К.О. Talalayev, М.М. Lebedyuk, R. Vastyanov, М.І. Golubyatnikov
{"title":"Medico-social and epidemiological aspects of occupational dermatoses incidence among water transport workers (literature review)","authors":"К.О. Talalayev, М.М. Lebedyuk, R. Vastyanov, М.І. Golubyatnikov","doi":"10.30978/ujdvk2023-2-40","DOIUrl":"https://doi.org/10.30978/ujdvk2023-2-40","url":null,"abstract":"Objective — to conduct a comprehensive retrospective study of the medico-social and epidemiological direction regarding the structure, determinants and cause-and-effect relationships between the performance of professional duties and skin diseases in sailors; substantiate proposals for additional measures that will improve the level of health protection of water transport workers of Ukraine to international standards.\u0000Materials and methods. The research methods applied in the work were as follows: bibliosemantic, statistical observation, analytical and structural analysis. These methods made it possible to process only valid, complete and up-to-date information, to make correct and thorough conclusions about the nature and regularities of the researched process.\u0000Results and discussion. The volume of water transportation of chemicals, goods or foods that were treated with chemicals is increasing every year. Some cargoes on board ships are disinfected, in particular, with the help of toxic fumigants. All fumigants that are used to protect transported goods are a potential health hazard for workers and can cause, among other things, occupational dermatoses.Available data on the study of sanitary-chemical, hygienic and epidemiological parameters of working conditions, living conditions and morbidity of dockers and sailors during transshipment in ports and transportation of bulk freight on ships of the bulk fleet indicate contamination of workplaces with dangerous and harmful substances, which caused damage to the mucous membranes and skin coverings.\u0000Conclusions. The mechanisms of health preservation and emergency response readiness constitute a complex scientific and practical problem and require further thorough study, considering the variety of determinants and risk factors in water transport, the differences in their physical and chemical properties, as well as the potential impact on human health and the aquatic environment. Scientifically based proposals have been provided regarding additional measures, the implementation of which will bring the level of health protection of water transport workers of Ukraine closer to international standards. Among the scientific and practical tasks related to the treatment and prevention of skin diseases among water transport workers, the priority is given to the implementation of modern diagnostic algorithms, training of personnel, organization of telemedical consultations, updating the completeness of ship’s first-aid kits in order to provide timely, high-quality emergency medical care as needed.","PeriodicalId":23420,"journal":{"name":"Ukrainian Journal of Dermatology, Venerology, Cosmetology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88462870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Modern clinico-epidemiological features of the course of some communicable infectious zooanthroponous exanthemas in times of war","authors":"O. Fedorenko, S. Ivanov, V. Stepanenko","doi":"10.30978/ujdvk2023-2-27","DOIUrl":"https://doi.org/10.30978/ujdvk2023-2-27","url":null,"abstract":"Objective — to study and analyze modern clinical and epidemiological features of emerging zooanthroponoses, legal and organizational measures to ensure the sanitary and epidemiological wellbeing of the population of Ukraine in wartime conditions and active hostilities on a large area of the south and east of the country.\u0000Materials and methods. An analytical review of a number of scientific publications devoted to the study of zoonotic diseases of the population accompanied by the appearance of exanthems on the skin was carried out. State legislative acts on issues of ensuring sanitary and epidemic welfare of citizens of Ukraine during wartime were also considered. The search for information was carried out in the medical databases PubMed, Elsevier, High Wire Press, Google Scholar for the period 2000—2022 according to the terms of the catalog of medical topics, subject headings with keywords: «dermatozoonosis», «exanthema», «epidemiology», «morbidity», «outbreak». Meta-analyses and reviews of relevant literature were studied. The work presents the principles of a scientific approach to the optimization of preventive and anti-epidemic measures to combat infectious zoonotic diseases, which should contribute to the maximally rational use of the laws of classical epidemiology in the conditions of war in order to increase the practical effectiveness of the anti-epidemic and dermatological services of the Ministry of Health of Ukraine.Results and discussion. The complex socio-economic situation of martial law and forced mass resettlement created quite favorable conditions for increasing the incidence of infectious zoonotic diseases in population, including their real outbreaks in certain territories near the front. The article describes methodical and diagnostic approaches, specific epidemiological principles and dermatological criteria for building effective measures to combat zoonotic diseases. A professional justification of the role and place of each of them in various infectious diseases is given, taking into account the provisions of general epidemiology and traditional dermatological semiotics.