Clinica e Investigacion en Arteriosclerosis最新文献

{"title":"Prof. Rafael Carmena Rodríguez","authors":"Juan F Ascaso","doi":"10.1016/j.arteri.2024.06.003","DOIUrl":"https://doi.org/10.1016/j.arteri.2024.06.003","url":null,"abstract":"","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 4","pages":"Pages 267-268"},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0214916824000470/pdfft?md5=6630edd5e6f1ce1259d5d554e497d908&pid=1-s2.0-S0214916824000470-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141595882","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":"Thrombotic risk assessed by PAI-1 in patients with COVID-19: The influence of hyperglycemia and diabetes mellitus","authors":"Lourdes Basurto ,&nbsp;Leticia Manuel-Apolinar ,&nbsp;Ariadna Robledo ,&nbsp;Sean O’Leary ,&nbsp;Carlos Martínez-Murillo ,&nbsp;Lina Ivette Medina-Ortíz ,&nbsp;Mario German Montes Osorio ,&nbsp;Julio Zarazua ,&nbsp;Lourdes Balcázar-Hernández ,&nbsp;Juan Carlos Anda-Garay","doi":"10.1016/j.arteri.2023.12.004","DOIUrl":"10.1016/j.arteri.2023.12.004","url":null,"abstract":"<div><h3>Objective</h3><p>To assess thrombotic risk with PAI-1 levels in patients with COVID-19, to evaluate PAI-1 differences between hyperglycemic and/or Type 2 Diabetes Mellitus (T2DM) versus non-hyperglycemic patients, and to analyze the association of plasminogen activator inhibitor-1 (PAI-1) with hyperglycemia and T2DM.</p></div><div><h3>Methods</h3><p>A cross-sectional study carried out in 181 patients hospitalized for COVID-19. Two groups were formed: the patients with hyperglycemia at admission and/or previously diagnosed T2DM group and the non-hyperglycemic group. Fibrinolysis was assessed by measuring PAI-1 levels by ELISA.</p></div><div><h3>Results</h3><p>The mean age was 59.4<!--> <!-->±<!--> <!-->16.1 years; 55.8% were male 54.1% of patients presented obesity, 38.1% had pre-existing T2DM and 50.8% had admission hyperglycemia and/or pre-existing T2DM. The patients with admission hyperglycemia and/or preexisting T2DM had higher PAI-1 compared with non-hyperglycemic patients [197.5 (128.8–315.9) vs 158.1 (113.4–201.4) ng/mL; <em>p</em> <!-->=<!--> <!-->0.031]. The glucose levels showed a positive correlation with PAI-1 levels (<em>r</em> <!-->=<!--> <!-->0.284, <em>p</em> <!-->=<!--> <!-->0.041). A multivariate logistic regression analysis showed association of PAI-1 level and hyperglycemia and pre-existing T2DM with severity of COVID-19.</p></div><div><h3>Conclusion</h3><p>Patients hospitalized for COVID-19 infection with preexisting T2DM or hyperglycemia detected during their hospitalization presented a greater increase in PAI-1 levels, which suggests that hyperglycemia contributes directly to the hypercoagulable state and probably a worse outcome from the patients.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 4","pages":"Pages 201-209"},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0214916823001195/pdfft?md5=86b08e9724c54f8fed9aa1ddc260273c&pid=1-s2.0-S0214916823001195-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139433090","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":"Consenso sobre lipoproteína (a) de la Sociedad Española de Arteriosclerosis. Revisión bibliográfica y recomendaciones para la práctica clínica","authors":"Javier Delgado-Lista ,&nbsp;Jose M. Mostaza ,&nbsp;Teresa Arrobas-Velilla ,&nbsp;Francisco Blanco-Vaca ,&nbsp;Luis Masana ,&nbsp;Juan Pedro-Botet ,&nbsp;Pablo Perez-Martinez ,&nbsp;Fernando Civeira ,&nbsp;Jose I. Cuende-Melero ,&nbsp;Jose J. Gomez-Barrado ,&nbsp;Carlos Lahoz ,&nbsp;Xavier Pintó ,&nbsp;Manuel Suarez-Tembra ,&nbsp;Jose Lopez-Miranda ,&nbsp;Carlos Guijarro","doi":"10.1016/j.arteri.2024.03.002","DOIUrl":"10.1016/j.arteri.2024.03.002","url":null,"abstract":"<div><p>The irruption of lipoprotein(a) (Lp(a)) in the study of cardiovascular risk factors is perhaps, together with the discovery and use of proprotein convertase subtilisin/kexin type 9 (iPCSK9) inhibitor drugs, the greatest novelty in the field for decades. Lp(a) concentration (especially very high levels) has an undeniable association with certain cardiovascular complications, such as atherosclerotic vascular disease (AVD) and aortic stenosis. However, there are several current limitations to both establishing epidemiological associations and specific pharmacological treatment. Firstly, the measurement of Lp(a) is highly dependent on the test used, mainly because of the characteristics of the molecule. Secondly, Lp(a) concentration is more than 80% genetically determined, so that, unlike other cardiovascular risk factors, it cannot be regulated by lifestyle changes. Finally, although there are many promising clinical trials with specific drugs to reduce Lp(a), currently only iPCSK9 (limited for use because of its cost) significantly reduces Lp(a).