Oral Surgery Oral Medicine Oral Pathology Oral Radiology最新文献

{"title":"A well-defined radiolucency of the mandible in a twenty-three year old female.","authors":"Deepak Pandiar, Reshma Poothakulath Krishnan","doi":"10.1016/j.oooo.2024.09.008","DOIUrl":"https://doi.org/10.1016/j.oooo.2024.09.008","url":null,"abstract":"","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic and survival factors in head and neck extra-nodal non-Hodgkin's lymphoma.","authors":"Alba Bello-Castro, Adrián Mosquera-Orgueira, Francisco Gude-Smpedro, Iván Varela-Aneiros, Javier Seoane-Romero, Benjamín Martin-Biedma, Pablo Castelo-Baz","doi":"10.1016/j.oooo.2024.09.007","DOIUrl":"https://doi.org/10.1016/j.oooo.2024.09.007","url":null,"abstract":"<p><strong>Objective: </strong>To make a clinical-biological characterization of this pathology and assess the survival of these patients and the associated prognostic factors.</p><p><strong>Study design: </strong>A retrospective observational study was designed to identify primary extranodal non-Hodgkin lymphomas of the head and neck diagnosed between January 1, 2005, and January 1, 2016. Cases were considered if they presented with a single tumor in situ or if the extranodal component was clinically predominant.</p><p><strong>Results: </strong>A total of 145 patients were included. Localized stages (I-II) were present in 69.3%. Overall, 91.8% were B-cell phenotype, with diffuse large B-cell lymphoma being the most frequent. Overall, 78% of patients were treated with immunochemotherapy. The overall survival at 3 and 5 years was 75% and 73%, respectively. Adverse prognostic factors were: low hemoglobin, elevated ß2-microglobulin, and lactate dehydrogenase (LDH) levels, Eastern Cooperative Oncology Group (ECOG), stage III/IV, and B symptomatology at diagnosis. The progression-free survival at 3 and 5 years was 71% and 68%. Risk factors for relapse were high ß2-microglobulin, high LDH, and stage III-IV at diagnosis.</p><p><strong>Conclusions: </strong>These pathologies show a good response to treatment with immuno-polychemotherapy. Factors associated with a worse prognosis included low hemoglobin, elevated levels of ß2-microglobulin and LDH, elevated ECOG, stage III/IV, and B symptomatology at diagnosis.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brazilian Society of Oral Medicine (Stomatology) and Oral & Maxillofacial Pathology: half-century of collaboration with the AAOM and the AAOMP.","authors":"Alan Roger Santos-Silva, Ana Carolina Prado Ribeiro, Thaís Cristina Esteves-Pereira, Luciana Estevam Simonato, Marcio Ajudarte Lopes, Pablo Agustin Vargas","doi":"10.1016/j.oooo.2024.09.005","DOIUrl":"https://doi.org/10.1016/j.oooo.2024.09.005","url":null,"abstract":"","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescription of potentially inappropriate medications in older adults; data from a dental institution.","authors":"Arwa Farag, Matthew Finkelman, Scarlet Charmelo-Silva, Christina Sun, Madison Mondry, Mohammed Bindakhil","doi":"10.1016/j.oooo.2024.09.006","DOIUrl":"https://doi.org/10.1016/j.oooo.2024.09.006","url":null,"abstract":"<p><strong>Objectives: </strong>The objectives of this study were to determine the types and frequency of potentially inappropriate medications (PIMs) prescribed to geriatric patients while considering the patients' age groups and their American Society of Anesthesiologists (ASA) physical status.</p><p><strong>Study design: </strong>We performed a 5-year retrospective chart review of patients aged 65 years and above who were seen in a dental institution. Patients' medical history, PIM prescriptions, and prescribers' specialty and professional status were analyzed.</p><p><strong>Results: </strong>Out of 10,675 geriatric patients identified, 6.2% (n = 662) received PIM prescriptions. Of those, 77% received one PIM whereas the others (23%) received anywhere between 2 and 6; the majority (73.7%) of these 662 patients fell within an ASA III physical status. Nonsteroidal anti-inflammatory drugs (NSAIDs) were the most prescribed PIM (provided to 60.1% of subjects) followed by opioids (provided to 32.5% of subjects). Both NSAIDs and opioids were largely provided by providers in oral and maxillofacial surgery followed by those in restorative dentistry and periodontics. Benzodiazepines were mostly prescribed by endodontics providers, whereas tricyclic antidepressants, muscle relaxants, and anticonvulsants were mostly prescribed by oral medicine providers. Residents prescribed opioids at similar rates to the faculty (P = .78) but exceeded the faculty in prescribing benzodiazepines (P < .001).</p><p><strong>Conclusion: </strong>PIMs were prescribed at low percentages to geriatric patients; however, most prescriptions were provided to patients classified with ASA III status. Further efforts are indicated, at institutional and national levels, to monitor/limit PIMs provided to geriatric population. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range).