Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"Análisis de modelos algorítmicos de aprendizaje automático para la predicción del estado vital a los seis meses tras fractura de cadera en pacientes mayores de 74 años","authors":"I. Calvo Lorenzo,&nbsp;I. Uriarte Llano,&nbsp;M.R. Mateo Citores,&nbsp;Y. Rojo Maza,&nbsp;U. Agirregoitia Enzunza","doi":"10.1016/j.recot.2024.05.005","DOIUrl":"10.1016/j.recot.2024.05.005","url":null,"abstract":"<div><h3>Background and objective</h3><div>The objective is to develop a model that predicts vital status six months after fracture as accurately as possible. For this purpose we will use five different data sources obtained through the National Hip Fracture Registry, the Health Management Unit and the Economic Management Department.</div></div><div><h3>Material and methods</h3><div>The study population is a cohort of patients over 74 years of age who suffered a hip fracture between May 2020 and December 2022. A warehouse is created from five different data sources with the necessary variables. An analysis of missing values and outliers as well as unbalanced classes of the target variable («vital status») is performed. Fourteen different algorithmic models are trained with the training. The model with the best performance is selected and a fine tuning is performed. Finally, the performance of the selected model is analyzed with test data.</div></div><div><h3>Results</h3><div>A data warehouse is created with 502 patients and 144 variables. The best performing model is Linear Regression. Sixteen of the 24 cases of deceased patients are classified as live, and 14 live patients are classified as deceased. A sensitivity of 31%, an accuracy of 34% and an area under the curve of 0.65 is achieved.</div></div><div><h3>Conclusions</h3><div>We have not been able to generate a model for the prediction of six-month survival in the current cohort. However, we believe that the method used for the generation of algorithms based on machine learning can serve as a reference for future works.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Pages 47-54"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141159015","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":"Understanding limb necrotizing infections: A comprehensive approach","authors":"A. Garrido-Hidalgo ,&nbsp;J. García-Coiradas ,&nbsp;M. Echevarría-Marín ,&nbsp;S. Llanos ,&nbsp;J.A. Valle-Cruz ,&nbsp;F. Marco","doi":"10.1016/j.recot.2024.03.012","DOIUrl":"10.1016/j.recot.2024.03.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Necrotizing soft tissue infections (NSTI) are increasing, posing a significant risk of morbidity and mortality. Due to nonspecific symptoms, a high index of suspicion is crucial. Treatment involves a multidisciplinary approach, with broad-spectrum antibiotics, early surgical debridement, and life support. This study analyzes the characteristics, demographics, complications, and treatment of NSTI in a hospital in Madrid, Spain.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted, including all surgically treated NSTI patients at our center from January 2016 to December 2022, examining epidemiological and clinical data. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) was prospectively calculated for all patients.</div></div><div><h3>Results</h3><div>Twenty-two patients (16 men, 6 women, mean age 54.8) were included. Median time from symptom onset to emergency room visit was 3.5 days. All reported severe treatment-resistant pain; sixteen had fever exceeding 37.8<!--> <!-->°C (72.7%). Skin lesions occurred in twelve (54.5%), and thirteen had hypotension and tachycardia (59.1%).</div><div>Treatment involved resuscitative support, antibiotherapy, and radical debridement. Median time to surgery was 8.25<!--> <!-->h. Intraoperative cultures were positive in twenty patients: twelve <em>Streptococcus pyogenes</em>, four <em>Staphylococcus aureus</em>, one <em>Escherichia coli</em>, and four polymicrobial infection. In-hospital mortality rate was 22.73%.</div></div><div><h3>Conclusions</h3><div>We examined the correlation between our results, amputation rates and mortality with LRINEC score and time to surgery. However, we found no significant relationship unlike some other studies. Nevertheless, a multidisciplinary approach with radical debridement and antibiotic therapy remains the treatment cornerstone. Our hospital stays, outcomes and mortality rates align with our literature review, confirming high morbimortality despite early and appropriate intervention.