\u0000Conclusions. The principles of mandatory complexity and qualified impact on the main link of the epidemic process are of great importance in the fight against various groups of infectious diseases. Their clinically justified and timely administrative use is necessary to achieve the goals of eradication, elimination and control of infectious diseases. In Ukraine, there is a sufficient normative and legal framework for the proper provision of sanitary and epidemic welfare of the population. In order to prevent the spread of existing or potential infectious agents, in particular emerging pathogens, it is necessary to develop and improve the already existing emergency response plan, particularly, the infrastructure of the health care system, to create a multi-level network of diagnostic laboratories and an integrated system of epidemiological surveillance. I","PeriodicalId":23420,"journal":{"name":"Ukrainian Journal of Dermatology, Venerology, Cosmetology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74946889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Non-dermatological interests of well-known dermatologists","authors":"S. S. Korkhov, M. Lebediuk","doi":"10.30978/ujdvk2023-2-51","DOIUrl":"https://doi.org/10.30978/ujdvk2023-2-51","url":null,"abstract":"In the turmoil of everyday life, in a series of events determined by the struggle between the concepts of «want» and «should», we look forward to the moment when there will be an opportunity to take up our favorite business. And it is inspiring because a hobby is something we do purely for pleasure.It is difficult to imagine a person who does not have any hobbies. In our historical research, we focused on interests, hobbies and preferences that go beyond the main work of more than one hundred well-known dermatologists, venereologists and some other specialists associated with dermatovenereology. For the most adventurous of them, such hobbies became an integral part of life, a key to the complex labyrinths of their spiritual world, a mirror of their worldview, a tuning fork of their morality.The names of most of the people mentioned in the article are inscribed in golden letters in the history of medicine and dermatovenerology in particular. They made many scientific discoveries, their brilliant clinical experience helped to heal and alleviate the suffering of a huge number of patients, they are talented teachers who generously shared their knowledge with their students. At the same time, most of them had high civic qualities.We have tried to reveal little-known pages of the lives of our esteemed colleagues. We modestly peeked behind the scenes to better see and appreciate what was happening on the main stage.So, the presented material is about our outstanding colleagues and their hobbies, banal, remarkable and diverse: love for painting, music, literature; collecting; passion for sports and other options for active pastime; extraordinary, exotic preferences and other things that can hardly be considered as hobbies which for some of our colleagues became perhaps more important than the medical vocation.","PeriodicalId":23420,"journal":{"name":"Ukrainian Journal of Dermatology, Venerology, Cosmetology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89091112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Caio Leal Carvalho, Ivana Nascimento Garcia de Santana, Paula Silva Rubio, Tassia Cruz Poit, Joelly Taynara Lapinski Levermann, Cristiane Ferreira Rallo de Almeida, Mário César Miranda Almeida
{"title":"Refractory Pityriasis rubra pilaris treated with Adalimumab: a case report","authors":"Caio Leal Carvalho, Ivana Nascimento Garcia de Santana, Paula Silva Rubio, Tassia Cruz Poit, Joelly Taynara Lapinski Levermann, Cristiane Ferreira Rallo de Almeida, Mário César Miranda Almeida","doi":"10.15406/jdc.2023.07.00236","DOIUrl":"https://doi.org/10.15406/jdc.2023.07.00236","url":null,"abstract":"Pityriasis Rubra Pilaris (PRP) is a rare inflammatory dermatosis, clinically presenting as a keratinization disorder, with follicular and palmoplantar hyperkeratosis, in addition to orange-red scaly plaques, accompanied by characteristic islands of healthy skin. Sometimes, conventional treatment proves to be ineffective, and this work aims to present a case of a patient with failed first and second lines treatment options, responding well to adalimumab. Despite of all options available, more qualified and specific studies are needed to establish a standardized treatment based on evidence of a high scientific level, thus raising the degree of efficacy and therapeutic safety in PRP.","PeriodicalId":23420,"journal":{"name":"Ukrainian Journal of Dermatology, Venerology, Cosmetology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136310703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marisa Gonzaga da Cunha, Ana Lúcia Gonzaga da Cunha, Luciana Gasques, Carlos D Apparecida Machado Filho, Fernando A Fonseca
