World Journal of Cardiology最新文献

{"title":"Recognizing and preventing complications regarding bioresorbable scaffolds during coronary interventions.","authors":"George Latsios, Leonidas Koliastasis, Konstantinos Toutouzas, Kostas Tsioufis","doi":"10.4330/wjc.v16.i9.508","DOIUrl":"10.4330/wjc.v16.i9.508","url":null,"abstract":"<p><p>The evolution of coronary intervention techniques and equipment has led to more sophisticated procedures for the treatment of highly complex lesions. However, as a result, the risk of complications has increased, which are mostly iatrogenic and often include equipment failure. Stent dislodgement warrants vigilance for the early diagnosis and a stepwise management approach is required to either expand or retrieve the lost stent. In the era of bioresorbable scaffolds that are not radiopaque, increased caution is required. Intravascular imaging may assist in detecting the lost scaffold in cases of no visibility fluoroscopically. Adequate lesion preparation is the key to minimizing the possibility of equipment loss; however, in the case that it occurs, commercially available and improvised devices and techniques may be applied.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"16 9","pages":"508-511"},"PeriodicalIF":1.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355258","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":"Medical dilemma: Programmed death 1 blockade (sintilimab) therapy in patients suffering from tumours combined with psoriasis.","authors":"Di Jin, Yu-Wei Wang, Zhi-Min Lin, Chen Li, Ming Li","doi":"10.4330/wjc.v16.i9.546","DOIUrl":"10.4330/wjc.v16.i9.546","url":null,"abstract":"<p><p>Tumour immunotherapy represented by immune checkpoint inhibitors (ICIs) has greatly improved the overall prognosis of patients with malignant tumours, and is regarded as an important breakthrough in the field of medicine in recent years. ICIs have gradually become the core of tumour therapy and are increasingly used in the clinic. In order to achieve early clinical prediction and management of immune-related adverse events (irAEs), it is still necessary to perform further research on the mechanisms, risk factors, and predictors of irAE occurrence in the future. Zhou <i>et al</i> describe the consultation of a patient with advanced gastric cancer combined with chronic plaque psoriasis. This case provides an important reference for the use of programmed cell death protein-1 (PD-1) inhibitors in patients of tumours combined with chronic plaque psoriasis. This case also highlights that screening of high-risk groups for irAEs is critical before applying PD-1 inhibitors to patients with chronic psoriasis combined with tumours. PD-1 inhibitors are new and potent antineoplastic agents that can cause serious immune-related adverse events such as toxic epidermal necrolysis release and psoriasis. Glucocorticosteroids are the first-line agents for irAEs. The incidence of rheumatic irAEs may be higher in reality, which will inevitably become a new challenge for rheumatologists and dermatologists.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"16 9","pages":"546-549"},"PeriodicalIF":1.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355257","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":"Left bundle branch area pacing: A new era of cardiac resynchronization therapy?","authors":"Carlo Alberto Caruzzo, Elia Rigamonti, Francesca Romana Scopigni","doi":"10.4330/wjc.v16.i9.542","DOIUrl":"10.4330/wjc.v16.i9.542","url":null,"abstract":"<p><p>The recent systematic review and meta-analysis provided a comprehensive focus on the current state of cardiac resynchronization therapy (CRT). The authors determined the feasibility of physiological left bundle branch area pacing (LBBAP) in patients indicated for CRT through a careful analysis of trials. They found that LBBAP was associated with significant reductions in QRS duration, New York Heart Association functional class, B-type natriuretic peptide levels, and pacing thresholds as well as improvements in echocardiographic parameters compared to biventricular pacing.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"16 9","pages":"542-545"},"PeriodicalIF":1.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355255","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":"Contemporary nationwide trends in major adverse cardiovascular events in young cannabis users without concomitant tobacco, alcohol, cocaine use.","authors":"Rupak Desai, Priyatham Gurram, Adil S Mohammed, Rishabh B Salian, Shanmukh Sai Pavan Lingamsetty, Sandeep Guntuku, Ravi Venkata Sai Krishna Medarametla, Rawnak Jahan, Zainab Muslehuddin, Paritharsh Ghantasala","doi":"10.4330/wjc.v16.i9.512","DOIUrl":"10.4330/wjc.v16.i9.512","url":null,"abstract":"<p><strong>Background: </strong>Cannabis use has increased among young individuals in recent years. Although dependent cannabis use disorder (CUD) has been associated with various cardiac events, its effects on young adults without concurrent substance use remain understudied.