International Journal of Hematology-Oncology and Stem Cell Research最新文献

{"title":"The Importance of Pseudo Thrombocytopenia Due to Platelet Cold Agglutination before Surgery, What Should We Do? A Case Report","authors":"Mohammad Ghorbani, Amin Solouki, Farhang Soltani, Amir Moayedpour, Zahra Khoshnegah","doi":"10.18502/ijhoscr.v18i1.14749","DOIUrl":"https://doi.org/10.18502/ijhoscr.v18i1.14749","url":null,"abstract":"Platelet cold agglutination (PCA) is a rare in-vitro phenomenon caused by Immunoglobulin M (IgM) autoantibodies, which results in Ethylenediaminetetraacetic Acid (EDTA) independent pseudo thrombocytopenia (PTCP). Its diagnosis is made based on the peripheral blood smear (PBS) examination and pre-test warming blood sample. \u0000Here, a case of PTCP secondary to PCA is presented. He was first admitted for pre-surgical tests but his platelet count was low. His blood was taken with EDTA and sodium citrate anticoagulant to rule pre-analytical error out. Then his sample warmed up and the test was run again with Mindray BC-6000 automated cell counter. Moreover, the rheumatologic tests were done for him. \u0000His platelet count was 23×109/L at first, and PBS showed many platelet aggregates. The low platelet count was not correct with Sodium Citrate or re-sampling with EDTA so platelet satellitism and improper sampling were ruled out. By warming the sample up to 37⸰C, the Platelet count rose to 216×109 / L.  The rheumatologic tests were negative except for HLA-B27 which was positive. \u0000Finally, he was diagnosed with PCA which is due to a cold antibody (clinically insignificant). This diagnosis is important for the prevention of recurrent tests, unnecessary platelet transfusion, and other problems. Here these conditions will be discussed.","PeriodicalId":38991,"journal":{"name":"International Journal of Hematology-Oncology and Stem Cell Research","volume":"18 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139609666","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":"Clinical Characteristics and Outcomes in Hospitalized Patients with COVID-19 and Cancer History: A Multicenter Cross-Sectional Study in Southwestern Iran","authors":"J. Zarei, Abbas Sheikhtaheri, Mehrnaz Ahmadi, Maria Cheraghi, A. Talaiezadeh, Adeleh Khazami","doi":"10.18502/ijhoscr.v18i1.14744","DOIUrl":"https://doi.org/10.18502/ijhoscr.v18i1.14744","url":null,"abstract":"Background: Cancer patients are more exposed to opportunistic infections, such as COVID-19, due to their poor health status. This study aimed to identify the clinical characteristics of cancer and non-cancer patients with COVID-19 that may lead to death, intubation, and ICU admission. \u0000Materials and Methods: A Multicenter Cross-Sectional study was conducted on confirmed COVID-19 adult patients with and without a history of cancer from March 2019 to March 2021. Demographic and clinical features, ICU admission, intubation, and discharge status have been extracted from patients’ medical records. Chi-square, odds ratio, Mann-Whitney test, and logistic regression were used to analyze the data. \u0000Results: The death rate in 1332 cancer patients was 28% compared to the 91464 noncancer patients which was 9% with an odds ratio of 3.94 and p<0.001. ICU admission rates among the cancer group were 43%, while in the noncancer group, it was 17.9% (p<0.001). Moreover, intubation was done for 20.9% of cancer patients and 7.4% of non-cancer patients (p<0.001). However, no significant difference was observed between the two groups in terms of length of stay in the hospital. Multivariable logistic regression analysis showed that age, level of consciousness, SPO2, and autoimmune disorders were associated with mortality in cancer patients with COVID-19. \u0000Conclusion: This study showed that older age, loss of consciousness, low oxygen saturation, and suffering from autoimmune disorders were the predictors of death in cancer patients with COVID-19. These results can have important implications for the management and care of cancer patients with COVID-19.","PeriodicalId":38991,"journal":{"name":"International Journal of Hematology-Oncology and Stem Cell Research","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139610275","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":"Donor Cell-Derived Myelodysplastic Syndrome Following Allogenic Peripheral Blood Stem Cell Transplant.","authors":"Ujjwala Narang,&nbsp;Sanjay Tewari","doi":"10.18502/ijhoscr.v17i2.12651","DOIUrl":"https://doi.org/10.18502/ijhoscr.v17i2.12651","url":null,"abstract":"<p><p>Donor cell-derived leukemia is a rare but well-described complication of allogeneic hematopoietic stem cell transplant (HSCT). This clinical case report aims to highlight the importance of recognizing this unusual disorder and thus, ensuring its appropriate management. We herein describe a case of a 9-year-old male diagnosed with acute lymphoblastic leukemia (ALL) and relapsed after initial chemotherapy. Subsequently, the patient had an allogenic peripheral blood stem cell transplant (PBSCT) from an HLA-matched, unrelated donor. Unfortunately, the patient then developed progressive thrombocytopenia, and following investigation, including bone marrow examination and cytogenetic analysis, he was diagnosed with donor cell-derived myelodysplastic syndrome. The literature review emphasizes the importance of considering it as a differential diagnosis of disease relapse following allogeneic HSCT.