Placenta最新文献

{"title":"AI-assisted placenta pathology in clinical use: barriers and opportunities.","authors":"Emma Clare Walker, Yiwen Huang, Craig A Glastonbury, Kenton O'Hara, Abigail Fraser, Sanne J Gordijn, Linda M Ernst, Christoffer Nellaker","doi":"10.1016/j.placenta.2026.05.006","DOIUrl":"https://doi.org/10.1016/j.placenta.2026.05.006","url":null,"abstract":"<p><p>Placental pathology provides critical diagnostic information following pregnancy complications and has the potential to inform mother and infant clinical care. Yet the field faces substantial challenges, including workforce shortages, high inter-observer variability, inconsistent reporting, and ongoing debate regarding clinical utility. Artificial intelligence (AI) and computer vision methods offer potential solutions through automated analysis of both gross photography and digital histology. Recent studies demonstrate technical feasibility across tasks including gestational age prediction, cellular and structural quantification, and lesion detection. Near-term clinical applications should prioritise standardising measurements, reducing inter-observer variability, and accelerating report generation through assistive workflows to deliver timely results for clinical decision-making. Over the longer term, AI-derived placental phenotypes could enable prognostic research linking placental features to maternal and childhood outcomes, supporting a shift from diagnostic to prognostic clinical pathways. However, significant barriers impede clinical translation. These include the infrastructure and deployment costs associated with digital pathology and AI, regulatory requirements, and challenges specific to placenta pathology such as limited open-source datasets, indication bias in clinical samples, difficulty integrating information across placental compartments, inconsistent data linkage, and uncertainty regarding which features should be measured. Together, these factors contribute to high development costs and limit the availability of clinically deployable models. This review examines both the opportunities for AI and computer vision in placental pathology and the barriers to their translation, and proposes priorities for the pathology community. Addressing these priorities would position AI to transform placental pathology from a resource-limited diagnostic service into a scalable, data-driven discipline that improves immediate clinical care and enables discovery-driven advances in maternal and child health.</p>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Image-informed modelling of microscale exchange in the human placenta.","authors":"Eleanor Doman, Richard Mcnair, Carl A Whitfield, Megan Sharps, Oliver E Jensen, Adam Stevens, Rohan M Lewis, Igor L Chernyavsky, Bram Sengers","doi":"10.1016/j.placenta.2026.04.027","DOIUrl":"https://doi.org/10.1016/j.placenta.2026.04.027","url":null,"abstract":"<p><p>The human placenta supports fetal development by mediating the exchange of gases, nutrients, drugs, and waste across a highly heterogeneous microscale interface formed by terminal villi. While placental transport has long been studied using simplified multiscale models, progress has been constrained by limited access to realistic microstructure geometries, uncertainty in barrier composition, and difficulties linking local geometries to organ-level measurements. Here, we review recent advances in placental imaging and mathematical modelling that are enabling better characterisation of microscale exchange. We outline how multimodal structural imaging, including X-ray phase-contrast approaches, microCT, optical microscopy and volume electron microscopy, can quantify villous and vascular architecture across scales. We discuss modelling frameworks informed by these data, including descriptions of maternal and fetal haemodynamics, image-based exchange-capacity concepts, and compartmental approaches that incorporate delivery limitations. We also discuss recent advances in the understanding of transporter-mediated transfer, and the emerging role of spatial 'omics in parametrising membrane function and regional heterogeneity. We conclude by identifying likely next steps and ways forward for image-based models of exchange in the human placenta.</p>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologically inspired digital histology for deep phenotyping of placental composition changes across major lesion types.","authors":"Emma Clare Walker, Claudia Vanea, Karen Meir, Drorith Hochner-Celnikier, Hagit Hochner, Triin Laisk, Cecilia Lindgren, Craig A Glastonbury, Linda M Ernst, Christoffer Nellaker","doi":"10.1016/j.placenta.2026.04.020","DOIUrl":"10.1016/j.placenta.2026.04.020","url":null,"abstract":"<p><strong>Background: </strong>Placental histopathology provides important insights into maternal and fetal health, yet the organ's spatial heterogeneity poses significant challenges for objective and reproducible histological analysis. Systematic assessment of cellular and structural composition across placental slides remains limited by the scale and subjectivity of manual evaluation. Quantitative approaches are therefore needed to characterise placental responses to injury beyond visually apparent lesions.