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Pages 9-16"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140768641","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":"[Translated article] Medial tab-type fasciocutaneous flap as an alternative for the management of soft tissue defects of the leg","authors":"X. Ríos Garrido ,&nbsp;A. De la Rosa ,&nbsp;L. Arzuza Ortega ,&nbsp;G. Vargas Lievano ,&nbsp;J. Molina Gándara ,&nbsp;D.A. Tellez Gamarra ,&nbsp;C. Medina Monje","doi":"10.1016/j.recot.2024.11.007","DOIUrl":"10.1016/j.recot.2024.11.007","url":null,"abstract":"<div><h3>Background</h3><div>Selecting the right technique for lower limb soft tissue reconstruction is a therapeutic challenge. Despite having several reconstruction options, it's important to choose a technique that is effective and with the least possible donor site morbidity.</div></div><div><h3>Objective</h3><div>Demonstrate the therapeutic efficacy of the medial tab flap in soft tissue reconstruction on the leg, compared to conventional flaps.</div></div><div><h3>Materials and methods</h3><div>Cohort study matched by age. 64 patients with soft tissue defects were selected and according to the intervention divided in: group (1) medial tab flap, and group (2) conventional flaps (sural, soleus, gastrocnemius) followed up to one year postoperatively. Outcome variables: surgical time in minutes, healing, healing time in days, complications.</div></div><div><h3>Results</h3><div>The patients who underwent surgery with medial tab flap and with conventional flaps healed completely. The healing time was 16.2<!--> <!-->±<!--> <!-->11.2 days in the tab flap and 16.1<!--> <!-->±<!--> <!-->11.2 days in conventional flaps, no statistically significant differences were found between the groups (<em>p</em> <!-->=<!--> <!-->.89).</div><div>The surgical time for tab flaps was 225.2<!--> <!-->±<!--> <!-->117.8<!--> <!-->min, and 191.3<!--> <!-->±<!--> <!-->117.2<!--> <!-->min for the comparison flaps (<em>p</em> <!-->=<!--> <!-->.65), there were no statistically significant differences. There were no complications in the medial tab flaps.</div></div><div><h3>Conclusion</h3><div>The findings suggest that the medial tab flap technique is as effective as the conventional flap technique, with complete flap survival and healing, and without any major complications in this studied group.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Pages T17-T26"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630266","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":"[Artículo traducido] Infecciones necrosantes de partes blandas: aproximación diagnóstico-terapéutica","authors":"A. Garrido-Hidalgo ,&nbsp;J. García-Coiradas ,&nbsp;M. Echevarría-Marín ,&nbsp;S. Llanos ,&nbsp;J.A. Valle-Cruz ,&nbsp;F. Marco","doi":"10.1016/j.recot.2024.11.002","DOIUrl":"10.1016/j.recot.2024.11.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Necrotizing soft tissue infections (NSTI) are increasing, posing a significant risk of morbidity and mortality. Due to nonspecific symptoms, a high index of suspicion is crucial. Treatment involves a multidisciplinary approach, with broad-spectrum antibiotics, early surgical debridement, and life support. This study analyzes the characteristics, demographics, complications, and treatment of NSTI in a hospital in Madrid, Spain.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted, including all surgically treated NSTI patients at our center from January 2016 to December 2022, examining epidemiological and clinical data. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) was prospectively calculated for all patients.</div></div><div><h3>Results</h3><div>Twenty-two patients (16 men, 6 women, mean age 54.8) were included. Median time from symptom onset to emergency room visit was 3.5 days. All reported severe treatment-resistant pain; sixteen had fever exceeding 37.8<!--> <!-->°C (72.7%). Skin lesions occurred in twelve (54.5%), and thirteen had hypotension and tachycardia (59.1%). Treatment involved resuscitative support, antibiotherapy, and radical debridement. Median time to surgery was 8.25<!--> <!-->h. Intraoperative cultures were positive in twenty patients: twelve <em>Streptococcus pyogenes</em>, four <em>Staphylococcus aureus</em>, one <em>Escherichia coli</em>, and four polymicrobial infection. In-hospital mortality rate was 22.73%.</div></div><div><h3>Conclusions</h3><div>We examined the correlation between our results, amputation rates and mortality with LRINEC score and time to surgery. However, we found no significant relationship unlike some other studies. Nevertheless, a multidisciplinary approach with radical debridement and antibiotic therapy remains the treatment cornerstone. Our hospital stays, outcomes and mortality rates align with our literature review, confirming high morbimortality despite early and appropriate intervention.