</p><p>However, and in line with other scientific societies, the SEA considers that, with the aim of increasing knowledge about the contribution of Lp(a) to cardiovascular risk, it is relevant to produce a document containing the current status of the subject, recommendations for the control of global cardiovascular risk in people with elevated Lp(a) and recommendations on the therapeutic approach to patients with elevated Lp(a).</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 4","pages":"Pages 243-266"},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0214916824000238/pdfft?md5=76435180d7cbcd8d281b2b14c374f51e&pid=1-s2.0-S0214916824000238-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860901","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":"Extracellular vesicles in atherosclerosis: Current and forthcoming impact?","authors":"José A Páramo, Ana Cenarro, Fernando Civeira, Carmen Roncal","doi":"10.1016/j.arteri.2024.03.006","DOIUrl":"https://doi.org/10.1016/j.arteri.2024.03.006","url":null,"abstract":"<p><p>Atherosclerosis is the main pathogenic substrate for cardiovascular diseases (CVDs). Initially categorized as a passive cholesterol storage disease, nowadays, it is considered an active process, identifying inflammation among the key players for its initiation and progression. Despite these advances, patients with CVDs are still at high risk of thrombotic events and death, urging to deepen into the molecular mechanisms underlying atherogenesis, and to identify novel diagnosis and prognosis biomarkers for their stratification. In this context, extracellular vesicles (EVs) have been postulated as an alternative in search of novel biomarkers in atherosclerotic diseases, as well as to investigate the crosstalk between the cells participating in the processes leading to arterial remodelling. EVs are nanosized lipidic particles released by most cell types in physiological and pathological conditions, that enclose lipids, proteins, and nucleic acids from parental cells reflecting their activation status. First considered cellular waste disposal systems, at present, EVs have been recognized as active effectors in a myriad of cellular processes, and as potential diagnosis and prognosis biomarkers also in CVDs. This review summarizes the role of EVs as potential biomarkers of CVDs, and their involvement into the processes leading to atherosclerosis.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877622","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":"Análisis clínico-epidemiológico de pacientes con lipoproteína(a) elevada en un hospital de tercer nivel","authors":"Manuel García de Prada ,&nbsp;Ramón Costa Segovia ,&nbsp;Marta de Castro Martínez ,&nbsp;Nuria Valdeolivas Hidalgo ,&nbsp;María Belén Sánchez López ,&nbsp;Agustín Blanco Echevarría","doi":"10.1016/j.arteri.2023.12.001","DOIUrl":"10.1016/j.arteri.2023.12.001","url":null,"abstract":"<div><h3>Objective</h3><p>The objective of the study is to describe the clinical and epidemiological characteristics of our patients with elevated Lp(a).</p></div><div><h3>Materials and methods</h3><p>A descriptive cross-sectional study was conducted on 316 patients with elevated Lp(a) (&gt;125 nmol/L) in a random sample between January and August 2022. We measured epidemiological, anthropometric, clinical and laboratory variables (lipid metabolism parameters, carbohydrates and hormones).</p></div><div><h3>Results</h3><p>Mean age of our sample subject's was 59 ± 15 years with 56% males. The average BMI was 27.6 kg/m2 (71% with elevated BMI). Elevated waist circumference was observed in 54.1% of men and 77.8% of women. 48% had hypertension, 30.7% had diabetes mellitus and 91.5% dyslipidemia. Only 39.7% of the patients had never smoked.</p><p>The mean values of total cholesterol were 158 ± 45 mg/dl, LDL was 81 ± 39 mg/dl, HDL was 53 ± 17 mg/dl, Triglycerides were 127 ± 61 mg/dl, and Lp(a) was 260 ± 129 nmol/L.</p><p>Regarding lipid lowering treatment, 89% were on statins, 68.6% on ezetimibe, and 13.7% on PCSK9 inhibitors. 177 patients (57,7%) had established cardiovascular disease (CVD), 16.3% had polyvascular disease, 11.7% had subclinical CVD, and 30.6% had no known CVD. Among patients with established CVD, 174 (98.3%) were on lipid-lowering treatment (97.2% on statins) and 86.4% were on antiplatelet therapy. The mean age of cardiovascular events was 55 ± 12 years in males and 60 ± 11 years in females. 