' Satisfaction with Pharmaceutical Care at a Nigerian Tertiary Healthcare Facility During the Covid-19 Pandemic.","authors":"Dalhatu Muhammad Ahmad,&nbsp;Emmanuel Ebuka Abonyi,&nbsp;Joseph Chukwudi Ugwuonah,&nbsp;Peter Esin Okon,&nbsp;Shuaibu Aliyu,&nbsp;Leonard Ighodalo Uzairue Bmls MSc,&nbsp;Don Eliseo Lucero-Prisno","doi":"10.1177/23259582231159093","DOIUrl":"https://doi.org/10.1177/23259582231159093","url":null,"abstract":"<p><p><b>Background:</b> Patients' satisfaction is an important indicator of determining the quality of pharmaceutical care (PC). This study investigated Human Immunodeficiency Virus (HIV) patients' satisfaction with PC at Federal Medical Centre, Keffi-Nigeria and determined the statistical correlation between the respondents' socio-demographic variables and their satisfaction with PC. <b>Methods:</b> This cross-sectional survey study involved 351 randomly selected HIV-positive patients receiving PC in the facility. A Likert-type questionnaire was used for the data collection. <b>Results:</b> The Cronbach's alpha of the questionnaire was .916. The \"overall perception of pharmacists' care or service\" had a mean satisfaction score of 4.24 ± 0.749 and \"the amount of time spent with the pharmacists\" had a mean score of 3.94 ± 0.791. No significant association was found between socio-demographic variables and overall patients' satisfaction with PC. <b>Conclusion:</b> The reliability of the questionnaire was high and the HIV patients had a good satisfaction with the PC they received in the facility.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/46/d7/10.1177_23259582231159093.PMC9989440.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9428508","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":"PrEP Acceptance among Eligible Patients Attending the Largest PrEP Clinic in Jackson, Mississippi.","authors":"Madison R Hollcroft, June Gipson, Alicia Barnes, Leandro Mena, Julia C Dombrowski, Lori M Ward, Christine M Khosropour","doi":"10.1177/23259582231167959","DOIUrl":"10.1177/23259582231167959","url":null,"abstract":"<p><p>Compared to other states in the United States, Mississippi has the lowest uptake of PrEP relative to the number of people newly diagnosed with HIV in the state. Open Arms Healthcare Center is the largest provider of PrEP in Mississippi, and has systematically documented PrEP eligibility, offers, and acceptance (ie, agreed to undergo a clinical PrEP evaluation) from 2017 to mid-2020. In encounter-based analyses, we examined factors associated with PrEP acceptance. Among 721 encounters where patients were eligible for PrEP, staff offered PrEP at 680 (94%) of encounters (526 unique individuals); individuals accepted a PrEP offer at 58% of encounters. Accepting a PrEP offer was lowest (15.8%) among transgender/non-binary individuals and highest (93.3%) among individuals who reported having sex partners living with HIV. This clinic's model worked to offer PrEP to a highly impacted population, though there is a need to enhance PrEP acceptance for key groups such as transgender/non-binary individuals.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/07/6b/10.1177_23259582231167959.PMC10088405.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9741016","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":"HCV Genotype Distribution and Clinical Characteristics of HCV Mono-Infected and HCV/HIV Co-Infected Patients in Liangshan Prefecture, Sichuan Province, China.","authors":"Bianchuan Cao, Mei Liu, Tao Jiang, Qinghua Yu, Tianru Yuan, Ping Ding, Xian Zhou, Yongmao Huang, Yongsheng Zou, Fuli Huang","doi":"10.1177/23259582231217810","DOIUrl":"10.1177/23259582231217810","url":null,"abstract":"<p><p><b>Objective:</b> The present study aimed to characterize the genotype distribution and clinical characteristics of HCV monoinfected and HCV/HIV coinfected patients in the Liangshan Prefecture, Sichuan Province, China. <b>Methods:</b> All the patients were divided into HCV monoinfection and HCV/HIV coinfection groups according to whether they were complicated with HIV infection. The data from the two groups were collected. <b>Results:</b> In this study, HCV genotype 3 was the most common genotype in both groups, while HCV genotype 6 was significantly higher in the coinfection group than in the monoinfection group (<i>p </i>= 0.046). The white blood cell count, total bilirubin level, and HCV RNA were significantly higher in the HCV monoinfection group than that in the HCV/HIV coinfection group (<i>p </i>= 0.031; <i>p </i>< 0.001; <i>p </i>= 0.027, respectively). <b>Conclusion:</b> HCV prevalence was high in HIV-positive patients in the Liangshan Prefecture. Thus, incorporating screening and management of HCV monoinfection and HCV/HIV coinfection is needed in local region programs.