</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison between 2- and 4-plate fixation in Le Fort I osteotomy: a mixed methods systematic review.","authors":"Ricardo Grillo, Bruno Alvarez Quinta Reis, Bernardo Correia Lima, Leonardo Augustus Peral Ferreira Pinto, Fernando Melhem-Elias","doi":"10.1016/j.oooo.2024.09.002","DOIUrl":"https://doi.org/10.1016/j.oooo.2024.09.002","url":null,"abstract":"<p><strong>Objective: </strong>Achieving postsurgical skeletal stability is crucial for successful outcomes and patient satisfaction. Precision maxillofacial surgery, which integrates precision techniques with minimally invasive approaches, is increasingly recognized for its potential to enhance long-term stability and reduce surgical risks and complications. This study aimed to comprehensively evaluate the impact of fixation techniques (2 vs 4 plates) during Le Fort I osteotomy in orthognathic surgery on skeletal stability. The main focus was to compare the stability achieved and potential risks of relapse between these two fixation methods.</p><p><strong>Material and methods: </strong>A mixed-methods approach was employed, combining a systematic review, in silico analysis, and in vitro studies. The systematic review adhered to Joanna Briggs Institute methodology and Good Reporting of A Mixed Methods Study guidelines, focusing on comparative studies that evaluated skeletal stability as the primary outcome measure. In silico and in vitro analyses were conducted to assess the biomechanical principles and relapse risks associated with maxillary advancement using different fixation techniques.</p><p><strong>Results: </strong>The systematic review included three clinical trials, four finite element analysis studies, and two in vitro analyses. The meta-analysis revealed no significant difference in skeletal stability between the 2- and 4-plate fixation methods. However, biomechanical analysis showed an atypical increase in relapse risk with 2-plate fixation at 3 mm maxillary advancement, compared to a 10 mm advancement for 4-plate fixation.</p><p><strong>Conclusions: </strong>While both 2- and 4-plate fixation methods are viable, the findings suggest that 4-plate fixation offers superior stability, particularly in cases of significant maxillary advancement, where 2-plate fixation showed an increased risk of relapse. Future research with larger sample sizes and addressing the biases identified in this study is needed to validate these findings and effectively guide clinical practice.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraosseous benign peripheral nerve sheath tumor of the jaws: report of 4 new cases and a comprehensive literature review.","authors":"Brendo Vinícius Rodrigues Louredo, Paulo Victor Mendes Penafort, Ana Luiza Oliveira Corrêa Roza, Maria Cecília Querido De Oliveira, Ricardo Pelletti Ocaña, Alexandre Machado Torres, Samuel de Barros Ferreira Júnior, André Caroli Rocha, Rafael Cabral da Costa, Fábio Ramoa Pires, José Divaldo Prado, Jacks Jorge-Júnior, Pablo Agustin Vargas","doi":"10.1016/j.oooo.2024.09.004","DOIUrl":"https://doi.org/10.1016/j.oooo.2024.09.004","url":null,"abstract":"<p><p>Benign peripheral nerve sheath tumors (BPNSTs) are a vast, common, heterogeneous group of lesions that are often diagnostically challenging. The head and neck region is recognized as the second most common location for these lesions, especially the tongue. However, BPNSTs occurring centrally within the jaw bones are exceedingly rare. To date, approximately 161 cases of intraosseous BPNSTs have been reported in the jaws. This group mainly includes the relatively more common neurofibromas and schwannomas, and the less common perineuriomas and hybrid forms. Unlike soft tissues, schwannomas are the most common BPNSTs occurring within the jaws, followed by neurofibromas and perineuriomas. These neoplasms can present as a well-defined unilocular lesion or as an ill-defined multilocular image, resembling several types of benign and malignant lesions of odontogenic origin. The aim of the current study was to report 4 new cases of intraosseous BPNSTs and a comprehensive literature review.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous bacterial peritonitis and soft tissue healing after tooth extraction in liver cirrhosis patients.","authors":"Gustavo Souza Galvão, Juliana Bertoldi Franco, Maria Paula Siqueira de Melo Peres, Gabriela Bănacu Melo, Jefferson R Tenório, Janaina B Medina, Camila de Barros Gallo, Karem L Ortega","doi":"10.1016/j.oooo.2024.09.003","DOIUrl":"https://doi.org/10.1016/j.oooo.2024.09.003","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to identify the association between tooth extraction and occurrence of spontaneous bacterial peritonitis (SBP) and to assess delayed soft tissue healing of extraction sockets in patients with cirrhosis.</p><p><strong>Study design: </strong>One hundred nineteen participants awaiting liver transplantation who required tooth extraction were included. Seven days before the surgery, the patients underwent panoramic radiography and laboratory examinations. Soft tissue healing was evaluated 7 days after the tooth extraction and medical records were checked after 21 days for development of SBP. The relationship between predictive factors and outcomes was assessed by using multiple binomial logistic regression.