Ching-Chien Chang , Min Peng , Li-Kuang Tsai , Chia-Chun Chang , Chia-Jung Li , Chia-Kuan Wu , Chin-Cheng Chien , Jie Xu , Zsolt Peter Nagy , Chi-Hong Liu , Chung-Hao Lu , Li-Ying Sung
{"title":"Sperm penetration at the maturing metaphase I stage can trigger oocyte activation in a mouse model","authors":"Ching-Chien Chang , Min Peng , Li-Kuang Tsai , Chia-Chun Chang , Chia-Jung Li , Chia-Kuan Wu , Chin-Cheng Chien , Jie Xu , Zsolt Peter Nagy , Chi-Hong Liu , Chung-Hao Lu , Li-Ying Sung","doi":"10.1016/j.rbmo.2024.104329","DOIUrl":"10.1016/j.rbmo.2024.104329","url":null,"abstract":"<div><h3>Research question</h3><div>Can spermatozoa penetrate maturing metaphase I (MI) oocytes, and render subsequent development following conventional IVF in a mouse model?</div></div><div><h3>Design</h3><div>ICR mice were used in this study. Metaphase II (MII) cumulus–oocyte complexes (COC) harvested 15 h after injection of human chorionic gonadotrophin (HCG) were used for IVF as the control group (Group 1). In the treatment group (Group 2), maturing MI COC harvested 7 h after HCG injection were used for IVF. Fertilization, pronuclear formation, cleavage, blastocyst formation, DNA methylation status, chromosome number and live birth rates were used to evaluate the developmental dynamics and competency of maturing MI oocytes following conventional IVF.</div></div><div><h3>Results</h3><div>Maturing MI COC were fertilized using conventional IVF, and sperm penetration at MI–telophase I triggered oocyte activation. Most embryos resulting from fertilized MI oocytes developed to blastocyst stage during preimplantation development, albeit a substantial proportion of them were triploids due to the absence of the second meiotic division. Some of the embryos derived from fertilization of maturing oocytes were able to implant and gave rise to full-term development.</div></div><div><h3>Conclusion</h3><div>Maturing MI COC from follicles before ovulation could be used for mouse IVF, and fertilized MI oocytes had high potential for development. Healthy offspring can be generated from maturing MI COC following conventional IVF. MI COC may represent a valuable source of ‘usable’ biomaterial in assisted reproduction. However, many embryos derived from MI COC via IVF have abnormal chromosome numbers in the mouse model. The implications of these findings for human IVF remain to be investigated.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paolo Vercellini , Martina Piccini , Francesca Caprara , Giulia Emily Cetera , Paola Viganò , Edgardo Somigliana
{"title":"Potential anatomical determinants of retrograde menstruation: a comprehensive narrative review","authors":"Paolo Vercellini , Martina Piccini , Francesca Caprara , Giulia Emily Cetera , Paola Viganò , Edgardo Somigliana","doi":"10.1016/j.rbmo.2024.104345","DOIUrl":"10.1016/j.rbmo.2024.104345","url":null,"abstract":"<div><p>A century ago, Sampson identified three uterine anatomical structures that may determine the amount of retrograde menstruation and the likelihood of the development of endometriosis: the cervix, the intramural portion of the fallopian tubes, and the myometrium. Critical appraisal was undertaken of data published over the last 40 years on the potential effect of the characteristics of these three anatomical variables on the risk of endometriosis. There is some evidence to support the pathogenic role of the diameter of the cervical canal, stenosis of internal or external orifices, and stiffness of cervical tissue. One study showed a significant association between the morphology of the intramural tubal tract and the frequency of endometriosis. A large body of evidence points to abnormalities of the myometrial structure as the anatomical aberration most consistently associated with endometriosis. These abnormalities have largely been interpreted as signs of early-onset adenomyosis, which may precede endometriosis and even lead to its development by increasing the amount of retrograde menstruation. Future research should aim to verify whether a positive relationship exists between the substantially increased number of ovulatory menses occurring in the decade following menarche, the development of anatomical myometrial abnormalities, changes in the amount of retrograde menstruation over time, and the risk of endometriosis.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141933649","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}
Parmis Notghi, Malek Soleimani Mehranjani, Seyed Mohammad Ali Shariatzadeh