65,1% of female and 56,2% of male patients suffered an early cardiovascular event.</p></div><div><h3>Conclusions</h3><p>Patients with elevated Lp(a) are at very high cardiovascular risk, particularly for early cardiovascular disease.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 3","pages":"Pages 118-125"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075393","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":"Hipobetalipoproteinemia familiar ApoB específica en una paciente con hiperplasia suprarrenal congénita no clásica","authors":"Beatriz Ramos Bachiller ,&nbsp;Manuel Luque-Ramírez ,&nbsp;Carmen Rodríguez-Jiménez ,&nbsp;Francisco J. Arrieta Blanco","doi":"10.1016/j.arteri.2023.12.002","DOIUrl":"10.1016/j.arteri.2023.12.002","url":null,"abstract":"<div><p>Familial hypobetalipoproteinaemia is a disorder of lipid metabolism characterized by low levels of total cholesterol, low-density lipoprotein cholesterol and apolipoprotein B. ApoB-related familial hypolipoproteinemia is an autosomal condition with a codominance inheritance pattern. Non-classical congenital adrenal hyperplasia is an autosomal recessive disorder due to mutations in the <em>CYP21A2</em>, a gene encoding for the enzyme 21-hydroxylase, which results in an androgen excess production from adrenal source. We here present the case of a 25-year-old woman with NCAH showing decreased levels of total-cholesterol, low-density lipoprotein cholesterol and triglycerides. Her parent had digestive symptoms and severe hepatic steatosis with elevated liver enzymes, as well as decreased levels of total and low-density lipoprotein cholesterol. A genetic-molecular study of the proband identified a mutation in the <em>APOB</em> gene, which allowed a diagnosis of heterozygous ApoB-related hypolipoproteinaemia to be made.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 3","pages":"Pages 128-132"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404727","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":"Estándares de la Sociedad Española de Arteriosclerosis 2024 para el control global del riesgo vascular","authors":"José María Mostaza ,&nbsp;Xavier Pintó ,&nbsp;Pedro Armario ,&nbsp;Luis Masana ,&nbsp;José T. Real ,&nbsp;Pedro Valdivielso ,&nbsp;Teresa Arrobas-Velilla ,&nbsp;Ramón Baeza-Trinidad ,&nbsp;Pilar Calmarza ,&nbsp;Jesús Cebollada ,&nbsp;Miguel Civera-Andrés ,&nbsp;José I. Cuende Melero ,&nbsp;José L. Díaz-Díaz ,&nbsp;Javier Espíldora-Hernández ,&nbsp;Jacinto Fernández Pardo ,&nbsp;Carlos Guijarro ,&nbsp;Carles Jericó ,&nbsp;Martín Laclaustra ,&nbsp;Carlos Lahoz ,&nbsp;José López-Miranda ,&nbsp;José Puzo","doi":"10.1016/j.arteri.2024.02.001","DOIUrl":"10.1016/j.arteri.2024.02.001","url":null,"abstract":"<div><p>One of the objectives of the Spanish Society of Arteriosclerosis is to contribute to the knowledge, prevention and treatment of vascular diseases, which are the leading cause of death in Spain and entail a high degree of disability and health expenditure. Atherosclerosis is a multifactorial disease and its prevention requires a global approach that takes into account the associated risk factors. This document summarises the current evidence and includes recommendations for patients with established vascular disease or at high vascular risk: it reviews the symptoms and signs to evaluate, the laboratory and imaging procedures to request routinely or in special situations, and includes the estimation of vascular risk, diagnostic criteria for entities that are vascular risk factors, and general and specific recommendations for their treatment. Finally, it presents aspects that are not usually referenced in the literature, such as the organisation of a vascular risk consultation.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 3","pages":"Pages 133-194"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0214916824000172/pdfft?md5=39f5d9b393096f14fbc00c313221dbe1&pid=1-s2.0-S0214916824000172-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140137301","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":"“Estándares de la Sociedad Española de Arteriosclerosis 2024 para el control global del riesgo vascular: Un documento de consulta imprescindible”","authors":"Fernando Civeira ,&nbsp;Rosa M. Sánchez-Hernández","doi":"10.1016/j.arteri.2024.04.003","DOIUrl":"https://doi.org/10.1016/j.arteri.2024.04.003","url":null,"abstract":"","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 3","pages":"Pages 126-127"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140825833","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":"Impacto del tratamiento con rolipram sobre la homeostasis rédox y la señalización celular en un modelo experimental de aneurisma de aorta abdominal","authors":"Lídia Puertas-Umbert ,&nbsp;Judith Alonso ,&nbsp;Elena Roselló-Díez ,&nbsp;Alicia Santamaría-Orleans ,&nbsp;José Martínez-González ,&nbsp;Cristina Rodríguez","doi":"10.1016/j.arteri.2023.11.004","DOIUrl":"10.1016/j.arteri.2023.11.