</p><p><strong>Methods: </strong>We applied the Histology Analysis Pipeline.PY (HAPPY), a biologically inspired hierarchical deep learning framework for quantitative single-cell-resolution analysis of Haematoxylin and Eosin (H&E) slides, to 130 placental parenchyma slides from 62 singleton full-term live births. The dataset included healthy normal controls and four common placental lesion types: infarction, perivillous fibrin, avascular villi, and intervillous thrombosis. Cell-type and tissue-structure compositions were quantified, and slide-level deviation from a healthy reference was assessed using compositional data analysis.</p><p><strong>Results: </strong>Placental slides with lesions exhibited significant cellular composition differences compared with healthy controls, including increased extravillous trophoblast and leukocyte densities and decreased Hofbauer cell densities. These cellular changes were accompanied by tissue-level alterations, particularly increased fibrin deposition and changes in villous structure. Compositional deviation increased with infarction size but not with other lesion types. Notably, compositional differences were also detected in slides without an apparent lesion from placentas with lesion(s) elsewhere, indicating organ-wide responses extending beyond focal pathology.</p><p><strong>Conclusions: </strong>Quantitative deep phenotyping reveals widespread cellular and structural changes associated with placental lesions, including effects not evident on routine histological assessment. These findings demonstrate the potential of AI-based digital histology to complement conventional placental pathology in research and clinical settings.</p>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147819713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic glucocorticoid excess during rat pregnancy disrupts placental oxygenation and alters feto-placental vascular architecture.","authors":"Yutthapong Tongpob, Andrew J H Mehnert, Kirk W Feindel, Alexander Joos, Shushan Xia, Brendan Waddell, Caitlin S Wyrwoll","doi":"10.1016/j.placenta.2026.04.019","DOIUrl":"https://doi.org/10.1016/j.placenta.2026.04.019","url":null,"abstract":"<p><strong>Introduction: </strong>Prenatal glucocorticoid overexposure causes fetal growth restriction, often mediated by placental vascular dysfunction, yet underlying mechanisms remain poorly defined. This study examined the temporal and spatial progression of placental oxygenation and feto-placental vascular structure following chronic dexamethasone exposure using three-dimensional imaging.</p><p><strong>Methods: </strong>Time-mated pregnant Wistar rats received dexamethasone (0.5 μg/mL) or vehicle in drinking water from embryonic day (E) 13-21. Placental oxygenation was evaluated at E15, E18, and E21 using T2∗ magnetic resonance imaging (MRI) during maternal hyperoxia challenge. Feto-placental arterial architecture was assessed at E21 using micro-computed tomography with Microfil® perfusion.</p><p><strong>Results: </strong>Dexamethasone exposure reduced fetal and placental weights from E18 onward. At E21, micro-CT revealed that placentas exhibited 50% reduction in vascular volume and 30% decrease in vessel segments, with selective loss of arterioles (-42%) and pre-arterioles (-38%) while preserving larger vessels. Terminal vessel branching was significantly reduced. Dexamethasone significantly reduced placental oxygenation (ΔT2∗) at E18 (51%, p < 0.05), through to E21 (55%, p < 0.0001). At E21, comparable reduction in oxygen occurred in both dexamethasone-treated labyrinth (52%) and junctional (54%) zones in comparison to control (both p < 0.001).</p><p><strong>Discussion: </strong>Chronic glucocorticoid exposure induces placental functional deficits with selective terminal vessel loss in late gestation. This temporal progression links impaired branching angiogenesis to compromised oxygen exchange capacity. These findings advance understanding of placental insufficiency mechanisms and highlight the potential of MRI for early detection of placental dysfunction.</p>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Andrée Gruslin award lecture: Vitamin D, pregnancy and the human placenta.","authors":"Jane K Cleal","doi":"10.1016/j.placenta.2026.04.015","DOIUrl":"https://doi.org/10.1016/j.placenta.2026.04.015","url":null,"abstract":"<p><p>Vitamin D plays diverse and complex roles during pregnancy affecting the mother, placenta and fetus. Vitamin D affects calcium homeostasis, cell proliferation and differentiation, inflammation and immune function. Understanding the roles of vitamin D in pregnancy is hindered by the complexity of vitamin D metabolism that generates multiple metabolites, transfer and processing by the placenta, and uncertainty of whether the biological effects are mediated directly in fetal organs or indirectly through the placenta. It is therefore necessary to distinguish the effects of vitamin D on the placenta from those of vitamin D transferred to the fetus by the placenta. The current understanding of the physiology of vitamin D during human pregnancy, specifically its interaction with the placenta will be discussed in this review. The evidence base linking placental function to fetal vitamin D supply will be discussed in relation to the underlying mechanisms, along with the placental responses to maternal vitamin D levels and their influence on fetal development. A greater understanding of pregnancy-specific vitamin D physiology is key to addressing clinical complications linked to impaired vitamin D status during pregnancy and designing effective interventions.