</p><p><strong>Aim: </strong>To examine trends in hospitalizations for major adverse cardiac and cerebrovascular events (MACCE) in this cohort.</p><p><strong>Methods: </strong>We used the National Inpatient Sample (2016-2019) to identify hospitalized young individuals (18-44 years), excluding those with concurrent substance usage (tobacco, alcohol, and cocaine). They were divided into CUD+ and CUD-. Using International Classification of Diseases-10 codes, we examined the trends in MACCE hospitalizations, including all-cause mortality (ACM), acute myocardial infarction (AMI), cardiac arrest (CA), and acute ischemic stroke (AIS).</p><p><strong>Results: </strong>Of 27.4 million hospitalizations among young adults without concurrent substance abuse, 4.2% (1.1 million) had co-existent CUD. In CUD+ group, hospitalization rates for MACCE (1.71% <i>vs</i> 1.35%), AMI (0.86% <i>vs</i> 0.54%), CA (0.27% <i>vs</i> 0.24%), and AIS (0.49% <i>vs</i> 0.35%) were higher than in CUD- group (<i>P</i> < 0.001). However, rate of ACM hospitalizations was lower in CUD+ group (0.30% <i>vs</i> 0.44%). From 2016 to 2019, CUD+ group experienced a relative rise of 5% in MACCE and 20% in AMI hospitalizations, compared to 22% and 36% increases in CUD- group (<i>P</i> < 0.05). The CUD+ group had a 13% relative decrease in ACM hospitalizations, compared to a 10% relative rise in CUD- group (<i>P</i> < 0.05). However, when adjusted for confounders, MACCE odds among CUD+ cohort remain comparable between 2016 and 2019.</p><p><strong>Conclusion: </strong>The CUD+ group had higher rates of MACCE, but the rising trends were more apparent in the CUD- group over time. Interestingly, the CUD+ group had lower ACM rates than the CUD- group.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"16 9","pages":"512-521"},"PeriodicalIF":1.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355252","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":"Medical appraisal of Chinese military aircrew with abnormal results of coronary computed tomographic angiography.","authors":"Jia Zeng, Yao Zhao, Di Gao, Xiang Lu, Jing-Jing Dong, Yan-Bing Liu, Bin Shen","doi":"10.4330/wjc.v16.i9.522","DOIUrl":"10.4330/wjc.v16.i9.522","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery diseases can cause myocardial ischemia and hypoxia, angina pectoris, myocardial infarction, arrhythmia, and even sudden death led to inflight incapacitation of aircrew. As the main cause of grounding due to illness, they severe threats to the health and fighting strength of military aircrew. Early warning in an early and accurate manner and early intervention of diseases possibly resulting in inflight incapacitation are key emphases of aeromedical support in clinic.</p><p><strong>Aim: </strong>To figure out the flight factors and clinical characteristics of military aircrew with abnormal results of coronary artery computed tomographic angiography (CTA), thereby rendering theoretical references for clinical aeromedical support of military flying personnel.</p><p><strong>Methods: </strong>The clinical data of 15 flying personnel who received physical examinations in a military medical center from December 2020 to June 2023 and were diagnosed with coronary artery diseases by coronary artery CTA were collected and retrospectively analyzed, and a descriptive statistical analysis was conducted on their onset age, aircraft type and clinical data.</p><p><strong>Results: </strong>The 15 military flying personnel diagnosed with coronary artery diseases by coronary artery CTA were composed of 9 pilots, 1 navigator and 5 air combat service workers. Multi-vessel disease was detected in 9 flying personnel, among which 8 (88.9%) were pilots. Flying personnel with multi-vessel disease had higher content of cholesterol, low-density lipoprotein cholesterol and apolipoprotein B than those with single-vessel disease.</p><p><strong>Conclusion: </strong>Coronary artery diseases are the major heart disease for the grounding of flying personnel due to illness, which can lead to inflight incapacitation. Coronary artery CTA is conducive to early detection and early intervention treatment of such diseases in clinic.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"16 9","pages":"522-530"},"PeriodicalIF":1.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355256","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":"Tissue-source effect on mesenchymal stem cells as living biodrugs for heart failure: Systematic review and meta-analysis.","authors":"Moaz Safwan, Mariam Safwan Bourgleh, Mohamed Aldoush, Khawaja Husnain Haider","doi":"10.4330/wjc.v16.i8.469","DOIUrl":"10.4330/wjc.v16.i8.469","url":null,"abstract":"<p><strong>Background: </strong>Mesenchymal stem cells (MSCs), as living biodrugs, have entered advanced phases of clinical assessment for cardiac function restoration in patients with myocardial infarction and heart failure. While MSCs are available from diverse tissue sources, bone-marrow-derived MSCs (BM-MSCs) remain the most well-studied cell type, besides umbilical-cord-derived MSCs (UC-MSCs). The latter offers advantages, including noninvasive availability without ethical considerations.