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Pages T9-T16"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630279","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":"[Translated article] New times, same objectives","authors":"M. Herrera-Pérez","doi":"10.1016/j.recot.2024.11.016","DOIUrl":"10.1016/j.recot.2024.11.016","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Page T1"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693780","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":"[Translated article] Preoperative instillation of epinephrine and lidocaine can reduce surgical time in the endoscopic treatment of GTPS","authors":"R. Seijas Vazquez ,&nbsp;F. Montaña I Pararols ,&nbsp;A. Ferré-Aniorte ,&nbsp;P. Laiz Boada ,&nbsp;M. Vázquez Gómez ,&nbsp;R. Cugat","doi":"10.1016/j.recot.2024.11.013","DOIUrl":"10.1016/j.recot.2024.11.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Greater trochanteric pain syndrome (GTPS) is a multifactorial clinical condition affecting the lateral area of the hip. Although conservative treatment shows good results, some patients may still require surgical bursectomy, which can be performed either openly or endoscopically. One of the main technical difficulties of the endoscopic procedure is intraoperative bleeding, which can hinder the medical team's vision and increase the operation time for endoscopic treatment of GTPS. <em>Hypothesis</em>: An instillation of vasoconstrictors and local anaesthetics before endoscopy will cause less intraoperative bleeding, which will translate into shorter surgical time.</div></div><div><h3>Materials and methods</h3><div>A prospective cohort was retrospectively divided based on the use or absence of a preoperative instillation of physiological saline solution with epinephrine and lidocaine. Surgical time was measured in each procedure and compared between the two groups.</div></div><div><h3>Results</h3><div>One hundred thirty-nine hips from 139 patients were included in the analysis. One hundred two patients were included in the instillation group versus 37 in the control group. The surgical time was significantly shorter in the instillation group than in the control group, with an average (standard deviation) of 52.01 (14.71) and 72.30 (11.70)<!--> <!-->min, respectively (<em>p</em> <!-->&lt;<!--> <!-->.001).</div></div><div><h3>Conclusion</h3><div>The instillation of a physiological saline solution with epinephrine and lidocaine prior to the surgical treatment of GTPS is effective in reducing surgical times, likely due to a reduction in intraoperative bleeding. Future research should focus on more direct outcomes such as intraoperative blood loss and between different instillation protocols.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Pages T77-T82"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630268","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":"[Artículo traducido] Análisis retrospectivo de supervivencia del uso de vástagos modulares cónicos no cementados para la revisión en fracturas periprotésicas tipo B de Vancouver. ¿Es la inestabilidad una amenaza para la supervivencia?","authors":"J. Lixa,&nbsp;P. Vieira,&nbsp;P. Pereira,&nbsp;A. Pinho,&nbsp;M. Seara,&nbsp;A. Sousa,&nbsp;L. Vieira","doi":"10.1016/j.recot.2024.11.004","DOIUrl":"10.1016/j.recot.2024.11.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Periprosthetic hip fractures show increasing incidence and complexity, representing a challenge for the surgeon. We aimed to evaluate the survival of uncemented modular tapered stems in the treatment of periprosthetic Vancouver B2 and B3 type fractures and review the main complications and factors associated with decreased survival.</div></div><div><h3>Materials and methods</h3><div>We performed a retrospective study of patients submitted to revision arthroplasty for treatment of periprosthetic femoral stem Vancouver B2 and B3 type fractures with an uncemented modular fluted tapered stem (MRP-Titan). Demographic and radiographic parameters were analyzed. The survival rate (free of reoperation) was calculated at 2- and 5-years using the Kaplan–Meier survivorship analysis.</div></div><div><h3>Results</h3><div>Thirty-nine patients were included with a mean age of 73.5 years and a mean follow-up of 5 years. Arthroplasty survivorship at 2 years was 73.7% and at 5 years was 67.5% (mean 8.4 years; range 6.7–10.2). Survivorship was inferior in the patients with episodes of instability (mean 2.5 years; range 0–5.42) (<em>p</em> <!-->&lt;<!--> <!-->0.001). At least one episode of instability occurred in 26.3% of patients and 60% of these patients had a femoral head size 32<!--> <!-->mm or lower. At least one episode of instability occurred in 71.4% of patients with a greater trochanter fracture (<em>p</em> <!-->=<!--> <!-->0.008). The consolidation rate was 90.6% and the mortality rate was 23.7%. In the group of patients that died, 55.6% were submitted to at least one revision surgery (<em>p</em> <!-->=<!--> <!-->0.044).</div></div><div><h3>Conclusion</h3><div>Survivorship of an uncemented modular stem (MRP-Titan) in revision for PHF is significantly reduced by episodes of instability.