{"title":"Atorvastatin improves ovarian function and follicular reserve in rats with premature ovarian insufficiency","authors":"Parmis Notghi, Malek Soleimani Mehranjani, Seyed Mohammad Ali Shariatzadeh","doi":"10.1016/j.rbmo.2024.104324","DOIUrl":"10.1016/j.rbmo.2024.104324","url":null,"abstract":"<div><h3>Research question</h3><p>Can atorvastatin, with its antioxidant, anti-inflammatory and anti-apoptotic properties, improve ovarian function and follicular reserve in rats with cyclophosphamide-induced premature ovarian insufficiency (POI)?</p></div><div><h3>Design</h3><p>In this experimental study, 24 adult female Wistar rats were divided into four groups: control; POI; POI + atorvastatin; and atorvastatin. After treatment with atorvastatin, serum concentrations of total antioxidant capacity, glutathione, malondialdehyde, FSH, oestradiol, anti-Müllerian hormone, tumour necrosis factor-alpha and interleukin-6 were evaluated. Additionally, mRNA and protein expression of Bax, Bcl-2 and VEGF-A; number of follicles; and total volume of the ovary, and volumes of the cortex and medulla were examined.</p></div><div><h3>Results</h3><p>The results showed that serum concentrations of total antioxidant capacity (<em>P</em> < 0.001), glutathione, oestradiol and anti-Müllerian hormone (<em>P</em> < 0.05); mRNA and protein expression of Bcl-2 and VEGF-A (<em>P</em> < 0.05); number of primordial and primary follicles (<em>P</em> < 0.001), and preantral and antral follicles (<em>P</em> < 0.01); and total volume of the ovary, and volume of the cortex (<em>P</em> < 0.05) increased significantly in the POI + atorvastatin group compared with the POI group. Serum concentrations of malondialdehyde, FSH, tumour necrosis factor-alpha and interleukin-6; and mRNA and protein expression of Bax decreased significantly in the POI + atorvastatin group compared with the POI group (<em>P</em> < 0.05).</p></div><div><h3>Conclusions</h3><p>Atorvastatin reduces the detrimental effects of cyclophosphamide in the POI model significantly by reducing oxidative stress and pro-inflammatory cytokines; regulating the expression of Bax, Bcl-2 and VEGF-A; and improving ovarian function and follicular reserve.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141933650","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":"Enucleated egg donation: why is it important to understand the attitudes of women on donating enucleated eggs?","authors":"Rekha Pillai, Meenakshi Choudhary","doi":"10.1016/j.rbmo.2024.104323","DOIUrl":"10.1016/j.rbmo.2024.104323","url":null,"abstract":"<div><p>Enucleated egg donation is increasingly used for mitochondrial replacement therapy and in assisted conception to improve the success rate for women with recurrent IVF failure. With the possibility of a future increase in demand for enucleated egg donation, it is important to understand the attitudes of the general public and egg donors towards it. This Viewpoint elaborates on the general public's and donors’ perspectives on important aspects of enucleated egg donation that need to be explored, and points towards the areas that need to be researched in the future.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141412632","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":"Why do oestrogens matter: systematic review and meta-analysis assessing GnRH antagonists, considering add-back therapy, for endometriosis-associated pain","authors":"","doi":"10.1016/j.rbmo.2024.104321","DOIUrl":"10.1016/j.rbmo.2024.104321","url":null,"abstract":"<div><p>Gonadotrophin-releasing hormone (GnRH) antagonists have been demonstrated to reduce endometriosis-associated pain. Because of the hypo-oestrogenic state they induce, however, higher dosages of GnRH antagonists are not recommended for used long term. This unwanted effect may be eliminated by so-called add-back therapy (ABT). This review was conducted to assess the safety and efficacy of GnRH antagonists, with or without add-back hormonal replacement therapy. Out of the 345 studies selected through the initial search, seven randomized controlled trials were included, comparing different oral GnRH antagonists at varying dosages, from a minimum of 50 mg to a maximum of 200 mg once or twice daily. Women treated with the lowest dose of GnRH antagonists had significantly greater mean pain score reductions from baseline throughout treatment compared with those treated with placebo (odds ratio [OR] –13.12, 95% CI –17.35 to –8.89 and OR –3.08, 95% CI –4.39 to –1.76 for dysmenorrhoea and non-menstrual pelvic pain, respectively). Compatible with the dose–response effect, a positive correlation was found between response rates and adverse event rates. While GnRH antagonists offer an advantage in terms of pain reduction for endometriosis, the more recent literature suggests using GnRH antagonists with ABT, which, while mitigating the hypo-oestrogenic effects of GnRH antagonists, maintain their efficacy, while allowing their long-term use.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1472648324005108/pdfft?md5=0c7a0767404d6e55a97201706e8ed261&pid=1-s2.0-S1472648324005108-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141409155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Blockage of the NLRP3 inflammasome by MCC950 inhibits migration and invasion in adenomyosis","authors":"","doi":"10.1016/j.rbmo.2024.104319","DOIUrl":"10.1016/j.rbmo.2024.104319","url":null,"abstract":"<div><h3>Research question</h3><p>Does the NOD-like receptor protein 3 (NLRP3) inflammasome have an effect in adenomyosis?