</p><p><strong>Aim: </strong>To compare the safety and efficacy of BM-MSCs and UC-MSCs in terms of left ventricular ejection fraction (LVEF), 6-min walking distance (6MWD), and major adverse cardiac events (MACEs).</p><p><strong>Methods: </strong>Five databases were systematically searched to identify randomized controlled trials (RCTs). Thirteen RCTs (693 patients) were included using predefined eligibility criteria. Weighted mean differences and odds ratio (OR) for the changes in the estimated treatment effects.</p><p><strong>Results: </strong>UC-MSCs significantly improved LVEF <i>vs</i> controls by 5.08% [95% confidence interval (CI): 2.20%-7.95%] at 6 mo and 2.78% (95%CI: 0.86%-4.70%) at 12 mo. However, no significant effect was observed for BM-MSCs <i>vs</i> controls. No significant changes were observed in the 6MWD with either of the two cell types. Also, no differences were observed for MACEs, except rehospitalization rates, which were lower only with BM-MSCs (odds ratio 0.48, 95%CI: 0.24-0.97) <i>vs</i> controls.</p><p><strong>Conclusion: </strong>UC-MSCs significantly improved LVEF compared with BM-MSCs. Their advantageous characteristics position them as a promising alternative to MSC-based therapy.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"16 8","pages":"469-483"},"PeriodicalIF":1.9,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112715","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":"Nomogram predicting the cardiovascular disease mortality for older patients with colorectal cancer: A real-world population-based study.","authors":"Jia-Yu Tan, Shuo-Hao Shen","doi":"10.4330/wjc.v16.i8.458","DOIUrl":"10.4330/wjc.v16.i8.458","url":null,"abstract":"<p><strong>Background: </strong>Cardio-oncology has received increasing attention especially among older patients with colorectal cancer (CRC). Cardiovascular disease (CVD)-specific mortality is the second-most frequent cause of death. The risk factors for CVD-specific mortality among older patients with CRC are still poorly understood.</p><p><strong>Aim: </strong>To identify the prognostic factors and construct a nomogram-based model to predict the CVD-specific mortality among older patients with CRC.</p><p><strong>Methods: </strong>The data on older patients diagnosed with CRC were retrieved from The Surveillance, Epidemiology, and End Results database from 2004 to 2015. The prognostic factors and a nomogram-based model predicting the CVD-specific mortality were assessed using least absolute shrinkage and selection operator and Cox regression.</p><p><strong>Results: </strong>A total of 141251 eligible patients with CRC were enrolled, of which 41459 patients died of CRC and 12651 patients died of CVD. The age at diagnosis, sex, marital status, year of diagnosis, surgery, and chemotherapy were independent prognostic factors associated with CVD-specific mortality among older patients with CRC. We used these variables to develop a model to predict CVD-specific mortality. The calibration curves for CVD-specific mortality probabilities showed that the model was in good agreement with actual observations. The C-index value of the model in the training cohort and testing cohort for predicting CVD-specific mortality was 0.728 and 0.734, respectively.</p><p><strong>Conclusion: </strong>The proposed nomogram-based model for CVD-specific mortality can be used for accurate prognostic prediction among older patients with CRC. This model is a potentially useful tool for clinicians to identify high-risk patients and develop personalized treatment plans.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"16 8","pages":"458-468"},"PeriodicalIF":1.9,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142117119","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":"Quality of life and functional capacity in patients after cardiac surgery intensive care unit.","authors":"Vasiliki Raidou, Katerina Mitete, Christos Kourek, Michael Antonopoulos, Theodora Soulele, Kyriaki Kolovou, Ioannis Vlahodimitris, Ioannis Vasileiadis, Stavros Dimopoulos","doi":"10.4330/wjc.v16.i8.436","DOIUrl":"10.4330/wjc.v16.i8.436","url":null,"abstract":"<p><p>Coronary heart disease and aortic stenosis are prevalent cardiovascular diseases worldwide, leading to morbidity and mortality. Coronary artery bypass grafting (CABG) and surgical aortic valve replacement (SAVR) have therapeutic benefits, including improved postoperative quality of life (QoL) and enhanced patient functional capacity which are key indicators of cardiac surgery outcome. In this article, we review the latest studies of QoL outcomes and functional capacity in patients who underwent cardiac surgery. Many standardized instruments are used to evaluate QoL and functional conditions. Preoperative health status, age, length of intensive care unit stay, operative risk, type of procedure, and other pre-, intra-, and postoperative factors affect postoperative QoL. Elderly patients experience impaired physical status soon after cardiac surgery, but it improves in the following period. CABG and SAVR are associated with increases of physical and mental health and functional capacity in the immediate postoperative and the long long-term. Cardiac rehabilitation improves patient functional capacity, QoL, and frailty following cardiac surgery.