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10725143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138804445","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":"Incidence of Allergic Drug Eruption due to Cotrimoxazole in HIV-Positive Individuals with CD4 ≤200 Cells/ul.","authors":"Irene Rosali,&nbsp;Putu Siska Virgayanti,&nbsp;Della Sabrina Marta,&nbsp;Emon Winardi Danudirgo,&nbsp;Sisca Hadinata","doi":"10.1177/23259582221146946","DOIUrl":"https://doi.org/10.1177/23259582221146946","url":null,"abstract":"<p><p>Allergic drug eruptions (ADE) remain a challenge in people living with HIV (PLWH), requiring more studies to guide clinical approaches. While cotrimoxazole is widely used as prophylaxis in PLWH, relationship between client characteristics toward the occurrence of cotrimoxazole ADEs is still poorly understood.A retrospective cohort study followed PLWH initiated with antiretroviral therapy (ART) in St. Carolus Hospital between January 2009 to December 2021. ADE occurrence due to cotrimoxazole were tested for significance using Pearson's Chi-square and Fisher's Exact Test (significant outcome measured as p < 0.05) against CD4 levels at very low (0-100 cells/ul) and low (101-200 cells/ul) groups, comorbidities, and retention status.Cotrimoxazole-related ADEs occurred in 258 (14%) of 1789 subjects with CD4 levels ≤200 cells/ul. Comorbidities of Hepatitis B, Hepatitis C, and M. tuberculosis infections were found in 11, 4, and 95 subjects respectively. 151 (59%) of ADE group had very low CD4 levels (p value<i> > </i>0.05). No significant difference was found in ADE incidence between age groups, genders, CD4 levels, comorbidities, and ART retention.Cotrimoxazole-induced ADE is unrelated to CD4 levels, and ART retention was not affected. ADE severity ranges from mild to serious manifestations, and close monitoring is crucial to ensure ADEs are treated ART are well-maintained.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/81/61/10.1177_23259582221146946.PMC9893344.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10845679","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":"Socio-Cultural Influencers of Disclosure of HIV Status to Children on Antiretroviral Therapy in the Masaka Region, Uganda: A Qualitative Study.","authors":"Robert Kairania,&nbsp;Washington Onyango-Ouma,&nbsp;Tom G Ondicho","doi":"10.1177/23259582231163695","DOIUrl":"https://doi.org/10.1177/23259582231163695","url":null,"abstract":"<p><p>This study explored sociocultural influencers of disclosure of HIV status to children taking daily antiretroviral therapy (ART) in the Masaka region, Uganda using data collected from 26 key informant interviews with caregivers between October 2020 and July 2021. The findings revealed both positive and negative sociocultural influencers of disclosure. Beliefs that disclosure cultivates responsibility in the child to improve ART adherence and the culture of routine sexual health education conversations with children were positive socio-cultural influencers. Beliefs that disclosure increases children's loss of hope in life and breaks confidentiality with children inadvertently disclosing their HIV status to others leading to discrimination and social rejection, were key negative sociocultural influencers. These findings suggest a need for socio-culturally informed interventions that target caregiver negative socio-cultural disclosure influencers in this setting through contextualized sensitization and training to prepare children taking daily ART to receive disclosure progressively.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a1/be/10.1177_23259582231163695.PMC10052469.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9217090","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":"Health-Seeking Behavior and Quality of Life of People Living With HIV: Novel Evidence From Ghana.","authors":"Benjamin Spears Ngmekpele Cheabu,&nbsp;Naasegnibe Kuunibe,&nbsp;Paul Kwame Nkegbe,&nbsp;Peter Yeboah,&nbsp;James Duah,&nbsp;Joseph Kwaku Addae,&nbsp;Francis Adjei Osei,&nbsp;Ignatius Terence Ako-Nnubeng,&nbsp;Kafui Senya","doi":"10.1177/23259582231164219","DOIUrl":"https://doi.org/10.1177/23259582231164219","url":null,"abstract":"<p><p>The health and economic burdens of HIV/AIDS in low-and-middle-income countries are enormous despite global and local efforts to prevent and mitigate its effect. This study seeks to assess cadres' (or people living with HIV [PLHIV]) health-seeking behavior and its effects on their quality of life (QoL). We collected cross-sectional data from 218 HIV community cadres and 255 noncadres in 11 out of the 16 political regions in Ghana based on a modified WHOQOL-HIV-Brief and EQ-5D questionnaires. We used descriptive statistics to describe the sample and calculate the QoL scores. We also used regression analysis (ordered logit and ordinary least squares) to analyze the factors associated with the QoL of our respondents. We found that women (77%) are still disproportionally affected by HIV. Similarly, the youth, less educated and informal sector employees continue to be affected most by HIV. Factors related to QoL of PLHIV include being a community cadre, health-seeking behavior, comorbidities, and employment type. We recommend that alternative health providers be educated on the basic science of HIV/AIDS to help them offer appropriate support to PLHIV who visit them for care. Additionally, PLHIV should be supported to engage in less energy demanding employment options.