Clocks & Sleep最新文献

{"title":"Effectiveness of Enriched Milk with Ashwagandha Extract and Tryptophan for Improving Subjective Sleep Quality in Adults with Sleep Problems: A Randomized Double-Blind Controlled Trial.","authors":"Silvia Pérez-Piñero, Juan Carlos Muñoz-Carrillo, Jon Echepare-Taberna, Macarena Muñoz-Cámara, Cristina Herrera-Fernández, Vicente Ávila-Gandía, María Heres Fernández Ladreda, Javier Menéndez Martínez, Francisco Javier López-Román","doi":"10.3390/clockssleep6030028","DOIUrl":"10.3390/clockssleep6030028","url":null,"abstract":"<p><p>A randomized, double-blind and controlled study was conducted to assess the effectiveness of the intake of 250 mL of lactose-free skimmed milk enriched with ashwagandha (<i>Withania somnifera</i>) alone or combined with tryptophan vs. non-enriched milk (control) on the subjective quality of sleep in healthy adults with sleep problems. The duration of supplementation was 90 days. Fifty-two eligible subjects were assigned to the study arms of ashwagandha 250 mg, ashwagandha 250 mg plus tryptophan 175 mg, ashwagandha 600 mg, and control with 13 subjects in each group. It was hypothesized that ashwagandha plus tryptophan could be superior to ashwagandha alone for improving sleep-related variables. Changes in the visual analogue scale (VAS) for sleep quality were significantly higher in the three experimental groups as compared with controls (<i>p</i> = 0.014). Improvements in the subscales of the Pittsburg Sleep Quality Index (PSQI) were found in all groups, but between-group differences were not significant. In the index of insomnia severity, decreases were higher in the three experimental groups as compared with controls especially in the group of ashwagandha 600 mg. Daytime somnolence was also reduced in the three experimental groups. Changes in anxiety levels and Morningness-Eveningness Questionnaire were not observed. The study products did not elicit changes in body composition and were well tolerated and safe. The data did not support the hypothesis, as the combination of ashwagandha and tryptophan did not show greater benefits in improving sleep quality than ashwagandha alone. However, the results from the three experimental groups containing ashwagandha were more favorable compared to the placebo group.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"6 3","pages":"417-432"},"PeriodicalIF":2.1,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074059","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":"The Impact of Lunch Timing on Nap Quality.","authors":"Jennifer E Fudge, Emily T Peterson, Shae-Lynn M Koe, Hans C Dringenberg","doi":"10.3390/clockssleep6030027","DOIUrl":"10.3390/clockssleep6030027","url":null,"abstract":"<p><strong>Purpose: </strong>Previous research has established that food intake is a biological regulator of the human sleep-wake cycle. As such, the timing of eating relative to sleep may influence the quality of sleep, including daytime naps. Here, we examine whether the timing of lunch (1 h vs. 2 h interval between lunch and a napping opportunity) impacts the quality of an afternoon nap.</p><p><strong>Methods: </strong>Using a randomized within-subject design over two separate experimental sessions (7 days apart), participants (<i>n</i> = 40, mean age = 25.8 years) consumed lunch 1 h and 2 h prior to an afternoon nap opportunity. Polysomnography and subjective self-reports were used to assess sleep architecture, sleepiness levels, and nap quality.</p><p><strong>Results: </strong>Results revealed no significant differences in subjective ratings of sleep quality and sleepiness, or in sleep architecture (total sleep time, sleep efficiency, sleep onset latency, sleep stages) between the 1 h and 2-h lunch conditions.</p><p><strong>Conclusions: </strong>All sleep measures were similar when napping followed eating by either 1 h or 2 h, suggesting that eating closer to nap onset may not negatively impact sleep architecture and quality. Future research should continue to identify conditions that improve nap quality, given the well-documented benefits of naps to reduce sleep pressure and improve human performance.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"6 3","pages":"402-416"},"PeriodicalIF":2.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074061","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":"Generative Models for Periodicity Detection in Noisy Signals.","authors":"Ezekiel Barnett, Olga Kaiser, Jonathan Masci, Ernst C Wit, Stephany Fulda","doi":"10.3390/clockssleep6030025","DOIUrl":"10.3390/clockssleep6030025","url":null,"abstract":"<p><p>We present the Gaussian Mixture Periodicity Detection Algorithm (GMPDA), a novel method for detecting periodicity in the binary time series of event onsets. The GMPDA addresses the periodicity detection problem by inferring parameters of a generative model. We introduce two models, the Clock Model and the Random Walk Model, which describe distinct periodic phenomena and provide a comprehensive generative framework. The GMPDA demonstrates robust performance in test cases involving single and multiple periodicities, as well as varying noise levels. Additionally, we evaluate the GMPDA on real-world data from recorded leg movements during sleep, where it successfully identifies expected periodicities despite high noise levels. The primary contributions of this paper include the development of two new models for generating periodic event behavior and the GMPDA, which exhibits high accuracy in detecting multiple periodicities even in noisy environments.