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"16 8","pages":"436-447"},"PeriodicalIF":1.9,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112713","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":"Unloading and successful treatment with bioresorbable stents during percutaneous coronary intervention: A case report.","authors":"Tao Sun, Ming-Xue Zhang, Yan Zeng, Li-Hua Ruan, Yi Zhang, Cheng-Long Yang, Zhang Qin, Jing Wang, Hai-Mei Zhu, Yun Long","doi":"10.4330/wjc.v16.i8.484","DOIUrl":"10.4330/wjc.v16.i8.484","url":null,"abstract":"<p><strong>Background: </strong>With the development of percutaneous coronary intervention (PCI), the number of interventional procedures without implantation, such as bioresorbable stents (BRS) and drug-coated balloons, has increased annually. Metal drug-eluting stent unloading is one of the most common clinical complications. Comparatively, BRS detachment is more concealed and harmful, but has yet to be reported in clinical research. In this study, we report a case of BRS unloading and successful rescue.</p><p><strong>Case summary: </strong>This is a case of a 59-year-old male with the following medical history: \"Type 2 diabetes mellitus\" for 2 years, maintained with metformin extended-release tablets, 1 g PO BID; \"hypertension\" for 20 years, with long-term use of metoprolol sustained-release tablets, 47.5 mg PO QD; \"hyperlipidemia\" for 20 years, without regular medication. He was admitted to the emergency department of our hospital due to intermittent chest pain lasting 18 hours, on February 20, 2022 at 15: 35. Electrocardiogram results showed sinus rhythm, ST-segment elevation in leads I and avL, and poor R-wave progression in leads V1-3. High-sensitivity troponin I level was 4.59 ng/mL, indicating an acute high lateral wall myocardial infarction. The patient's family requested treatment with BRS, without implantation. During PCI, the BRS became unloaded but was successfully rescued. The patient was followed up for 2 years; he had no episodes of angina pectoris and was in generally good condition.</p><p><strong>Conclusion: </strong>We describe a case of a 59-year-old male experienced BRS unloading and successful rescue. By analyzing images, the causes of BRS unloading and the treatment plan are discussed to provide insights for BRS release operations. We discuss preventive measures for BRS unloading.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"16 8","pages":"484-490"},"PeriodicalIF":1.9,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112716","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":"Antiphospholipid syndrome presenting as recurrent coronary thrombosis: A case report.","authors":"Xue-Chen Liu, Wei Wang, Lian-Yi Wang","doi":"10.4330/wjc.v16.i8.491","DOIUrl":"10.4330/wjc.v16.i8.491","url":null,"abstract":"<p><strong>Background: </strong>Antiphospholipid syndrome (APS) is a chronic autoimmune disease characterized by venous or arterial thrombosis, pregnancy morbidity and a variety of other autoimmune and inflammatory complications. Here, we report a case of APS associated with multiple coronary thromboses.</p><p><strong>Case summary: </strong>The patient, a 28-year-old male, suffered from recurrent coronary thromboses over a period of 31 months. Despite undergoing interventional coronary procedures, thrombolytic therapy, and anticoagulation treatment, the condition persisted intermittently. An extensive search for underlying thrombogenic factors revealed a diagnosis of APS. Accurate adjustment of the medication regimen led to the absence of further acute coronary syndrome (ACS) episodes during the subsequent 20-month follow-up. Although the patient occasionally experiences chest tightness, no further symptoms of distress have been reported.</p><p><strong>Conclusion: </strong>APS can manifest as ACS. Screening for rheumatologic and immunological conditions is essential when encountering patients with multiple coronary thromboses. Treatment strategy should include symptomatic relief and a targeted and aggressive approach to address the underlying pathophysiology.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"16 8","pages":"491-495"},"PeriodicalIF":1.9,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112712","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}