</p>","PeriodicalId":38991,"journal":{"name":"International Journal of Hematology-Oncology and Stem Cell Research","volume":"17 2","pages":"125-127"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/07/9a/IJHOSCR-17-125.PMC10452952.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10107377","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":"FAT1 Gene Expression in Iranian Acute Lymphoid and Myeloid Leukemia Patients.","authors":"Mohammadreza Ostadali Dehagi,&nbsp;Shahrbano Rostami,&nbsp;Ahmadreza Shamshiri,&nbsp;Fatemeh Safari,&nbsp;Reza Haji Hosseini,&nbsp;Rick F Thorne,&nbsp;Ardeshir Ghavamzadeh","doi":"10.18502/ijhoscr.v17i2.12644","DOIUrl":"https://doi.org/10.18502/ijhoscr.v17i2.12644","url":null,"abstract":"<p><strong>Background: </strong>FAT atypical cadherin 1 (FAT1) is a member of the cadherin superfamily whose loss or gain is associated with the initiation and/or progression of different cancers. FAT1 overexpression has been reported in hematological malignancies. This research intended to investigate FAT1 gene expression in adult Iranian acute leukemia patients, compared to normal mobilized peripheral blood CD34+ cells.</p><p><strong>Materials and methods: </strong>The peripheral blast (peripheral blood mononuclear cells) cells of 22 acute myeloid leukemia (AML), 14 acute lymphoid leukemia (ALL) patients, and mobilized peripheral blood CD34+ cells of 12 healthy volunteer stem cell donors were collected. Then, quantitative real-time polymerase chain reaction (qPCR) was used to compare FAT1 gene expression.</p><p><strong>Results: </strong>Overall, there were no significant differences in FAT1 expression between AML and ALL patients (p>0.2). Nonetheless, the mean expression level of FAT1 was significantly higher in leukemic patients (AML and ALL) than in normal CD34+ cells (p=0.029). Additionally, the FAT1 expression levels were significantly higher in both CD34+ and CD34- leukemic patients than in normal CD34+ cells (p=0.028).</p><p><strong>Conclusion: </strong>No significant differences were found between FAT1 expression in CD34+ and CD34- leukemic samples (p> 0.3). Thus, higher FAT1 expression was evident in ALL and AML leukemia cells but this appeared unrelated to CD34 expression. This suggests in a proportion of adult acute leukemia, FAT1 expression may prove to be a suitable target for therapeutic strategies.</p>","PeriodicalId":38991,"journal":{"name":"International Journal of Hematology-Oncology and Stem Cell Research","volume":"17 2","pages":"81-88"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7f/e4/IJHOSCR-17-81.PMC10452949.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10107382","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":"Prognostic Significance of Microvessel Density in Invasive Ductal Carcinoma of Breast.","authors":"Ata Abbasi,&nbsp;Farzaneh Ghaffarizadeh,&nbsp;Hengameh Mojdeganlou","doi":"10.18502/ijhoscr.v17i2.12646","DOIUrl":"https://doi.org/10.18502/ijhoscr.v17i2.12646","url":null,"abstract":"<p><p><b>Background:</b> Breast cancer is the most common malignant tumor and cause of death in women. Factors that play role in tumor metastasis are lymph node involvement, lack of tumor differentiation and hormone receptor expression, high proliferation rate, and angiogenesis. In the present study, we tried to evaluate the microvessel density (MVD) using Immunohistochemistry for the CD34 marker to investigate the amount of angiogenesis in breast cancer and its relationship with other histopathological parameters and compare it with normal tissue. <b>Materials and Methods:</b> 58 paraffin-embedded samples of breast cancer were enrolled. All blocks were sectioned and stained for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2(HER 2/neu), ki67, and CD34 by immunohistochemistry (IHC) method. <b>Results:</b> The mean age of patients in this study was 49.6 ± 10.6 years. Statistically, there was a significant relationship between the grade of the tumor (P = 0.01), absence of expression of estrogen receptor (P = 0.008), and progesterone receptor (P = 0.003) with MVD. <b>Conclusion:</b> Due to the association between MVD, tumor grade, and absence of ER and PR expression, this valuable marker can play an important role in the prediction of prognosis in breast cancer patients and can lead to new-targeted therapy in the future.