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"6 3","pages":"359-388"},"PeriodicalIF":2.1,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074060","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":"The Impact of Sleep on Haematological Parameters in Firefighters.","authors":"Sara Alves, Francisca Silva, Filipa Esteves, Solange Costa, Klara Slezakova, Maria Alves, Maria Pereira, João Teixeira, Simone Morais, Adília Fernandes, Felisbina Queiroga, Josiana Vaz","doi":"10.3390/clockssleep6030021","DOIUrl":"10.3390/clockssleep6030021","url":null,"abstract":"<p><p>Sleep is a vital process that impacts biological functions such as cell renewal, bone regeneration, and immune system support. Disrupted sleep can interrupt erythropoiesis, leading to fewer red blood cells, reduced haemoglobin concentration, and decreased haematocrit levels, potentially contributing to haematological disorders. This is particularly concerning for shift workers for example firefighters. While previous studies have explored sleep's adverse effects on various professions, research specific to firefighters is limited. This study investigates the relationship between sleep quality and haematological parameters among firefighters in Northeast Portugal. From a sample of 201 firefighters, variations in red blood cells, haemoglobin, and haematocrit values were linked to sleep quality. The study utilised non-parametric tests (Wilcoxon-Mann-Whitney, Spearman's correlation) to explore the connection between sleep quality and haematological profile. The impact of covariates on haematological parameters was assessed using non-parametric ANCOVA (Quade's). A multiple regression analysis was employed to further understand how sleep quality and various confounding variables impact haematological levels. Findings suggest a negative link between sleep quality and haematological levels, meaning that as sleep quality deteriorates, there is a tendency for haematological levels to decrease, as indicated by Spearman's correlation (rRBC = -0.157, pRBC = 0.026; rHb = -0.158, pHb = 0.025; rHCT = -0.175, pHCT = 0.013). As observed in scientific literature, the correlation found suggests a possible inhibition of erythropoiesis, the process responsible for red blood cell production. Despite firefighters presenting a haematological profile within the reference range (RBC: 5.1 × 10⁶/mm³ (SD ± 0.4), Hb: 15.6 g/dL (SD ± 1.3), 47% (SD ± 1.0), there is already an observable trend towards lower levels. The analysis of co-variables did not reveal a significant impact of sleep quality on haematological levels. In conclusion, this study underscores the importance of sleep quality in determining haematological parameters among firefighters. Future research should investigate the underlying mechanisms and long-term implications of poor sleep quality on firefighter health. Exploring interventions to enhance sleep quality is vital for evidence-based strategies promoting firefighter well-being.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"6 3","pages":"291-311"},"PeriodicalIF":2.1,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761333","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":"Time of Day and Sleep Deprivation Effects on Risky Decision Making.","authors":"Noelia Ruiz-Herrera, Mia Friedman, Melissa A St Hilaire, Arturo Arrona-Palacios, Charles A Czeisler, Jeanne F Duffy","doi":"10.3390/clockssleep6020020","DOIUrl":"10.3390/clockssleep6020020","url":null,"abstract":"<p><p>Previous research has revealed that daily variations in human neurobehavioral functions are driven in part by the endogenous circadian system. The objective of this study was to explore whether there exists a circadian influence on performance regarding a risky decision-making task and to determine whether the performance changes with sleep deprivation (SD). Thirteen participants underwent a 39 h constant routine (CR) protocol, during which they remained awake in constant conditions and performed the BART (balloon analogue risk task) every two hours. The mean pumps (gains) (<i>p</i> < 0.001) and balloons popped (losses) (<i>p</i> = 0.003) exhibited variation during the CR. The reaction time (RT) also showed significant variation across the CR (<i>p</i> < 0.001), with slower mean RTs in the morning hours following SD. A greater risk propensity was observed around midday before SD and a lower risk propensity after 29.5 h of being awake. The sensitivity to punishment varied during the CR, but did not follow a predictable trend. Further research using real monetary incentives and neurophysiological measures is warranted to elucidate these findings.