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Pages T2-T8"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630274","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":"Nuevos tiempos, mismos objetivos","authors":"M. Herrera-Pérez","doi":"10.1016/j.recot.2024.11.001","DOIUrl":"10.1016/j.recot.2024.11.001","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Page 1"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630283","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":"Explorando el potencial de la inteligencia artificial en traumatología: respuestas conversacionales a preguntas específicas","authors":"F. Canillas del Rey ,&nbsp;M. Canillas Arias","doi":"10.1016/j.recot.2024.05.004","DOIUrl":"10.1016/j.recot.2024.05.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Generative Artificial Intelligence is a technology that provides greater connectivity with people through conversational bots («chatbots»). These bots can engage in dialogue using natural language indistinguishable from humans and are a potential source of information for patients.The aim of this study is to examine the performance of these bots in solving specific issues related to orthopedic surgery and traumatology using questions from the Spanish MIR exam between 2008 and 2023.</div></div><div><h3>Material and methods</h3><div>Three «chatbot» models (ChatGPT, Bard and Perplexity) were analyzed by answering 114 questions from the MIR. Their accuracy was compared, the readability of their responses was evaluated, and their dependence on logical reasoning and internal and external information was examined. The type of error was also evaluated in the failures.</div></div><div><h3>Results</h3><div>ChatGPT obtained 72.81% correct answers, followed by Perplexity (67.54%) and Bard (60.53%).Bard provides the most readable and comprehensive responses. The responses demonstrated logical reasoning and the use of internal information from the question prompts. In 16 questions (14%), all 3 applications failed simultaneously. Errors were identified, including logical and information failures.</div></div><div><h3>Conclusions</h3><div>While conversational bots can be useful in resolving medical questions, caution is advised due to the possibility of errors. Currently, they should be considered as a developing tool, and human opinion should prevail over Generative Artificial Intelligence.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Pages 38-46"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088915","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":"La instilación preoperatoria de epinefrina y lidocaína puede reducir el tiempo quirúrgico del tratamiento endoscópico del SDTM","authors":"R. Seijas Vazquez ,&nbsp;F. Montaña I Pararols ,&nbsp;A. Ferré-Aniorte ,&nbsp;P. Laiz Boada ,&nbsp;M. Vázquez Gómez ,&nbsp;R. Cugat","doi":"10.1016/j.recot.2024.06.013","DOIUrl":"10.1016/j.recot.2024.06.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Greater Trochanteric Pain Syndrome (GTPS) is a multifactorial clinical condition affecting the lateral area of the hip. Although conservative treatment shows good results, some patients may still require surgical bursectomy, which can be performed either openly or endoscopically. One of the main technical difficulties of the endoscopic procedure is intraoperative bleeding, which can hinder the medical team's vision and increase the operation time for endoscopic treatment of GTPS. <em>Hypothesis</em>: An instillation of vasoconstrictors and local anesthetics before endoscopy will cause less intraoperative bleeding, which will translate into shorter surgical time.</div></div><div><h3>Materials and methods</h3><div>A prospective cohort was retrospectively divided based on the use or absence of a preoperative instillation of physiological saline solution with epinephrine and lidocaine. Surgical time was measured in each procedure and compared between the two groups.</div></div><div><h3>Results</h3><div>One hundred thirty-nine hips from 139 patients were included in the analysis. One hundred two patients were included in the instillation group versus 37 in the control group. The surgical time was significantly shorter in the instillation group than in the control group, with an average (standard deviation) of 52.01 (14.71) and 72.30 (11.70) minutes, respectively (<em>P</em>&lt;.001).</div></div><div><h3>Conclusion</h3><div>The instillation of a physiological saline solution with epinephrine and lidocaine prior to the surgical treatment of GTPS is effective in reducing surgical times, likely due to a reduction in intraoperative bleeding. Future research should focus on more direct outcomes such as intraoperative blood loss and between different instillation protocols.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 1","pages":"Pages 77-82"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724665","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}