Journal of Optometry最新文献

{"title":"Prevalence of refractive errors among school students in Iraq — A systematic review and meta-analysis","authors":"Hassan A. Aljaberi ,&nbsp;I.R. Ali ,&nbsp;Zaydoon Tariq M. Noori","doi":"10.1016/j.optom.2024.100534","DOIUrl":"10.1016/j.optom.2024.100534","url":null,"abstract":"<div><h3>Purpose</h3><div>This research aimed to thoroughly examine and meta-analyse statistical information about the prevalence of refractive error in Iraq.</div></div><div><h3>Methods</h3><div>To discover every pertinent Iraqi epidemiological study from March 2014 to March 2024, Scopus, Science Direct, Google Scholar, Embase, PubMed, and the Cochrane Library were searched and reviewed. The Iraqi refractive error rate was interesting. The Comprehensive Meta-Analysis Software received unprocessed events and sample sizes for effect size calculations.</div></div><div><h3>Results</h3><div>A meta-analysis was undertaken by pooling data from 10 studies. The fixed effects model indicates an estimated effect size of 29.8% (95% CI: 28.6—30.9%). However, the statistical measures of heterogeneity (Q-value <em>p</em> &lt; 0.001; I2 = 98.707) showed significant heterogeneity among the studies, which indicates that a random-effects model should be used. The random effects model suggests that the prevalence of refractive error in the Iraqi population is predicted to be 27.6% (95% CI: 18.9—38.5%). The most common refractive defect was myopia, found in 35.1% of cases (95% CI: 24.9—46.8%). Astigmatism was the second most prevalent, affecting 32.2% (95% CI: 19.1—49.0%), followed by hyperopia in 23.9% (95% CI: 16.0—34.2%).</div></div><div><h3>Conclusions</h3><div>Current estimate of refractive error prevalence in Iraq may be conservative of this condition's burden. Nevertheless, this corresponds to a minimum of 8 to 18 million individuals in Iraq who have a refractive error. Due to study variability, wide estimate ranges, and random effects, more research and reliable sources are needed to obtain more accurate results.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"18 1","pages":"Article 100534"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529862","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":"Longitudinal change in central corneal thickness among primary schoolchildren","authors":"Hassan Hashemi ,&nbsp;Mehdi Khabazkhoob ,&nbsp;Elham Azizi ,&nbsp;Mohammad Hassan Emamian ,&nbsp;Akbar Fotouhi","doi":"10.1016/j.optom.2025.100537","DOIUrl":"10.1016/j.optom.2025.100537","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the longitudinal changes in corneal thickness and its contributing factors in primary schoolchildren.</div></div><div><h3>Methods</h3><div>This study is a part of the Shahroud Schoolchildren Eye Cohort Study, conducted longitudinally in two phases; in 2015 and then in 2018. Participants were tested for uncorrected visual acuity, best-corrected visual acuity, cycloplegic refraction, biometry, and Scheimpflug corneal imaging.</div></div><div><h3>Results</h3><div>After applying the exclusion criteria, 8782 eyes from 4432 participants were analysed. Of these, 2309 (52.1%) were male. Average three-year changes in central corneal thickness (CCT) and corneal apex thickness were −0.58 (95% CI: −0.94 to −0.22) and −0.59 (95% CI: −0.95 to −0.23) microns, respectively. There was an increase of 8.63 (95% CI: 8.1 to 9.17) microns in the superior corneal thickness after three years while the inferior corneal thickness decreased by an average of −5.75 (95% CI: −6.3 to −5.2) microns. The multiple generalized estimating equation (GEE) model showed that the three-year changes in the CCT were lower in rural than in urban students (β = −1.71; <em>p</em> &lt; 0.001). Moreover, the baseline CCT (β = −0.04; <em>p</em> &lt; 0.001), anterior chamber depth (β = −1.6; <em>p</em> = 0.003), and corneal diameter (β = −1.18; <em>p</em> &lt; 0.001) had a significant inverse association while the body mass index (β = 0.12; <em>p</em> = 0.002) and axial length (β = 0.84; <em>p</em> &lt; 0.001) had a significant direct association with the 3-year changes in CCT. After three years, CCT decreased by advancing age in boys, while remaining almost constant in girls.</div></div><div><h3>Conclusion</h3><div>The 3-year change in CCT was clinically negligible and could indicate its stability in schoolchildren. However, CCT thinning was more remarkable in urban students.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"18 1","pages":"Article 100537"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527075","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":"Quantification of visual acuity: “Counting fingers” and “Hand movement” with the Berkeley Rudimentary Vision Test","authors":"Alba Herrero ,&nbsp;Halima Berrada ,&nbsp;Rafael I. Barraquer ,&nbsp;Ralph Michael","doi":"10.1016/j.optom.2024.100531","DOIUrl":"10.1016/j.optom.2024.100531","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to compare the results of the Finger Count Test (FCT) for “Counting fingers” (CF) and “Hand movement” (HM) with the visual acuity (VA) obtained from the Berkeley Rudimentary Vision Test (BRVT) in low vision patients with different pathologies.