{"title":"Treatment of deep wrinkles with superficial application technique of hyaluronic acid","authors":"Marisa Gonzaga da Cunha, Ana Lúcia Gonzaga da Cunha, Luciana Gasques, Carlos D Apparecida Machado Filho, Fernando A Fonseca","doi":"10.15406/jdc.2023.07.00229","DOIUrl":"https://doi.org/10.15406/jdc.2023.07.00229","url":null,"abstract":"Introduction: Throughout the aging process, the skin is subject to continuous structural, cellular and molecular modifications that affect not only its mechanical properties but also its biological and physiological functions, which clinically, it manifests with dry skin, loss of elasticity and the consequent appearance of fine lines, wrinkles and creases, representing a therapeutic challenge with a difficult solution. Objective: To describe the superficial application technique of cohesive polydensified matrix hyaluronic acid (Belotero soft®) for the resolutive treatment of superficial perioral, periorbicular and lateral wrinkles and creases of the face. Conclusion: The superficial and transversal application technique showed to be ideal for the treatment of wrinkles and superficial creases, without description of important adverse effects or Tyndall effect with the cohesive polydensified matrix hyaluronic acid that was applied.","PeriodicalId":23420,"journal":{"name":"Ukrainian Journal of Dermatology, Venerology, Cosmetology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135891579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Polymorphism of VDR (Bsml) gene in patients with atopic dermatitis","authors":"E. Garibeh","doi":"10.30978/ujdvk2022-3-4-5","DOIUrl":"https://doi.org/10.30978/ujdvk2022-3-4-5","url":null,"abstract":"Objective — to study the significance of the BsmI (rs1544410) gene of the VDR as a genetic molecular marker of the risk of atopic dermatitis (AD) development. \u0000Materials and methods. The study included 54 patients with atopic dermatitis (the main group). The control group consisted of 32 people. All of the participants of this study lived in Podilliya region and had Ukrainian origin. The method of allele detection is based on the polymorphism of the length of restriction fragments that are obtained after treatment with certain restriction enzymes. BsmI polymorphism was studied, the international polymorphism code is rs1544410. Correct distribution of genotype frequencies was determined in accordance with Hardy—Weinberg’s law. Statistically significant differences were considered at p < 0.05. \u0000Results and discussion. Analysis of the genotypes of single nucleotide polymorphism rs1544410 of VDR gene in patients with atopic dermatitis showed the predominance of the heterozygous variant (G/A). However, the proportion of allele A reached (47.2 ± 3.7) %, which may indicate a significant number of people with increased risk of atopic dermatitis development. According to our study of the single nucleotide polymorphism of the BsmI gene of the VDR among the subjects of the control group, the percentage of A/A-genotype carriers was significantly lower than that of individuals with G/G (р = 0.028) and G/A-genotype (р = 0.023). While comparing the distribution of genotypes and alleles of single-nucleotide polymorphism BsmI VDR gene among individuals of the main and the control groups, we noted that allele A was more common in patients with atopic dermatitis (47.2 vs. 39.07 %, (OR 1.412; 95 % SI 0.203—0.978; р = 0.271). According to the obtained data, the carriers of the A/A-genotype dominated among the patients with severe atopic dermatitis, in contrast to the patients with a moderate course of the disease in whom G/A-genotype predominated. Carriers of the G/A- and G/G-genotypes also predominated among the patients with a mild course of the disease. Their number was significantly higher than that of the patients with the A/A-genotype (p < 0.05).Conclusions. Polymorphism of the VDR rs1544410 gene may be associated with an increased risk of atopic dermatitis development. Carriers of A/A-genotype of VDR rs1544410 gene are more common among patients with atopic dermatitis than among healthy persons of the control group.","PeriodicalId":23420,"journal":{"name":"Ukrainian Journal of Dermatology, Venerology, Cosmetology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86487501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Modern approaches to complex treatment of patients with localized scleroderma using narrowband phototherapy (UVB-spectrum) with a wave length of 311 nm","authors":"T. Lytynska","doi":"10.30978/ujdvk2022-3-4-29","DOIUrl":"https://doi.org/10.30978/ujdvk2022-3-4-29","url":null,"abstract":"Localizeds cleroderma (LC) is a chronic multifactorial disease characterized by a long, chronic, progressive course with successive stages of inflammation, fibrosis, and atrophy. The relevance and medico-social importance of LC (Morphea disease) is determined not only by the permanent increase in the number of patients with this pathology, but also by the variety of clinical manifestations of the disease, the increase in the number of cases of a severe aggressive course, errors in diagnosis, and the lack of effective treatment methods.Objective — to increase the effectiveness of treatment of patients with various clinical forms of LC (Morfea’s disease) by including narrow-band phototherapy (UVB-spectrum) with a wave length of 311 nm into complex therapy. \u0000Materials and methods. 42 patients with LC (plaque and linear forms), extragenital scleroatrophic lichen and idiopathic Pazini—Pierini atrophoderma) were examined and treated. The evaluation of therapy effectiveness was based on the results of treatment of patients who were randomly divided into two clinical groups. The patients of the main group were prescribed narrow-band phototherapy (UVB spectrum) with a wavelength of 311 nm against the background of basic therapy. The patients of the comparison group were given basic therapy. \u0000Results and discussion. As a result of the complex treatment of patients in the main group, significant improvement was observed in 11 (32.6 %), improvement in 14 (41.2 %), stabilization of the process in 9 (26.5 %). In the patients of the comparison group, improvement was noted in 2 (25 %), stabilization of the process — in 3 (37.5 %), preservation of the negative dynamics and further progression of the process — in 3 (37.5 %). Within 12 months after the end of the course of treatment, relapses of the disease were observed