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/96/1d/10.1177_23259582231164219.PMC10052464.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9464732","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":"Is Intimate Partner Violence More Common Among HIV-Positive Pregnant Women? A Comparative Study in Oyo State, Nigeria.","authors":"Oluwatosin Ruth Ilori,&nbsp;Adenike Iyanuoluwa Olugbenga-Bello,&nbsp;Phillip Oluwatobi Awodutire","doi":"10.1177/23259582231151844","DOIUrl":"https://doi.org/10.1177/23259582231151844","url":null,"abstract":"<p><p><b>Introduction:</b> Intimate partner violence (IPV) is the most common form of violence against women. Pregnant women are also not exempted from the menace of IPV which has dire consequences for both the mother and child. There is an established link between HIV and IPV and both have a synergistic effect. This study is aimed at comparing the prevalence, pattern, and determinants of IPV among pregnant women living with HIV and HIV-negative pregnant women attending antenatal clinics in Oyo state. <b>Methodology:</b> This is a descriptive cross-sectional study carried out among women attending antenatal clinics in Oyo state using a multistage sampling technique. The study spanned through March and September 2019. The data collection was conducted using a semi-structured questionnaire and the analysis was done using Statistical Package for Social Sciences version 22. The pattern and prevalence of IPV were measured using the Composite Abuse Scale, a 30-item validated interviewer-administered research instrument. It measured 4 dimensions of abuse: physical, emotional, severe, combined, and sexual harassment. A preliminary cut-off score of 7 was used to divide respondents into the presence or absence of IPV. A Chi-square test was used to test for an association between IPV and socio-demographic characteristics and a logistic regression was used at the multivariate level to identify the determinants of IPV. The <i>P</i>-value was set at <.05. <b>Results:</b> Out of the 240 booked pregnant women, 44.2% of HIV-negative respondents and 47.5% of women living with HIV reported being abused in the index pregnancy. Severe combined abuse was the most common type of abuse, 110 (75.1%), followed by emotional abuse, 70 (40.2%), physical abuse, 68 (39.3%), and sexual harassment, 67 (38.1%). Respondents living with HIV reported suffering more physical abuse than their HIV-negative counterparts. Occupation of respondents and duration of marriage determinants of IPV among HIV-positive participants are statistically significant while the duration of marriage was not statistically significant for IPV among HIV-negative respondents. <b>Conclusion:</b> This study recorded a high prevalence of IPV among pregnant women living with HIV and HIV-negative pregnant women with a slight increase in the group living with HIV. It is therefore recommended that IPV screening programs and intervention strategies should be developed for every pregnant woman, irrespective of their HIV status.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c0/d1/10.1177_23259582231151844.PMC9893387.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10842488","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":"Health-Related Quality of Life in People Living With HIV With Cognitive Symptoms: Assessing Relevant Domains and Associations.","authors":"Kate Alford,&nbsp;Sube Banerjee,&nbsp;Stephanie Daley,&nbsp;Elizabeth Hamlyn,&nbsp;Daniel Trotman,&nbsp;Jaime H Vera","doi":"10.1177/23259582231164241","DOIUrl":"https://doi.org/10.1177/23259582231164241","url":null,"abstract":"<p><p>This study aimed to validate and assess a comprehensive set of illness-specific health-related quality of life (HRQL) domains in people living with HIV (PLWH) with cognitive symptoms. One hundred and three HIV patients with cognitive symptoms (<i>n</i> = 93 male, 90.3%) were identified from two UK HIV clinics and complete a series of validated scales measuring seven HRQL domains identified as important to HRQL by PLWH with cognitive impairment. These included: physical functioning, cognition, social connectedness, self-concept, HIV stigma, acceptance of and perceived control over cognitive health, and physical and mental health and wellbeing. Exploratory factor analysis confirmed that domain total scores loaded onto one main factor, representing HRQL. Scale cut-off scores revealed a significant proportion of patients scored outside the normal range on single domains (between 26.2% and 79.6%), and many patients on multiple domains (40.8% on 4 or more domains). We found evidence of poor HRQL across domains in the majority of PLWH with cognitive symptoms and identified domains driving these experiences. This provides targets for intervention development and clinical action to maintain or improve HRQL in PLWH with cognitive symptoms or impairment.