AnemiaPub Date : 2017-01-01Epub Date: 2017-01-30DOI: 10.1155/2017/7916348
Aimé Lukusa Kazadi, René Makuala Ngiyulu, Jean Lambert Gini-Ehungu, Jean Marie Mbuyi-Muamba, Michel Ntetani Aloni
{"title":"Factors Associated with Growth Retardation in Children Suffering from Sickle Cell Anemia: First Report from Central Africa.","authors":"Aimé Lukusa Kazadi, René Makuala Ngiyulu, Jean Lambert Gini-Ehungu, Jean Marie Mbuyi-Muamba, Michel Ntetani Aloni","doi":"10.1155/2017/7916348","DOIUrl":"https://doi.org/10.1155/2017/7916348","url":null,"abstract":"<p><p><i>Background</i>. The aim of this study was to investigate and determine the risk factors associated with poor growth among SCA children. <i>Methods.</i> A cross-sectional study was conducted in Kinshasa, the capital's country. The nutritional status was assessed using the Z scores of the anthropometric indices. <i>Results.</i> We gathered data on the 256 patients, 138 females (53.9%), who entered the study. The mean age at presentation was 8.4 ± 4.9 years of age. Underweight, stunting, and wasting were found, respectively, in 47.7%, 10.5%, and 50.3% of SCA children. A history of hand-foot syndrome, more than 3 blood transfusions, being less than 12 months of age when receiving the first transfusion, more than two severe sickle crises per year, a medical history of severe infections, and the presence of hepatomegaly were associated with poor growth. When comparing sickle cell patients under 12 years of age (<i>n</i> = 159) to a group of 296 age-matched children with normal Hb-AA, a significantly higher proportion of subjects with stunting and underweight were found among SCA. <i>Conclusion.</i> Nutritional status encountered in Congolese sickle cell children has been described for the first time in this study. A high prevalence of poor growth in SCA children was found in our study.</p>","PeriodicalId":46055,"journal":{"name":"Anemia","volume":"2017 ","pages":"7916348"},"PeriodicalIF":2.9,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/7916348","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34775927","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}
AnemiaPub Date : 2016-12-12DOI: 10.1155/2016/9817358
Aklilu Alemayehu, Lealem Gedefaw, T. Yemane, Yaregal Asres
{"title":"Prevalence, Severity, and Determinant Factors of Anemia among Pregnant Women in South Sudanese Refugees, Pugnido, Western Ethiopia","authors":"Aklilu Alemayehu, Lealem Gedefaw, T. Yemane, Yaregal Asres","doi":"10.1155/2016/9817358","DOIUrl":"https://doi.org/10.1155/2016/9817358","url":null,"abstract":"Background. Anemia is one of the major health problems among refugee pregnant women in the world. Anemia among pregnant women is multifactorial and results in detrimental consequences on the mothers and infants. The aim of this study was to determine the prevalence, severity, and determinants of anemia among pregnant women in South Sudanese refugees, Pugnido western, Ethiopia. Methods. A facility-based cross-sectional study was conducted in Pugnido Administration Refugee and Returnee Affairs Health Center from April 15 to June 30, 2015. Demographic and related data were collected using questionnaire based interview. Complete blood count was done using CELL-DYN 1800 (Abbott USA). Blood smear and fecal specimen were examined for hemoparasite and intestinal parasite, respectively. Bivariate and multivariate logistic regression analyses were done using SPSS-Version 20.0. Results. The overall prevalence of anemia was 36.1%, from whom 2.3% had severe anemia. Being in third trimester, eating meat at most once a week, drinking tea immediately after meal at least once a day, having mid-upper arm circumference below 21 centimeters, and intestinal parasitic infection were identified as independent factors of anemia. Conclusion. More than one-third of pregnant women had anemia in this study. Intervention based strategies on identified determinant factors will be very important to combat anemia among the group.","PeriodicalId":46055,"journal":{"name":"Anemia","volume":"2016 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2016-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/9817358","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64641823","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}
AnemiaPub Date : 2016-11-08DOI: 10.1155/2016/5725634
I. Sumbele, Sharon Odmia Sama, H. Kimbi, G. S. Taiwé
{"title":"Malaria, Moderate to Severe Anaemia, and Malarial Anaemia in Children at Presentation to Hospital in the Mount Cameroon Area: A Cross-Sectional Study","authors":"I. Sumbele, Sharon Odmia Sama, H. Kimbi, G. S. Taiwé","doi":"10.1155/2016/5725634","DOIUrl":"https://doi.org/10.1155/2016/5725634","url":null,"abstract":"Background. Malaria remains a major killer of children in Sub-Saharan Africa, while anaemia is a public health problem with significant morbidity and mortality. Examining the factors associated with moderate to severe anaemia (MdSA) and malarial anaemia as well as the haematological characteristics is essential. Methodology. Children (1–14 years) at presentation at the Regional Hospital Annex-Buea were examined clinically and blood samples were collected for malaria parasite detection and full blood count evaluation. Results. Plasmodium