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Cyclic nucleotide phosphodiesterases (PDEs) of the PDE4 subfamily are responsible for the hydrolysis and subcellular compartmentalization of cAMP, a second messenger that modulates vascular functionality. We had shown that PDE4B is induced in abdominal aortic aneurysms (AAA) and that PDE4 inhibition by rolipram limits experimental aneurysms. In this study we have delved into the mechanisms underlying the beneficial effect of rolipram on AAA.</p></div><div><h3>Methods</h3><p>AAA were induced in ApoE^-/− mice by angiotensin II (Ang II) infusion. Aneurysm formation was evaluated by ultrasonography. The expression of enzymes involved in rédox homeostasis was analyzed by real-time RT-PCR and the activation of signaling pathways by Western blot.</p></div><div><h3>Results</h3><p>Induction of PDE4B in human AAA has been confirmed in a second cohort of patients. In Ang II-infused ApoE^-/− mice, rolipram increased the percentage of animals free of aneurysms without affecting the percentage of aortic ruptures. Quantitative analyses determined that this drug significantly attenuated aortic collagen deposition. Additionally, rolipram reduced the increased <em>Nox2</em> expression triggered by Ang II, exacerbated Sod1 induction, and normalized Sod3 expression. Likewise, PDE4 inhibition decreased the activation of both ERK1/2 and the canonical Wnt pathway, while AKT activity was not altered.</p></div><div><h3>Conclusions</h3><p>The inhibition of PDE4 activity modulates the expression of enzymes involved in rédox homeostasis and affects cell signaling pathways involved in the development of AAA.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 3","pages":"Pages 108-117"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811748","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":"Validation of the IberScore model in a primary care population","authors":"Carlos Fernández-Labandera Ramos ,&nbsp;Irene Moral ,&nbsp;Carlos Brotons ,&nbsp;Luis Quevedo Aguado ,&nbsp;Inmaculada Coca Prieto ,&nbsp;Pedro Valdivielso ,&nbsp;Miguel Ángel Sánchez Chaparro","doi":"10.1016/j.arteri.2023.12.003","DOIUrl":"10.1016/j.arteri.2023.12.003","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to validate the IberScore cardiovascular risk model in a population attended in the primary care setting.</p></div><div><h3>Methods</h3><p>A cohort of patients with no history of cardiovascular disease visited in a primary care center during the years 2008 and/or 2009 and followed up until 2018 was selected.</p><p>Cardiovascular risk was calculated with the IberScore formula for all the subjects of the cohort and the model was calibrated, graphically represented by risk deciles the proportion of expected events and proportion of observed events at 10-year follow-up, stratified by sex. The area under the ROC curve was calculated to assess the discrimination of the model.</p></div><div><h3>Results</h3><p>A total of 10,085 patients visited during the years 2008 and/or 2009 were included in the study. Men showed a mean 10-year risk of suffering a fatal or non-fatal cardiovascular events according to IberScore of 17.07% (SD 20.13), with a mean estimated vascular age of more than 4 years higher than the biological age; while women had a mean 10-year risk of 7.91% (SD 9.03), with an estimated vascular age of more than 2 years above the biological age.</p><p>The area under the ROC curve showed a discrimination index of the model of 0.86 (95% CI 0.84–0.88) in men and 0.82 (95% CI 0.79–0.85) in women.</p></div><div><h3>Conclusion</h3><p>IberScore model discriminates well in the population attended in primary care but the model overestimates the risk.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 3","pages":"Pages 101-107"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139467316","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}