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"6 2","pages":"281-290"},"PeriodicalIF":2.1,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11202614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141451794","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":"SleepSync: Early Testing of a Personalised Sleep-Wake Management Smartphone Application for Improving Sleep and Cognitive Fitness in Defence Shift Workers.","authors":"Prerna Varma, Svetlana Postnova, Stuart Knock, Mark E Howard, Eugene Aidman, Shantha W M Rajaratnam, Tracey L Sletten","doi":"10.3390/clockssleep6020019","DOIUrl":"10.3390/clockssleep6020019","url":null,"abstract":"<p><p>Shift work, long work hours, and operational tasks contribute to sleep and circadian disruption in defence personnel, with profound impacts on cognition. To address this, a digital technology, the SleepSync app, was designed for use in defence. A pre-post design study was undertaken to examine whether four weeks app use improved sleep and cognitive fitness (high performance neurocognition) in a cohort of shift workers from the Royal Australian Air Force. In total, 13 of approximately 20 shift-working personnel from one base volunteered for the study. Sleep outcomes were assessed using the Insomnia Severity Index (ISI), the Patient-Reported Outcomes Measurement Information System (PROMIS), Sleep Disturbance and Sleep-Related Impairment Scales, the Glasgow Sleep Effort Scale, the Sleep Hygiene Index, and mental health was assessed using the Depression, Anxiety, and Stress Scale-21. Sustained attention was measured using the 3-min Psychomotor Vigilance Task (PVT) and controlled response using the NBack. Results showed significant improvements in insomnia (ISI scores 10.31 at baseline and 7.50 after app use), sleep-related impairments (SRI T-scores 53.03 at baseline to 46.75 post-app use), and healthy sleep practices (SHI scores 21.61 at baseline to 18.83 post-app use; all <i>p</i> < 0.001). Trends for improvement were recorded for depression. NBack incorrect responses reduced significantly (9.36 at baseline; reduced by -3.87 at last week of app use, <i>p</i> < 0.001), but no other objective measures improved. These findings suggest that SleepSync may improve sleep and positively enhance cognitive fitness but warrants further investigation in large samples. Randomised control trials with other cohorts of defence personnel are needed to confirm the utility of this intervention in defence settings.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"6 2","pages":"267-280"},"PeriodicalIF":2.1,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11203003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141451793","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":"Efficacy of Morning Shorter Wavelength Lighting in the Visible (Blue) Range and Broad-Spectrum or Blue-Enriched Bright White Light in Regulating Sleep, Mood, and Fatigue in Traumatic Brain Injury: A Systematic Review.","authors":"Chin Moi Chow, Kanchana Ekanayake, Daniel Hackett","doi":"10.3390/clockssleep6020018","DOIUrl":"10.3390/clockssleep6020018","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) profoundly affects sleep, mood, and fatigue, impeding daily functioning and recovery. This systematic review evaluates the efficacy of morning shorter wavelength lighting in the visible (blue) range and broad-spectrum or blue-enriched bright white light exposure in mitigating these challenges among TBI patients. Through electronic database searches up to May 2023, studies assessing sleep, circadian rhythm, sleepiness, mood, and fatigue outcomes in TBI patients exposed to morning shorter wavelength lighting in the visible (blue) range and broad-spectrum or blue-enriched bright white light were identified. Seven studies involving 309 participants met the inclusion criteria. Results indicated consistent advancement in sleep timing among individuals with mild TBI, alongside improvements in total sleep time, mood, and reduced sleepiness with both types of light exposure, particularly in mild TBI cases. Notably, two studies demonstrated alleviation of fatigue exclusively in severe TBI cases following light exposure. Despite promising findings, evidence remains limited, emphasizing the need for future research with standardized protocols to confirm the potential and optimize the benefits of light therapy for TBI recovery.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"6 2","pages":"255-266"},"PeriodicalIF":2.1,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11202910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452709","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":"A Protocol for Evaluating Digital Technology for Monitoring Sleep and Circadian Rhythms in Older People and People Living with Dementia in the Community.","authors":"Ciro Della Monica, Kiran K G Ravindran, Giuseppe Atzori, Damion J Lambert, Thalia Rodriguez, Sara Mahvash-Mohammadi, Ullrich Bartsch, Anne C Skeldon, Kevin Wells, Adam Hampshire, Ramin Nilforooshan, Hana Hassanin, The Uk Dementia Research Institute Care Research Amp Technology Research Group, Victoria L Revell, Derk-Jan Dijk","doi":"10.3390/clockssleep6010010","DOIUrl":"10.3390/clockssleep6010010","url":null,"abstract":"<p><p>Sleep and circadian rhythm disturbance are predictors of poor physical and mental health, including dementia. Long-term digital technology-enabled monitoring of sleep and circadian rhythms in the community has great potential for early diagnosis, monitoring of disease progression, and assessing the effectiveness of interventions. Before novel digital technology-based monitoring can be implemented at scale, its performance and acceptability need to be evaluated and compared to