falciparum, anaemia, and malarial anaemia occurred in 33.8%, 62.0%, and 23.6% of the 216 children, respectively. Anaemia prevalence was significantly higher in malaria parasite positive children and those with fever than their respective counterparts. MdSA and moderate to severe malarial anaemia (MdSMA) were detected in 38.0% and 15.3% of the participants, respectively. The prevalence of MdSA was significantly higher in children whose household head had no formal education, resided in the lowland, or was febrile, while MdSMA was significantly higher in febrile children only. Children with MdSMA had significantly lower mean white blood cell, lymphocyte, and platelet counts while the mean granulocyte count was significantly higher. Conclusion. Being febrile was the only predictor of both MdSA and MdSMA. More haematological insult occurred in children with MdSMA compared to MdSA.","PeriodicalId":46055,"journal":{"name":"Anemia","volume":"1 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2016-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/5725634","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64436816","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}
AnemiaPub Date : 2016-02-29DOI: 10.1155/2016/9310905
V. Pathak, K. Ghosh
{"title":"Erythropoiesis in Malaria Infections and Factors Modifying the Erythropoietic Response","authors":"V. Pathak, K. Ghosh","doi":"10.1155/2016/9310905","DOIUrl":"https://doi.org/10.1155/2016/9310905","url":null,"abstract":"Anemia is the primary clinical manifestation of malarial infections and is responsible for the substantial rate of morbidity. The pathophysiology discussed till now catalogued several causes for malarial anemia among which ineffective erythropoiesis being remarkable one occurs silently in the bone marrow. A systematic literature search was performed and summarized information on erythropoietic response upon malaria infection and the factors responsible for the same. This review summarizes the clinical and experimental studies on patients, mouse models, and in vitro cell cultures reporting erythropoietic changes upon malaria infection as well as factors accountable for the same. Inadequate erythropoietic response during malaria infection may be the collective effect of various mediators generated by host immune response as well as parasite metabolites. The interplay between various modulators causing the pathophysiology needs to be explored further. Globin gene expression profiling upon malaria infection should also be looked into as abnormal production of globin chains could be a possible contributor to ineffective erythropoiesis.","PeriodicalId":46055,"journal":{"name":"Anemia","volume":"2016 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2016-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/9310905","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64608387","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}
AnemiaPub Date : 2016-02-22DOI: 10.1155/2016/1073192
A. Bekele, M. Tilahun, Aleme Mekuria
{"title":"Prevalence of Anemia and Its Associated Factors among Pregnant Women Attending Antenatal Care in Health Institutions of Arba Minch Town, Gamo Gofa Zone, Ethiopia: A Cross-Sectional Study","authors":"A. Bekele, M. Tilahun, Aleme Mekuria","doi":"10.1155/2016/1073192","DOIUrl":"https://doi.org/10.1155/2016/1073192","url":null,"abstract":"Background. Anemia during pregnancy is a major cause of morbidity and mortality of pregnant women in developing countries and has both maternal and fetal consequences. Despite its known serious effect on health, there is very little research based evidence on this vital public health problem in Gamo Gofa zone in general and in Arba Minch town of Southern Ethiopia in particular. Therefore, this study aims to assess the prevalence and factors associated with anemia among pregnant women attending antenatal care in health institutions of Arba Minch town, Gamo Gofa zone, Southern Ethiopia. Method. Institution-based, cross-sectional study was conducted from February 16 to April 8, 2015, among 332 pregnant women who attended antenatal care at government health institutions of Arba Minch town. Interviewer-administered questionnaire supplemented by laboratory tests was used to obtain the data. Bivariate and multivariate logistic regressions were used to identify predictors of anemia. Result. The prevalence of anemia among antenatal care attendant pregnant women of Arba Minch town was 32.8%. Low average monthly income of the family (AOR = 4.0; 95% CI: 5.62–11.01), having birth interval less than two years (AOR = 3.1; 95% CI: 6.01, 10.23), iron supplementation (AOR = 2.31; 95% CI: 7.21, 9.31), and family size >2 (AOR = 2.8; 95% CI: 1.17, 6.81) were found to be independent predictors of anemia in pregnancy. Conclusion. Anemia is found to be a moderate public health problem in the study area. Low average monthly income, birth interval less than two years, iron supplementation, and large family size were found to be risk factors for anemia in pregnancy. Awareness creation towards birth spacing, nutritional counselling on consumption of iron-rich foods, and iron supplementation are recommended to prevent anemia among pregnant women with special emphasis on those having low income and large family size.","PeriodicalId":46055,"journal":{"name":"Anemia","volume":"2016 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2016-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/1073192","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64203245","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}