</p>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative human placental imaging: Concepts, technologies, and the persistent challenge of the villous tree.","authors":"Nirav Barapatre, Hans-Georg Frank","doi":"10.1016/j.placenta.2026.04.011","DOIUrl":"https://doi.org/10.1016/j.placenta.2026.04.011","url":null,"abstract":"<p><p>The human placenta is a transient yet highly complex organ whose structural organisation underpins materno-fetal exchange and pregnancy outcome. Despite more than a century of anatomical investigation and rapid advances in imaging technology, quantitative linking of placental structure to function remains challenging. This review surveys the evolution of placental imaging from classical histology and stereology to contemporary microscopic, mesoscopic, and functional imaging approaches, with a particular emphasis on the extraction and interpretation of quantitative information. Microscopic techniques, including stereology and immunohistochemistry-guided villous typing, have enabled robust quantification of cellular and subcellular features, but remain constrained by their reliance on two-dimensional sections. Three-dimensional microscopy and optical tissue clearing provide richer spatial information, yet are still largely experimental for human placentas and limited in scalability and standardisation. Mesoscopic modalities such as micro-computed tomography and magnetic resonance imaging have expanded access to villous architecture, fetal vasculature, and flow-related proxies, but a pronounced gap persists at the intermediate scale where the hierarchical branching of the villous tree resides. Across imaging modalities, heterogeneity of protocols and analytical frameworks hampers reproducibility and cross-study comparability, impeding translation to clinically actionable biomarkers. We argue that future progress in quantitative placental imaging depends on closing the mesoscopic gap, harmonising imaging and analysis workflows, and integrating structural imaging with quantitative models of placental function. Only through coordinated methodological development and conceptual clarity can the full diagnostic and prognostic potential of placental imaging be realised.</p>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic MRI of the placenta.","authors":"A Melbourne, Z Yuan, Z Xiao, A Peters, R Bartin, L J Salomon, J Chappell, D Flouri, M C Schabel, A L David, V H J Roberts","doi":"10.1016/j.placenta.2026.04.010","DOIUrl":"https://doi.org/10.1016/j.placenta.2026.04.010","url":null,"abstract":"<p><p>Great strides have been made recently in advanced placental imaging. The last decade has seen MRI transform our understanding of the placenta. Most early work was interested in snapshot imaging of structure or slow functional changes with gestation. Recent methods are now studying the dynamic in vivo placenta, analysing uterine contractility and modelling the flow properties of the tissue. These are exciting times for placental imaging as we improve our understanding of this enigmatic organ and move towards the development of personalized placental digital twins for the simulation of intervention and outcome.</p>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of functional spiral artery count and jet dispersion index using power Doppler ultrasound: in vivo insights into the vascular pathology of placental dysfunction.","authors":"Sam Mathewlynn, Mohammedreza Soltaninejad, May Swinburne, Theophilus Adu-Bredu, Leticia Nicolatino Starck, Kypros H Nicolaides, Argyro Syngelaki, Antonio Galan Contreras, Sara Bigiotti, Eva-Maria Woess, Sally Collins","doi":"10.1016/j.placenta.2026.04.004","DOIUrl":"https://doi.org/10.1016/j.placenta.2026.04.004","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate two novel vascular markers - functional spiral artery (FSA) count and jet dispersion index (DI)-derived from first-trimester 3D placental power Doppler ultrasound, and to assess their association with pre-eclampsia (PE) and fetal growth restriction (FGR).</p><p><strong>Methods: </strong>We analysed a combined dataset of 6246 pregnancies from two prospective cohort studies (FirstPLUS and OxPLUS). Participants underwent 3D placental ultrasound between 11 + 2 and 14 + 1 weeks' gestation. Images were processed using the OxNNet convolutional neural network for automated segmentation of placental and vascular structures. FSAs were defined as vessel segments crossing the uteroplacental interface and terminating within placental tissue. DI quantified vessel dispersion relative to length. Associations between vascular markers and pregnancy outcomes were assessed using logistic regression.</p><p><strong>Results: </strong>Of 6246 cases, 5555 yielded evaluable FSA counts and 2991 yielded DI results. Lower FSA count z-score was associated with FGR (median z-score -0.05 vs 0.08, P < 0.001), but not significantly with PE. Lower mean DI was associated with both PE (median z-score -0.22 vs 0.05, P = 0.005) and FGR (median z-score -0.31 vs 0.06, P < 0.001). Odds of adverse outcomes decreased with higher FSA count and FSA mean DI values.