</div></div><div><h3>Methods</h3><div>Uncorrected visual acuity was estimated using BRVT and using the corresponding CF or HM in 38 low vision patients (VA range between 1.40 and 3.50 logMAR). Detailed ocular pathologies were recorded for each patient. Patients were categorized into two groups: one with severe visual field defects (constrictions of the central visual field or central scotomas) due to any cause and a general group which included all other ocular pathologies.</div></div><div><h3>Results</h3><div>The mean age was 67 years, with an age range from 26 to 92 years. The General group revealed a median VA of 2.00 logMAR for CF and 2.60 logMAR for HM (<em>p</em> &lt; 0.001). This study showed a large variation of VA from BRVT in the Visual field group and considerable overlap with the VA results for CF and HM; with a median VA of 2.10 logMAR for CF and 2.30 logMAR for HM (<em>p</em> = 0.824).</div></div><div><h3>Conclusion</h3><div>The VA found in this study for CF confirmed values from earlier studies, while VA for HM was found to be slightly worse. These findings allow a translation of older VA data of CF and HM to logMAR for proper statistical analysis. Patients with central visual field defects showed a large variation of measured VA with BRVT.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"18 1","pages":"Article 100531"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372694","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":"Changes in the thickness of the crystalline lens components before and after cycloplegia in children with different refractive errors","authors":"Yongle Bao ,&nbsp;Zhirong Zhang ,&nbsp;Jian Cao ,&nbsp;Yong Ma ,&nbsp;Yanze Yu ,&nbsp;Zhanying Wang ,&nbsp;Lingling Niu ,&nbsp;Xiaoying Wang ,&nbsp;Xingtao Zhou ,&nbsp;Jia Huang ,&nbsp;Jing Zhao","doi":"10.1016/j.optom.2025.100539","DOIUrl":"10.1016/j.optom.2025.100539","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate changes in the thickness of the crystalline lens components in children with different refractive errors before and after cycloplegia.</div></div><div><h3>Methods and Analysis</h3><div>This prospective study recruited 132 right eyes from 132 children (age 5–15 years) with different spherical equivalent (SE) ranging from −6.00 diopters (D) to +6.75 D. We categorized these eyes into non-myopia (N = 30), low-myopia (N = 77), and moderate-myopia (N = 25) groups. The thickness parameters of the crystalline lens components, including lens thickness (LT), lens nucleus thickness (LNT), anterior cortex thickness (ACT), and posterior cortex thickness (PCT), were assessed using optical coherence tomography before and after 0.5 % tropicamide-induced cycloplegia.</div></div><div><h3>Results</h3><div>After cycloplegia, LT significantly decreased from 3.47 ± 0.20 to 3.41 ± 0.20 mm in non-myopia eyes (<em>P</em> &lt; 0.05), and from 3.30 ± 0.17 to 3.27 ± 0.16 mm in low-myopia eyes (<em>P</em> &lt; 0.05), with no significant changes in moderate-myopia eyes (<em>P</em> &lt; 0.05). LNT decreased from 3.15 ± 0.19 to 3.09 ± 0.19 mm in non-myopia eyes (<em>P</em> &lt; 0.05), and from 3.02 ± 0.20 to 2.99 ± 0.17 mm in low-myopia eyes (<em>P</em> &lt; 0.01), with no reduction observed in moderate-myopia eyes (<em>P</em> &gt; 0.05). Cycloplegia-induced changes in ACT and PCT (all <em>P</em> &gt; 0.05) did not differ significantly between the groups. SE was positively correlated with LT and LNT before (Pearson's <em>r</em> = 0.353 and 0.272, respectively; both <em>P</em> &lt; 0.05) and after cycloplegia (<em>r</em> = 0.285 and 0.198, respectively; both <em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>LT and LNT significantly decreased after cycloplegia induced by 0.5 % tropicamide in children with non-myopia and low-myopia, while neither ACT nor PCT changed significantly. SE was positively correlated with LT and LNT.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"18 1","pages":"Article 100539"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535062","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":"Evaluation of the repeatability of corneal epithelial thickness mapping in healthy and keratoconic eyes with two spectral domain optical coherence tomography","authors":"Branka Samolov ,&nbsp;Stephanie van de Moosdijk ,&nbsp;Abinaya Priya Venkataraman ,&nbsp;Alberto Domínguez-Vicent","doi":"10.1016/j.optom.2025.100535","DOIUrl":"10.1016/j.optom.2025.100535","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the repeatability of corneal epithelial thickness measurements using anterior segment optical coherence tomography (AS-OCT) and a posterior segment OCT adapted with an anterior module, in subjects with keratoconus and healthy controls.