AnemiaPub Date : 2016-02-04DOI: 10.1155/2016/8057650
T. Steinmetz, J. Schröder, M. Plath, H. Link, M. Vogt, M. Frank, N. Marschner
{"title":"Antianemic Treatment of Cancer Patients in German Routine Practice: Data from a Prospective Cohort Study—The Tumor Anemia Registry","authors":"T. Steinmetz, J. Schröder, M. Plath, H. Link, M. Vogt, M. Frank, N. Marschner","doi":"10.1155/2016/8057650","DOIUrl":"https://doi.org/10.1155/2016/8057650","url":null,"abstract":"The aim of this prospective cohort study was to assess current antianemic treatment of cancer patients in German routine practice, including diagnostics, treatments, and quality of life (QoL). 88 study sites recruited 1018 patients at the start of antianemic treatment with hemoglobin (Hb) levels <11 g/dL (females) or <12 g/dL (males). Patients were followed up for 12 weeks. 63% of the patients had inoperable solid tumors, 22% operable solid tumors, and 15% hematological malignancies. Over 85% received chemotherapy. Median age was 67 years; 48% were male. Red blood cell transfusions (RBCTx) were given to 59% of all patients and to 55% of the patients with Hb ≥8 g/dL on day 1 of the observation period (day 1 treatment). Erythropoiesis-stimulating agents (ESAs) were the second most frequently applied day 1 treatment (20%), followed by intravenous (IV) iron (15%) and ESA + IV iron (6%). Only about a third of patients were tested for blood serum iron parameters at the start of treatment. Overall, more than half of the patients had long-term responses to antianemic therapy. Our data suggest that in routine practice diagnostics for treatable causes of anemia are underused. A high proportion of cancer patients receive RBCTx. It should be discussed whether thorough diagnostics and earlier intervention could decrease the need for RBCTx. This trial is registered with NCT01795690.","PeriodicalId":46055,"journal":{"name":"Anemia","volume":"2016 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2016-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/8057650","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64547205","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}
AnemiaPub Date : 2016-02-02DOI: 10.1155/2016/2046535
L. Ngolet, M. Moyen Engoba, I. Kocko, A. Elira Dokékias, J. Mombouli, G. Moyen
{"title":"Sickle-Cell Disease Healthcare Cost in Africa: Experience of the Congo","authors":"L. Ngolet, M. Moyen Engoba, I. Kocko, A. Elira Dokékias, J. Mombouli, G. Moyen","doi":"10.1155/2016/2046535","DOIUrl":"https://doi.org/10.1155/2016/2046535","url":null,"abstract":"Background. Lack of medical coverage in Africa leads to inappropriate care that has an impact on the mortality rate. In this study, we aimed to evaluate the cost of severe acute sickle-cell related complications in Brazzaville. Methods. A retrospective study was conducted in 2014 in the Paediatric Intensive Care Unit. It concerned 94 homozygote sickle-cell children that developed severe acute sickle-cell disease related complications (average age 69 months). For each patient, we calculated the cost of care complication. Results. The household income was estimated as low (<XAF 90,000/<USD 158.40) in 27.7%. The overall median cost for hospitalization for sickle-cell related acute complications was XAF 65,460/USD 115.21. Costs were fluctuating depending on the generating factors of the severe acute complications (p = 0.041). They were higher in case of complications generated by bacterial infections (ranging from XAF 66,765/USD 117.50 to XAF 135,271.50/USD 238.07) and lower in case of complications associated with malaria (ranging from XAF 28,305/49.82 to XAF 64,891.63/USD 114.21). The mortality rate was 17% and was associated with the cost of the case management (p = 0.006). Conclusion. The case management cost of severe acute complications of sickle-cell disease in children is high in Congo.","PeriodicalId":46055,"journal":{"name":"Anemia","volume":"2016 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2016-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/2046535","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64258115","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}
AnemiaPub Date : 2016-01-01Epub Date: 2016-04-04DOI: 10.1155/2016/1729147
Shuchismita Behera, Gandham Bulliyya