</p></div><div><h3>Design</h3><p>Fresh-frozen endometrial tissues and paraffin specimens were obtained from endometrial tissues from patients with adenomyosis and controls. Western blot, quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry (IHC) were applied to assess expression of the NLRP3 inflammasome components. Primary eutopic endometrial stromal cells were isolated from the uteri of patients with adenomyosis. After NLRP3 was knocked down using small interfering RNA, proliferation, invasion and epithelial–mesenchymal transition (EMT) were evaluated using EdU, CCK8, transwell assays and western blot. Importantly, a mouse model of adenomyosis was established to evaluate the effects of the NLRP3 inhibitor MCC950 on the formation of adenomyosis.</p></div><div><h3>Results</h3><p>Expression of the NLRP3 inflammasome components was elevated in the ectopic or eutopic endometrium of patients with adenomyosis. NLRP3 knockdown inhibited migration, invasion and EMT in endometrial cells and primary endometrial cells (<em>P</em> < 0.0001). MCC950, which blocks the NLRP3 inflammasome, reduced migration and invasion of endometrial cells (<em>P <</em> 0.01) and primary endometrial cells (<em>P</em> < 0.0001) considerably. Importantly, in the mouse model of adenomyosis, MCC950 had a mitigating effect on the severity of adenomyosis (<em>P <</em> 0.01).</p></div><div><h3>Conclusions</h3><p>NLRP3 was found to enhance migration, invasion and EMT of human endometrial cells in adenomyosis. Notably, the NLRP3 inhibitor MCC950 reduced migration and invasion of endometrial cells effectively. Furthermore, in the mouse model of adenomyosis, MCC950 exhibited a therapeutic effect by alleviating the severity of adenomyosis.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141389818","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":"Blastocoel fluid as an alternative source of DNA for minimally invasive PGT and biomarker of embryo competence","authors":"","doi":"10.1016/j.rbmo.2024.104322","DOIUrl":"10.1016/j.rbmo.2024.104322","url":null,"abstract":"<div><p>The discovery of DNA in blastocoel fluid (BF-DNA) generated new perspectives in the potential development of simpler and safer alternative non-invasive tests in reproductive genetics. Short DNA fragments of apoptotic origin, together with specific expression patterns of pro- and anti-apoptotic genes in the blastocoel fluid of euploid and aneuploid embryos, suggest a self-correction mechanism to preferentially eliminate aneuploid cells, and purge defective and non-viable cells. The correlation of blastocoel fluid content with the genetic status of the whole embryo, and therefore its potential use in minimally invasive preimplantation genetic testing (miPGT), or as an indicator of embryo potential, remains uncertain and needs to be determined. The limited amount and compromised integrity of BF-DNA, with likely apoptotic origination, constrains its amplification, leading to low concordance and reproducibility rates for both aneuploidy screening and monogenic testing. While embryo genotyping constitutes a more ambitious goal, the presence of analysable DNA after amplification in blastocoel fluid may be used as a clinical biomarker of embryo competency to select the most viable embryo(s) for transfer, and potentially improve the implantation rate. Although blastocentesis remains a promising area for future research, several technical and methodological limitations are currently constraining its consideration for clinical practice.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141392046","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":"Association between frozen embryo transfer and childhood allergy: a retrospective cohort study","authors":"","doi":"10.1016/j.rbmo.2024.104320","DOIUrl":"10.1016/j.rbmo.2024.104320","url":null,"abstract":"<div><h3>Research question</h3><p>Does frozen embryo transfer (FET) increase the risk of allergic diseases in offspring?</p></div><div><h3>Design</h3><p>This study followed up 653 singleton children: 166 born through FET and 487 born through natural conception. Demographic characteristics, perinatal information and allergic diseases of children and their parents were collected through clinical medical systems and questionnaires. Among these 653 children, allergen-specific immunoglobulin E (IgE) testing was performed using peripheral blood samples collected from 207 children: 145 in the FET group and 62 in the natural conception group. The prevalence of allergic diseases and positive rates of allergen-specific IgE testing were compared between the two groups with adjustments for confounding factors.