</p>","PeriodicalId":38991,"journal":{"name":"International Journal of Hematology-Oncology and Stem Cell Research","volume":"17 2","pages":"100-105"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/77/4f/IJHOSCR-17-100.PMC10452950.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10110633","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 Evaluation of Hematological Parameters and Their Correlation with Disease Prognosis in COVID-19 Disease in Iran.","authors":"Farhad Shahi,&nbsp;Sayyed Reza Safaee Nodehi,&nbsp;Saba Fekrvand,&nbsp;Fatemeh Fathi,&nbsp;Mohammad Reza Dabiri,&nbsp;Alireza Abdollahi,&nbsp;Hanieh Hosseini","doi":"10.18502/ijhoscr.v17i2.12645","DOIUrl":"https://doi.org/10.18502/ijhoscr.v17i2.12645","url":null,"abstract":"<p><p><b>Background:</b> Since 2019, Coronavirus has been a highly contagious disease. The COVID-19 outbreak was declared a pandemic by the World Health Organization in March 2020. Variable laboratory findings are reported in COVID-19 patients, among which elevated levels of D-dimer, lactate dehydrogenase, as well as lymphopenia, have been reported to be associated with increased severity of disease symptoms requiring ventilator support, intensive care unit admission, and mortality. <b>Materials and Methods:</b> In the current study, inclusion criteria were: patient age above 18 years and hospitalization in the Imam Khomeini hospital with COVID-19 disease confirmed with nasopharyngeal swab polymerase chain reaction tests. Levels of white blood cells, neutrophils, lymphocytes, hemoglobin, platelets, D-dimer, C-reactive protein, LDH, and ferritin were measured and their correlation with the final patients' outcome was evaluated. <b>Results:</b> A total of 208 patients were included in the present study. Higher neutrophil to lymphocyte ratio, (WBC count excluding lymphocyte)/lymphocyte, LDH, platelet to lymphocyte ratio, ferritin, and D-dimer were significantly related to O₂ dependency. Neutrophil to lymphocyte ratio, (WBC count excluding lymphocyte)/lymphocyte and LDH were significantly related to higher rates of mortality. Higher Hb and lymphocyte count were significantly related to higher rates of survival. <b>Conclusion:</b> Hematological parameters including neutrophil to lymphocyte ratio, (WBC count excluding lymphocyte)/lymphocyte, LDH, platelet to lymphocyte ratio, ferritin, D-dimer, Hb, and lymphocyte count were significantly related to the prognosis of patients with COVID-19 disease. This could help decide which COVID-19 patients have priority for hospitalization and intensive medical care, particularly when the pandemic disease causes limitations in healthcare service.</p>","PeriodicalId":38991,"journal":{"name":"International Journal of Hematology-Oncology and Stem Cell Research","volume":"17 2","pages":"89-99"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0f/0f/IJHOSCR-17-89.PMC10452951.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10112657","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":"Epstein-Barr Viral Infection and the Risk for Breast Cancer: A Systematic Review.","authors":"Arjola Agolli,&nbsp;Angela Ishak,&nbsp;Mahima Viswanathan,&nbsp;Edzel Lorraine Co,&nbsp;Jeevan Shivakumar,&nbsp;Olsi Agolli","doi":"10.18502/ijhoscr.v17i2.12650","DOIUrl":"https://doi.org/10.18502/ijhoscr.v17i2.12650","url":null,"abstract":"<p><p><b>Background</b>: The prevalence of breast cancer has increased and has currently become one of the most common cancers. Although the majority of the world's population is infected with Epstein Barr Virus (EBV) during their lives, the severity of symptoms varies and not everyone infected with EBV is diagnosed with cancer. EBV might increase the risk for breast cancer either by activating the HER2/HER3 signaling cascades or by creating a state of prolonged immune stimulation. <b>Materials and Methods</b>: A systematic search of several electronic databases including PubMed, ScienceDirect, Cochrane, EBSCOhost, JSTOR, and Scopus, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. The primary outcome of this review was to assess the prevalence of people with breast cancer that had a prior EBV infection. <b>Results</b>: For this review, 24 case-control studies were accepted. Our analyses included 1.989 breast cancer cases versus 1.034 control cases. EBV was found to be present in 27.9% of breast cancer cases versus 8.02% found in the normal breast tissue of controls. All affected people were women with a mean age was 48.19 years. The most common type of breast cancer found in EBV-infected tissues was invasive breast cancer. Cases were reported sporadically in a wide geographical distribution, and the prevalence varied from 4.6% - 64.1%. <b>Conclusions</b>: A previous EBV infection might be associated with a higher risk for breast malignancy. The most common type is invasive cancer. It mainly affects women and geographical variances are observed. More studies are necessary to elucidate the role of EBV in the mechanisms of breast cancer. Also, it is crucial to improve the prevention and treatment strategies.