{"title":"Magnitude of Anemia and Hematological Predictors among Children under 12 Years in Odisha, India.","authors":"Shuchismita Behera, Gandham Bulliyya","doi":"10.1155/2016/1729147","DOIUrl":"10.1155/2016/1729147","url":null,"abstract":"<p><p>Background. Anemia is a wide spread public health problem in India which affects children. The present study evaluates the prevalence of anemia and status of various hematological parameters among children of Khurda district, Odisha. Method. A total of 313 children aged 0-12 years were enrolled for the study which included preschool (0-5 years) and school aged (6-12 years) groups. Hematological indicators were measured by standard procedures, which include red blood cell (RBC) indicators, white blood cell (WBC) indicators, and plasma ferritin. Results. Mean hemoglobin (Hb) of the study population was 10.43 ± 3.33 g/dL and prevalence of anemia was 62%. In this population, boys had a lower mean Hb value than that of the girls. All grades of anemia were higher among school age children than preschool children. Mean plasma ferritin was found to be higher in school age boys than their counterpart girls. The mean level of WBC count was found to be higher among preschool age boys than among the school age boys (p = 0.025). Conclusion. The prevalence of anemia was higher with concomitant acute infection among study population, which is a matter of concern. Since the hematological parameters are interrelated with each other as well as with the age and gender, relevant intervention strategy and constant monitoring are needed while providing public health nutrition programs to eradicate anemia. </p>","PeriodicalId":46055,"journal":{"name":"Anemia","volume":"2016 ","pages":"1729147"},"PeriodicalIF":2.9,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34441331","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}
AnemiaPub Date : 2016-01-01Epub Date: 2016-03-22DOI: 10.1155/2016/7345835
Emilia Parodi, Maria Teresa Giraudo, Fulvio Ricceri, Maria Luigia Aurucci, Raffaela Mazzone, Ugo Ramenghi
{"title":"Absolute Reticulocyte Count and Reticulocyte Hemoglobin Content as Predictors of Early Response to Exclusive Oral Iron in Children with Iron Deficiency Anemia.","authors":"Emilia Parodi, Maria Teresa Giraudo, Fulvio Ricceri, Maria Luigia Aurucci, Raffaela Mazzone, Ugo Ramenghi","doi":"10.1155/2016/7345835","DOIUrl":"https://doi.org/10.1155/2016/7345835","url":null,"abstract":"We report data regarding kinetic of response to oral iron in 34 iron deficiency anemia children. Twenty-four/34 patients (70.5%) reached reference value of hemoglobin (Hb) concentration for age and sex at day + 30 from the beginning of treatment (complete early responders (CERs)), and 4/34 (12%) reached an Hb concentration at least 50% higher than the original (partial early responders (PERs)). CHr at T1 (within 7 days from the beginning of treatment) was significantly different in the different groups (22.95 in CERs versus 18.41 in other patients; p = 0.001; 22.42 in early responders versus 18.07 in NERs; p = 0.001). Relative increase of CHr from T0 to T1 resulted significantly higher in CERs than in other patients (0.21 versus 0.11, p = 0.042) and in early responders than in NERs (0.22 versus 0.004, p = 0.006). Multivariate logistic models revealed a higher probability of being a complete early responder due to relative increase of ARC from T0 to T1 [OR (95% CI) = 44.95 (1.54–1311.98)] and to CHr at T1 [OR (95% CI) =3.18 (1.24–8.17)]. Our preliminary data confirm CHr as early and accurate predictor of hematological response to oral iron.","PeriodicalId":46055,"journal":{"name":"Anemia","volume":"2016 ","pages":"7345835"},"PeriodicalIF":2.9,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/7345835","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34473346","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}
AnemiaPub Date : 2016-01-01Epub Date: 2016-03-21DOI: 10.1155/2016/8454286
Lamia Mustafa Al-Naama, Meaad Kadum Hassan, Muhannad Maki Abdul Karim
{"title":"Evaluation of Serum Leptin Levels and Growth in Patients with β-Thalassaemia Major.","authors":"Lamia Mustafa Al-Naama, Meaad Kadum Hassan, Muhannad Maki Abdul Karim","doi":"10.1155/2016/8454286","DOIUrl":"https://doi.org/10.1155/2016/8454286","url":null,"abstract":"<p><p>Background. Iron deposition in the body can damage the endocrine glands of patients with β-thalassaemia major (β-TM). Leptin plays a key role in the regulation of appetite, body fat mass, and endocrine function. Objectives. This study aimed to evaluate the relationship between serum leptin and growth and pubertal development in patients with β-TM, as well as whether serum leptin can predict growth retardation and delayed puberty in these patients. Methods. Fifty β-TM patients (aged 8-20 years) and 75 age-matched healthy controls were recruited. Anthropometric data and sexual maturity ratings were assessed. Serum leptin was measured by ELISA. Results. Serum leptin levels were significantly lower in patients with β-TM than in healthy individuals (P < 0.001). Leptin levels were also significantly reduced in female patients with short stature (P < 0.002) and in patients who displayed delayed puberty (P = 0.032) compared to those with normal stature who had reached puberty. The sensitivity of leptin for predicting short stature and delayed puberty among patients was 84.6% and 92.3%, respectively. Conclusion. Low serum leptin is sensitive to predict short stature and significant in β-TM females only. This link could thus be used as a guide for further therapeutic or hormonal modulation. </p>","PeriodicalId":46055,"journal":{"name":"Anemia","volume":"2016 ","pages":"8454286"},"PeriodicalIF":2.9,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/8454286","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34411803","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}