in 11.8 % of patients of the main group against 63 % of people in the comparison group. \u0000Conclusions. The inclusion of narrow-band phototherapy (UVB-spectrum) with a wavelength of 311 nm in complex therapy increases the effectiveness of treatment and reduces the frequency of relapses in patients with various clinical forms of LC.The use of narrow-band phototherapy (UVB-spectrum) with a wave length of 311 nm in the complex therapy of LC is possible both in inpatient and outpatient settings.","PeriodicalId":23420,"journal":{"name":"Ukrainian Journal of Dermatology, Venerology, Cosmetology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76628968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The use of a longpulse neodymium (LPNd:YAG) laser in treatment of patients with human papillomavirus (common and plantar warts)","authors":"Zh.V. Korolova, Е.О. Vasilchuk","doi":"10.30978/ujdvk2022-3-4-17","DOIUrl":"https://doi.org/10.30978/ujdvk2022-3-4-17","url":null,"abstract":"Objective — to compare the effectiveness of a non-ablative method of treatment with the use of a neodymium laser and cryodestruction in patients with vulgar warts. \u0000Materials and methods. 45 patients with vulgar warts, who were selected according to inclusion and exclusion criteria based on retrospective analysis of disease histories, were under observation. Three groups of patients were formed: 1st — treatment using the traditional method of laser therapy with a neodymium laser, 2nd — combined laser therapy with additional treatment of the affected areas with a laser scanner, 3rd — cryodestruction of warts. The Fotona SP Spectro new laser system — a long-pulse neodymium laser on yttria aluminum garnet (LP-Nd:YAG) with a wavelength of 1064 nm, a Fotona S11 scanner and Cry-Аc cryospray — was used for treatment. \u0000Results and discussion. According to the observation data within a year from the start of therapy, the best result according to the criterion of the speed of achieving positive treatment results and the absence of the appearance of new elements was noted in patients of the 2nd group who underwent combined laser therapy. Significant advantages of laser therapy over cryodestruction have been determined, both according to the results of this study and according to the literature. \u0000Conclusions. The combined method of laser therapy requires further careful study, but, without a doubt, is the most effective both in terms of aesthetic results and pathogenetic ones, since the action of laser radiation leads primarily to the neutralization of infected cells on the entire treatment area. Also, this combined technique allows reducing the recurrence of papillomavirus infection, and is practically painless for the patient. Based on the data obtained in the study, it can be concluded that the use of a neodymium laser is an effective alternative to cryotherapy, and significantly reduces the duration of treatment.","PeriodicalId":23420,"journal":{"name":"Ukrainian Journal of Dermatology, Venerology, Cosmetology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89458302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Oral allergy syndrome. Literature review","authors":"A. Bogomolov","doi":"10.30978/ujdvk2022-3-4-49","DOIUrl":"https://doi.org/10.30978/ujdvk2022-3-4-49","url":null,"abstract":"Objective — to improve the methods of differential diagnosis and management of patients with oral allergy syndrome (OAS). \u0000Materials and methods. A literature review is presented and diagnostic approaches and principles of management of patients with OAS are analyzed. \u0000Results and discussion. OAS is a type of food allergy limited to the oral mucosa and triggered primarily by raw fruits, vegetables, flavorings, and nuts. Data on the prevalence of OAS vary considerably from study to study due to the use of different patient inclusion and exclusion criteria. However, there are reports of its frequency from 4.7 to more than 20 % in children and from 13 to 53.8 % in adults. It is reliably known that among the children’s population, OAS is mostly diagnosed in teenagers. Etiologically, OAS is caused by food allergens; mostly these are unprocessed fruits and raw vegetables that enter the patient’s oropharynx. Food allergens that cause OAS are actually inactivated by the gastric juice, so the reaction usually stops after the food is swallowed. \u0000Conclusions. OAS is a subtype of food allergy that can be found in the practice of allergists, dermatologists, general practitioners. After contact with food, patients experience the following symptoms: itching of the lips and oropharynx; paresthesia; angioedema of the mucous membrane of the oral cavity, tongue, palate and oropharynx; sometimes hoarseness is possible. Modern therapy of OAS involves the use of a complex approach, which includes adherence to an elimination diet, pharmacotherapy, and allergen-specific immunotherapy. Antihistamines, corticosteroids, and adrenaline (intramuscular) are most often used in pharmacotherapy.","PeriodicalId":23420,"journal":{"name":"Ukrainian Journal of Dermatology, Venerology, Cosmetology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74854676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Design of the future of european dermatovenerology","authors":"Prepared by K.V. Kolyadenko, O.Ye. Fedorenko","doi":"10.30978/ujdvk2022-3-4-54","DOIUrl":"https://doi.org/10.30978/ujdvk2022-3-4-54","url":null,"abstract":"","PeriodicalId":23420,"journal":{"name":"Ukrainian Journal of Dermatology, Venerology, Cosmetology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77671686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}