</p><p><strong>Conclusion: </strong>Reduced terminal vessel number and dispersion in early pregnancy are associated with placental insufficiency syndromes. These novel ultrasound-derived markers may provide predictive insights into the haemodynamic basis of PE and FGR.</p>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sound of nurturing: Advanced photoacoustic and ultrasound imaging of placental hemodynamics.","authors":"Van Tu Nguyen, Nanchao Wang, Liping Feng, Junjie Yao","doi":"10.1016/j.placenta.2026.03.019","DOIUrl":"10.1016/j.placenta.2026.03.019","url":null,"abstract":"<p><p>The placenta is a transient yet vital organ that regulates maternal-fetal exchange and profoundly influences pregnancy outcomes. Placental hemodynamic dysfunction is central to many major obstetric complications, including preeclampsia and fetal growth restriction. Despite advances in obstetric imaging, existing modalities such as Doppler ultrasound, magnetic resonance imaging, and X-Ray computed tomography remain limited in their ability to resolve placental microvasculature or quantify hemodynamics in vivo. Recent developments in photoacoustic (PA) and advanced ultrasound imaging have enabled assessment of placental vasculature, blood perfusion, and oxygenation with improved spatial and temporal resolution. Photoacoustic microscopy (PAM) and photoacoustic computed tomography (PACT) provide optical contrast derived from endogenous hemoglobin, offering functional insight into oxygen transport and vascular remodeling at various scales, while power Doppler (PWD), and ultrasound localization microscopy (ULM) deliver complementary blood flow and microvascular information at clinically-relevant depths. Integrating photoacoustic and ultrasound imaging allows for quantitative, multiscale visualization of placental hemodynamics from the macroscopic to the microscopic level. This review summarizes current progress in photoacoustic and ultrasound-based placental imaging, discusses different system implementations, reports important preclinical and clinical findings, and identifies remaining challenges in technical improvement and broad translation. Together, emerging photoacoustic and ultrasound imaging platforms promise to transform placental research and reproductive healthcare by enabling comprehensive, functional evaluation of maternal-fetal exchange in health and disease.</p>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Placental anti-angiogenic and inflammatory markers and postpartum cardiovascular risk following preeclampsia","authors":"Erika Elizabeth Mery ,&nbsp;Julia Hajjar ,&nbsp;Shrreya Sudade ,&nbsp;Goutham Vasam ,&nbsp;Samantha Benton ,&nbsp;Laura Gaudet ,&nbsp;Dina El Demellawy ,&nbsp;David Grynspan ,&nbsp;Shannon Bainbridge","doi":"10.1016/j.placenta.2026.01.016","DOIUrl":"10.1016/j.placenta.2026.01.016","url":null,"abstract":"<div><h3>Background</h3><div>Preeclampsia (PE) increases lifetime maternal cardiovascular disease (CVD) risk. Placental transcriptomic and histological evidence suggests distinct PE subtypes—hypoxic (malperfusion, elevated FLT-1/ENG), inflammatory (immune infiltration, pro-inflammatory mediators), and maternal maladaptation (minimal placental disease)—which may differentially influence long-term CVD risk. This study evaluated whether subtype-specific immunohistochemical (IHC) biomarkers and placental pathology predict postpartum CVD risk.</div></div><div><h3>Methods</h3><div>In this pilot study, placental IHC for FLT-1, ENG, and CD68 was performed on biopsies from 41 women (35 with PE and 6 normotensive controls). Postpartum CVD risk was assessed at six months using validated lifetime risk algorithms. Biomarker intensity, histopathological scores for maternal vascular malperfusion (MVM) and inflammation, and clinical covariates were analyzed using logistic regression and receiver operating characteristic (ROC) modeling. Correlation analyses examined associations between cardiovascular measures, placental biomarkers, and pathology.</div></div><div><h3>Results</h3><div>Biomarker expression did not differ significantly between high- and low-risk groups. A biomarker-only model showed limited discrimination (AUC = 0.59), whereas combining biomarkers with clinical and pathological variables improved performance (AUC = 0.84; sensitivity 62.5%, specificity 90.5%). MVM, FLT-1, and ENG correlated positively with systolic blood pressure and total cholesterol, while CD68 correlated inversely. Precision analysis indicated only large effects were detectable given the pilot sample size.</div></div><div><h3>Conclusions</h3><div>Integrating placental biomarkers, pathology, and clinical data enhances prediction of postpartum CVD risk after PE. These exploratory findings highlight the potential of placental profiling for individualized CVD risk stratification following hypertensive pregnancy.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"176 ","pages":"Pages 43-52"},"PeriodicalIF":2.5,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146181851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}