</p>","PeriodicalId":38991,"journal":{"name":"International Journal of Hematology-Oncology and Stem Cell Research","volume":"17 2","pages":"114-124"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/f8/IJHOSCR-17-114.PMC10452945.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10165030","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 Obesity Controversy: Does It Impact Treatment Response in Diffuse Large B-Cell Lymphoma?","authors":"Suheyla Atak,&nbsp;Stemi Serin,&nbsp;Naciye Demirel,&nbsp;Esma Evrim Dogan,&nbsp;Demet Aydın,&nbsp;Nihan Nizam,&nbsp;Ilknur Mansuroglu,&nbsp;Rafet Eren","doi":"10.18502/ijhoscr.v17i2.12643","DOIUrl":"https://doi.org/10.18502/ijhoscr.v17i2.12643","url":null,"abstract":"<p><p><b>Background:</b> We aimed to investigate the association of body mass index (BMI) with treatment response in patients with DLBCL. <b>Material and Methods:</b> Seventy-nine DLBCL subjects were included in this study. Data about patient age, sex, serum LDH level, presence of B symptoms, IPI score, ECOG performance score, disease stage, extranodal involvement, and BMI values at diagnosis were retrieved by retrospective patient record review. Patients were staged according to Ann Arbor classification using CT and/or PET/CT findings, and the presence of B symptoms. Body mass index was calculated by dividing weight in kilograms by height in meters squared (kg/m²). Patients were divided into groups according to their BMI as underweight (BMI≤ 18.5 kg/m²), normal weight (BMI 18.5-25 kg/m²), overweight (BMI 25-30 kg/m²), and obese (BMI≥ 30 kg/m²), as defined by the World Health Organization. <b>Results:</b> Patients were divided into four groups according to their BMIs, but because there was only one patient in the underweight group, comparisons were performed between normal-weight, overweight, and obese patients. There was no statistically significant difference between these groups in terms of age, sex, serum LDH level, disease stage, presence of B symptoms, extranodal involvement, ECOG performance score, IPI score and treatment response (p= 0.070, 0.704, 0.325, 0.464, 0.254, 0.152, 0.658, 0.620, and 0.947, respectively). <b>Conclusion</b>: In our study, we showed that BMI has no significant impact on treatment response in patients with DLBCL.</p>","PeriodicalId":38991,"journal":{"name":"International Journal of Hematology-Oncology and Stem Cell Research","volume":"17 2","pages":"75-80"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3c/5a/IJHOSCR-17-75.PMC10452947.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10112661","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":"Atypical Course of SarsCov-2 Infection in a Patient with Multiple Myeloma Treated with Autologous Stem Cell Transplantation.","authors":"Gianluca Isaia,&nbsp;Silvia Valerio,&nbsp;Stefania Oliva,&nbsp;Enrico Brunetti,&nbsp;Mario Bo","doi":"10.18502/ijhoscr.v17i2.12652","DOIUrl":"https://doi.org/10.18502/ijhoscr.v17i2.12652","url":null,"abstract":"<p><p>Covid-19 infection has more relevant consequences in frail and comorbid patients, but little is known about its course in patients with hematologic malignancies. In this report, we would like to present the case of a patient with multiple myeloma treated with recent autologous bone marrow stem cell transplantation and affected by Covid-19 pneumonia, presenting with a possible reinfection or an extremely long viral shedding.</p>","PeriodicalId":38991,"journal":{"name":"International Journal of Hematology-Oncology and Stem Cell Research","volume":"17 2","pages":"128-131"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/99/d1/IJHOSCR-17-128.PMC10452944.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10165031","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":"Trastuzumab and ECG Changes Dilemma.","authors":"Azin Alizadehasl,&nbsp;Mina Mohseni,&nbsp;Feridoun Noohi Bezanjani,&nbsp;Majid Maleki,&nbsp;Kamran Roudini","doi":"10.18502/ijhoscr.v17i2.12641","DOIUrl":"https://doi.org/10.18502/ijhoscr.v17i2.12641","url":null,"abstract":"The Article Abstract is not available.","PeriodicalId":38991,"journal":{"name":"International Journal of Hematology-Oncology and Stem Cell Research","volume":"17 2","pages":"63-64"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/50/IJHOSCR-17-63.PMC10452953.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10110632","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}