</div></div><div><h3>Methods</h3><div>A spectral domain AS-OCT (MS-39) and a posterior segment OCT (HS-100) with ASA-1 adaptor were used to measure the corneal epithelial thickness in healthy and keratoconic eyes. Three measurements per participant were taken, and the repeatability was described using the repeatability limit (Rlim), calculated from the within-subject standard deviation.</div></div><div><h3>Results</h3><div>81 eyes of 81 controls and 80 eyes of 52 keratoconus subjects (43 % cross-linking, and 13 % contact lens users) were included. For the MS-39, the central sector showed the best repeatability for both groups, with Rlim never exceeding 5 μm in any sector. For the HS-100, the best repeatability was obtained for the central sector, with the Rlim never exceeding 7 μm in any of the sectors for the control group and all but one (outer-inferior) in the keratoconus group. The Rlim for the keratoconus group varied &lt;1 μm between contact users/non-users or between eyes with/without a history of CXL. Differences in Rlim were larger than 2 μm in the peripheral horizontal sectors between each sub-group with the HS-100.</div></div><div><h3>Conclusions</h3><div>Both OCTs showed good epithelial thickness measurement repeatability in all groups, though the repeatability of the HS-100 was mildly lower for keratoconic eyes. Contact lens use and crosslinking history did not affect repeatability. These OCTs effectively measure epithelial thickness in keratoconus patients, which could be helpful in monitoring keratoconus progression.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"18 1","pages":"Article 100535"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143241991","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 correlation between relative peripheral refraction and myopia progression: A commentary on the utility of retinoscopy for peripheral refraction assessment","authors":"Gladson Joyse Stanly","doi":"10.1016/j.optom.2024.100526","DOIUrl":"10.1016/j.optom.2024.100526","url":null,"abstract":"","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"18 1","pages":"Article 100526"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972733","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":"Blue light stimulation of the optic nerve head reduces melatonin levels in rabbit posterior segment","authors":"Carlos Carpena-Torres ,&nbsp;Fernando Huete-Toral ,&nbsp;Gonzalo Carracedo","doi":"10.1016/j.optom.2024.100525","DOIUrl":"10.1016/j.optom.2024.100525","url":null,"abstract":"","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"17 4","pages":"Article 100525"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510167","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":"Visual performance of a new trifocal intraocular lens design evaluated with a clinical adaptative optics visual simulator","authors":"Anabel Martínez-Espert ,&nbsp;Diego Montagud-Martínez ,&nbsp;Vicente Ferrando ,&nbsp;Salvador García-Delpech ,&nbsp;Juan A. Monsoriu ,&nbsp;Walter D. Furlan","doi":"10.1016/j.optom.2024.100527","DOIUrl":"10.1016/j.optom.2024.100527","url":null,"abstract":"<div><h3>Objective</h3><div>The digital transformation of daily routines has increased visual demands, especially at intermediate and near distances. The Devil multifocal intraocular lens (MIOL) design was developed to enhance intermediate visual performance. This design is a novel trifocal intraocular lens inspired by the fractal structure known as the 'Devil's staircase'. The aim of this research is to evaluate the visual performance of the Devil MIOL design in real patients.</div></div><div><h3>Methods</h3><div>The visual acuity defocus curve was obtained from 25 eyes of healthy volunteers using the Visual Adaptive Optics Simulator (VAO, Voptica SL, Murcia, Spain). Additionally, images of optotypes simulating those seen through the Devil MIOL design were captured to qualitatively illustrate optotype perception at different vergence values.</div></div><div><h3>Results</h3><div>Mean visual acuity values of the evaluation were 0.03 logMAR at 0.00 D vergence, 0.10 logMAR at +1.50 D vergence, and 0.11 logMAR at +3.00 D vergence, corresponding to far (optical infinity), intermediate (66.7 cm), and near foci (33.3 cm), respectively. The experimental outcomes were indeed slightly better than numerical results obtained previously in a model eye.</div></div><div><h3>Conclusions</h3><div>The Devil MIOL design provides satisfactory visual acuity across three primary foci and produces extended depth of focus between the intermediate and near foci.