</p></div><div><h3>Results</h3><p>The prevalence of food allergy was significantly higher in children born through FET compared with children born through natural conception (adjusted OR = 3.154, 95% CI 1.895–5.250; <em>P</em> < 0.001). In addition, positive rates of food allergen sensitization were higher in children in the FET group compared with children in the natural conception group (adjusted OR = 5.769, 95% CI 2.859–11.751, <em>P</em> < 0.001). Children in the FET group had a higher positive sensitization rate to at least one allergen compared with children in the natural conception group (adjusted OR = 3.127, 95% CI 1.640–5.961, <em>P</em> < 0.001). No association was observed between FET and other allergic diseases, including asthma (<em>P</em> = 0.136), atopic dermatitis (<em>P</em> = 0.130) and allergic rhinitis (<em>P</em> = 0.922). Allergen sensitization IgE testing indicated no differences between the two groups in terms of positive sensitization rates of other common allergens, including animal and insect allergens (<em>P</em> = 0.627), inhaled outdoor allergens (<em>P</em> = 0.915) and inhaled outdoor allergens (<em>P</em> = 0.544).</p></div><div><h3>Conclusion</h3><p>This study suggests that children born through FET have increased risk of developing food allergy in early childhood.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141405522","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":"Impact of different progesterone timings on live birth rates for blastocyst frozen embryo transfer cycles","authors":"","doi":"10.1016/j.rbmo.2024.104307","DOIUrl":"10.1016/j.rbmo.2024.104307","url":null,"abstract":"<div><h3>Research question</h3><p>Do different timings of progesterone administration for day 5 and day 6 blastocysts affect the live birth rate (LBR) of artificial frozen embryo transfer (FET) cycles?</p></div><div><h3>Design</h3><p>This retrospective cohort study included 1362 patients who underwent artificial FET cycles. The effects of 6 and 7 days of progesterone administration prior to blastocyst transfer on clinical outcomes were compared in day 5 and day 6 blastocysts. Univariable and multivariable regression analyses were undertaken.</p></div><div><h3>Results</h3><p>In all patients, LBR was comparable between the two groups (51.8% versus 47.9%, <em>P</em> = 0.165). For day 6 blastocysts, after adjusting for confounders, the 7-day progesterone regimen resulted in a significantly higher LBR (44.8% versus 36.4%, <em>P</em> = 0.039, adjusted OR = 1.494, 95% CI 1.060–2.106) and lower pregnancy loss rate (15.4% versus 25.2%, <em>P</em> = 0.031, adjusted OR = 0.472, 95% CI 0.260–0.856) compared with the 6-day progesterone regimen. For day 5 blastocysts, there were no significant differences in pregnancy outcomes between the two regimens, but the rate of low birthweight was higher with the 7-day progesterone regimen than with the 6-day progesterone regimen (13.9% versus 6.7%, <em>P</em> = 0.032).</p></div><div><h3>Conclusions</h3><p>In all blastocyst analyses, no difference in LBR was found between the 6- and 7-day progesterone regimens in artificial FET cycles. For day 6 blastocysts, LBR was significantly higher with the 7-day progesterone regimen than with the 6-day progesterone regimen, whereas for day 5 blastocysts, pregnancy outcomes were comparable between the two regimens.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141396803","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":"Surrogacy in the United States: analysis of sociodemographic profiles and motivations of surrogates","authors":"","doi":"10.1016/j.rbmo.2024.104302","DOIUrl":"10.1016/j.rbmo.2024.104302","url":null,"abstract":"<div><h3>Research question</h3><p>What is the profile of women in the USA who become surrogates, and what is their power of decision and motivations?</p></div><div><h3>Design</h3><p>This quantitative study was performed with 231 participants in the USA, given the country's long history of surrogacy, to help clarify the profile of women who become surrogates, their power of decision and motivations.</p></div><div><h3>Results</h3><p>Descriptive and multivariate cluster analyses showed that women who become surrogates earn above the average income for their state of residency, have a high level of education, have health insurance, are employed, and decide to become a surrogate for prosocial/altruistic reasons.</p></div><div><h3>Conclusions</h3><p>In contrast to the premise of both radical feminism and ultra-conservative Catholicism, this study found that altruism and empathy are the primary motivations for participating in surrogacy processes, and that a woman's decision to become a surrogate is not motivated by social conditioning relating to poverty or social status.</p></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1472648324004917/pdfft?md5=7009fa6526bab86ca3b4f1ab5e8c85d8&pid=1-s2.0-S1472648324004917-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141275174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}