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10034276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9564632","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":"Oral Abstracts From Adherence 2023 Conference.","authors":"","doi":"10.1177/23259582231196717","DOIUrl":"10.1177/23259582231196717","url":null,"abstract":"Background: To achieve ending the HIV Epidemic goals, key populations, including sexual minority men, need to adhere to evidence-based biomedical interventions including antiretroviral therapy as treatment (ART) or preexposure prophylaxis (PrEP). The present study integrates traditional and machine learning methods to evaluate whether a common set of factors can predict adherence to ART for both treatment and prevention. Method: Participants included 365 sexual minority men taking antiretroviral therapy as treatment or PrEP in South Florida. Survey respondents provided information on adherence to treat-ment or PrEP and demographic, psychosocial, and behavioral factors potentially associated with adherence. Data were analyzed using machine learning algorithms that are simple to interpret such as Classi fi cation and Regression Tree and LASSO regression variable selection, techniques that require specialized extra steps to look inside “ black box models ” like Multivariate Adaptive Regression Spline (MARS) and Random Forest models, and traditional stepwise logistic regression to identify factors associated with adherence. Results: Taking ART for HIV treatment or PrEP was not an important predictor for adherence in any of the models. Rather, the models suggested that a common set of predictors can be used to predict adherence to ART for both treatment and PrEP. Race/ethnicity was identi fi ed by all models as an important predictor of adherence. Additionally, depressive symptoms, anxiety symptoms, and substance use were identi-fi ed as an important adherence predictor by at least three (of fi ve) models. Determinants less commonly identi fi ed as important for adherence were alcohol use (CART and LASSO only), sexual orientation (CART only), self-esteem, and condomless sex (Random Forest and LASSO only). Conclusion:","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e1/65/10.1177_23259582231196717.PMC10605798.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50158249","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":"\"There Are Just Too Many Rooms Here!\" Perception of Clients and Health Care Workers on the Implementation of Test and Treat Strategy at Area 25 Health Center in Lilongwe, Malawi.","authors":"Regina Kasiya Chigona,&nbsp;Alinane Linda Nyondo Mipando","doi":"10.1177/23259582231154224","DOIUrl":"https://doi.org/10.1177/23259582231154224","url":null,"abstract":"<p><p><b>Background:</b> Malawi adopted World Health Organisation test-and-treat policy in 2016. The policy initiates early antiretroviral treatment to all clients diagnosed with HIV, irrespective of their CD4 count. However, some facilities record low linkage following the strategy. Perceptions of clients and health care workers on the implementation of test-and-treat strategy were explored in Malawi. <b>Methods:</b> A descriptive qualitative approach was conducted in which 21 in-depth interviews, 9 key informant interviews, and 15 non-participatory observations were conducted. Data were analyzed following thematic approach. <b>Results:</b> Most participants had positive perceptions of the test-and-treat strategy. However, negative perceptions stemmed from the fragmented structure of the facility with multiple rooms in which the client navigates through as well as limited privacy. <b>Conclusion:</b> Optimal implementation of the test-and-treat strategy will need to strengthen privacy and minimize unintended disclosure that is inherent in the organization of services.</p>","PeriodicalId":17328,"journal":{"name":"Journal of the International Association of Providers of AIDS Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/aa/10.1177_23259582231154224.PMC9943958.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10846363","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}