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"17 4","pages":"Article 100527"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649102","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":"Effect of a vergence-accommodation conflict induced during a 30-minute Virtual Reality game on vergence-accommodation parameters and related symptoms","authors":"Maciej Dymczyk,&nbsp;Anna Przekoracka-Krawczyk,&nbsp;Zuzanna Kapturek,&nbsp;Paulina Pyżalska","doi":"10.1016/j.optom.2024.100524","DOIUrl":"10.1016/j.optom.2024.100524","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of the study was to verify the hypotheses that vergence-accommodation conflict (VAC) induced with head-mounted device (HMD) could cause symptoms in relation to changes in the accommodative-vergence system. In order to test this hypothesis, the Virtual Reality (VR) exposures were carried out in two types of VAC: VAC_small and VAC_large.</div></div><div><h3>Method</h3><div>Eighteen females, with a mean age of 22.5 ± 2.0 years, participated in two 30-minutes sessions with VR, which were separated by at least one week. Two sessions were differentiated by intensity of VAC presented in the VR system (VAC_small and VAC_large). Visual parameters were measured such as associated and dissociated phoria, accommodative response, the near point of convergence (NPC), fusional vergence ranges (FVR) and subjective complaints were measured using Simulator Sickness Questionnaire (SSQ). The parameters were measured immediately before (Pre-test) and after (Post-test) the VR exposure.</div></div><div><h3>Results</h3><div>The subjective symptoms as nausea, oculomotor disorders and disorientation increased significantly after 30-minutes of exposure on VAC_large (<em>P</em>&lt;0.05). The associated and dissociated phoria, lag of accommodation, FVR and the NPC did not significantly change after the VR exposure (<em>P</em>&gt;0.05).</div></div><div><h3>Conclusion</h3><div>Short-term use of HMD (30-min) did not significantly affect accommodative-vergence functions regardless of the size of VAC (VAC_small and VAC_large). However, the level of symptoms increased after VR sessions, which was probably related to inappropriate oculo-vestibular relationship.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"17 4","pages":"Article 100524"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630199","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":"Analysis of patient referrals from primary care to ophthalmology. The role of the optometrist","authors":"Rafael Carrasco Solís ,&nbsp;María Rosario Rodríguez Griñolo ,&nbsp;Beatríz Ponte Zúñiga ,&nbsp;Beatriz Mataix Albert ,&nbsp;María Leticia LLedó de Villar ,&nbsp;Rocío Martínez de Pablos ,&nbsp;Enrique Rodríguez de la Rúa Franch","doi":"10.1016/j.optom.2024.100521","DOIUrl":"10.1016/j.optom.2024.100521","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to characterize the quality of primary care referrals of patients to ophthalmology at the Virgen Macarena Hospital in Seville. This will enable us to optimize ophthalmologic resources and to evaluate the role of the optometrist in improving referrals.</div></div><div><h3>Methods</h3><div>We performed a retrospective cross-sectional review of 220 ophthalmology consultations referred from primary care to the hospital from March to May 2022.</div><div>The following data were extracted: age, sex, reason for consultation, diagnosis, priority level, whether it was an initial consultation or a follow-up visit, whether there was a secondary referral and whether the referral was appropriate. Excel (version 2312) was used for the data analysis.</div></div><div><h3>Results</h3><div>The age range of the patients was from 3 years to 91 years. The patients were 41.8 % male and 58.2 % female. The conditions found were grouped as follows: cataracts (27.27 %), refractive errors (20.9 %), anterior segment disease (18.8 %), posterior segment disease (14.07 %), normal examination (18.63 %) and others (0.9 %). The most common reason for consultation was blurred vision or loss of vision (43.63 %). In total, 41.36 % of the consultations were considered inappropriate. The age group requiring the highest number of consultations was over 65 years (38.64 %).</div></div><div><h3>Conclusions</h3><div>With 41.36 percent of referrals deemed unnecessary, it is clear that referrals can be improved. This would reduce strain on the ophthalmology service and improve patient care. The importance of the optometrist in primary care is demonstrated by the fact that 20.9 % of the diagnoses were refractive errors.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"17 4","pages":"Article 100521"},"PeriodicalIF":2.2,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142320315","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}