gold-standard methodology in relevant populations. Here, we describe our protocol for the evaluation of novel sleep and circadian technology which we have applied in cognitively intact older adults and are currently using in people living with dementia (PLWD). In this protocol, we test a range of technologies simultaneously at home (7-14 days) and subsequently in a clinical research facility in which gold standard methodology for assessing sleep and circadian physiology is implemented. We emphasize the importance of assessing both nocturnal and diurnal sleep (naps), valid markers of circadian physiology, and that evaluation of technology is best achieved in protocols in which sleep is mildly disturbed and in populations that are relevant to the intended use-case. We provide details on the design, implementation, challenges, and advantages of this protocol, along with examples of datasets.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"6 1","pages":"129-155"},"PeriodicalIF":3.1,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10968838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294788","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":"Power Analysis for Human Melatonin Suppression Experiments.","authors":"Manuel Spitschan, Parisa Vidafar, Sean W Cain, Andrew J K Phillips, Ben C Lambert","doi":"10.3390/clockssleep6010009","DOIUrl":"10.3390/clockssleep6010009","url":null,"abstract":"<p><p>In humans, the nocturnal secretion of melatonin by the pineal gland is suppressed by ocular exposure to light. In the laboratory, melatonin suppression is a biomarker for this neuroendocrine pathway. Recent work has found that individuals differ substantially in their melatonin-suppressive response to light, with the most sensitive individuals being up to 60 times more sensitive than the least sensitive individuals. Planning experiments with melatonin suppression as an outcome needs to incorporate these individual differences, particularly in common resource-limited scenarios where running within-subjects studies at multiple light levels is costly and resource-intensive and may not be feasible with respect to participant compliance. Here, we present a novel framework for virtual laboratory melatonin suppression experiments, incorporating a Bayesian statistical model. We provide a Shiny web app for power analyses that allows users to modify various experimental parameters (sample size, individual-level heterogeneity, statistical significance threshold, light levels), and simulate a systematic shift in sensitivity (e.g., due to a pharmacological or other intervention). Our framework helps experimenters to design compelling and robust studies, offering novel insights into the underlying biological variability in melatonin suppression relevant for practical applications.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"6 1","pages":"114-128"},"PeriodicalIF":3.1,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10969333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294789","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":"Can the Brain's Thermostatic Mechanism Generate Sleep-Wake and NREM-REM Sleep Cycles? A Nested Doll Model of Sleep-Regulating Processes.","authors":"Arcady A Putilov","doi":"10.3390/clockssleep6010008","DOIUrl":"10.3390/clockssleep6010008","url":null,"abstract":"<p><p>Evidence is gradually accumulating in support of the hypothesis that a process of thermostatic brain cooling and warming underlies sleep cycles, i.e., the alternations between non-rapid-eye-movement and rapid-eye-movement sleep throughout the sleep phase of the sleep-wake cycle. A mathematical thermostat model predicts an exponential shape of fluctuations in temperature above and below the desired temperature setpoint. If the thermostatic process underlies sleep cycles, can this model explain the mechanisms governing the sleep cyclicities in humans? The proposed nested doll model incorporates Process s generating sleep cycles into Process S generating sleep-wake cycles of the two-process model of sleep-wake regulation. Process s produces ultradian fluctuations around the setpoint, while Process S turns this setpoint up and down in accord with the durations of the preceding wake phase and the following sleep phase of the sleep-wake cycle, respectively. Predictions of the model were obtained in an <i>in silico</i> study and confirmed by simulations of oscillations of spectral electroencephalographic indexes of sleep regulation obtained from night sleep and multiple napping attempts. Only simple-inverse exponential and exponential-functions from the thermostatic model were used for predictions and simulations of rather complex and varying shapes of sleep cycles during an all-night sleep episode. To further test the proposed model, experiments on mammal species with monophasic sleep are required. If supported, this model can provide a valuable framework for understanding the involvement of sleep-wake regulatory processes in the mechanism of thermostatic brain cooling/warming.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"6 1","pages":"97-113"},"PeriodicalIF":3.1,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10885066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933210","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}