</p><p><strong>Results: </strong>One hundred ninety-five teeth were extracted, resulting in 146 alveolar wounds, in which the majority (47%) consisted of alveolar sockets of multirooted teeth. One participant was diagnosed with SBP (Escherichia coli [E. coli]) and another diagnosed with bacterascites (Streptococcus viridans [S. viridans] group), occurring 11 and 6 days after tooth extraction. Poor soft tissue healing was observed in 20 (13.7%) patients, which was correlated to 2 risk factors, that is, jaundice (P = .007, adjusted odds ratio [OR] = 4.91, 95% confidence interval [CI] = 1.56-15.47) and moderate neutropenia (P = .048, adjusted OR = 13.99, 95% CI = 1.02-192.07).</p><p><strong>Conclusions: </strong>No association was found between tooth extraction and SBP in patients with cirrhosis. The delayed soft tissue healing was related to jaundice (hyperbilirubinemia) and moderate neutropenia.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stratification of orthognathic surgery patients for painful TMD and associated factors.","authors":"Danielle Veiga Bonotto, Jessica Sarah Cavalheiro, Ramon Targino Firmino, Juliana Stuginski-Barbosa, Rafaela Scariot, Aline Monise Sebastiani","doi":"10.1016/j.oooo.2024.09.001","DOIUrl":"https://doi.org/10.1016/j.oooo.2024.09.001","url":null,"abstract":"<p><p>The prevalence of temporomandibular disorder (TMD) in patients with (dentofacial deformities) DFD is high, indicating a multifaceted relationship between physical and psychosocial factors.</p><p><strong>Objective: </strong>To identify clusters of patients with DFD based on variables related to TMD, psychological aspects, somatization, oral habits, and sleep.</p><p><strong>Method: </strong>Ninety-two patients with DFD were evaluated before orthognathic surgery according to demographic data, facial profile, presence of painful TMD (DC/TMD), psychological aspects, oral habits, comorbidities, substance use, and sleep quality.</p><p><strong>Results: </strong>Eighty-six individuals comprised the final sample. The K-means cluster analysis identified two distinct but internally similar groups. One called \"Vulnerable\" with a higher prevalence of muscular TMD and associated factors with 43 (50%) participants, and another with 43 (50%) participants, called \"Adaptive\" with a lower prevalence of these variables (P<.01). The determining variables were signs and symptoms of anxiety and somatization, awake bruxism and self-reported sleep quality. The presence of arthralgia, comorbidities, or smoking did not influence the formation of the groups. The clusters were tested with gender, age, facial profile, maxillary excess, and deficiency. Only females were associated with the vulnerable group (P=.015). These results highlight the importance of multidimensional assessment of patients with DFD. The stratification of these individuals can help with personalized treatment, targeting specific strategies for each group, such as behavioral interventions and referrals to a multidisciplinary team.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of postoperative peri-implant reactive tissues following implant supported prosthetic rehabilitation in fibula free flaps","authors":"Samuel D. Raffaelli DDS ,&nbsp;Timothy W. Neal DDS, MD ,&nbsp;Jonathan J. Jelmini DDS, MD ,&nbsp;Roderick Y. Kim DDS, MD, MBA, FACS ,&nbsp;Fayette C. Williams DDS, MD, FACS","doi":"10.1016/j.oooo.2024.08.017","DOIUrl":"10.1016/j.oooo.2024.08.017","url":null,"abstract":"<div><h3>Objectives</h3><div>The purpose of this study was to measure the frequency of peri-implant reactive tissue development in a cohort of patients following immediate implant supported prosthetic rehabilitation in fibula free flaps at our institution and to document 2 cases of management based on our institution's experience.</div></div><div><h3>Study Design</h3><div>To address this question of study design, a case series was performed from October 2014 to May 2022. We included patients that underwent a fibula free flap reconstruction of the mandible or maxilla with immediate implant placement and dental prostheses fabrication. Forty-four patients met the inclusion criteria, and, among the participants, a total of 26 male patients (59%) and 18 female patients (41%) were evaluated, with 185 implants placed all together.</div></div><div><h3>Results</h3><div>Twenty patients (45%) were treated for benign pathology, 12 with malignant pathology (27%), 5 with trauma (11%), and 7 with osteoradionecrosis (16%). Postoperative peri-implant reactive tissues were seen to develop at 39 of the implant sites (21%).</div></div><div><h3>Conclusion</h3><div>Reactive tissues were found to be a common complication in patients treated with fibular free flap reconstructions involving implant rehabilitation. Our institution noted that local excision of such reactive tissues, in addition to silver nitrate cauterization and topical steroid application, may provide reasonable success in dealing with these occurrences. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range)</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"138 6","pages":"Pages e107-e112"},"PeriodicalIF":2.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digoxin attenuates bisphosphonate related osteonecrosis of the jaws by RORγt-dependent Th17 response in male rats","authors":"José Vitor Mota Lemos MS ,&nbsp;Joyce Ohana de Lima Martins MS ,&nbsp;Larissa Carvalho Machado DDS ,&nbsp;Lara Rabelo Aragão MS ,&nbsp;Maria Elisa Quezado Lima Verde PhD ,&nbsp;Cláudia do Ó. Pessoa PhD ,&nbsp;Maria Júlia Barbosa Bezerra PhD ,&nbsp;Ana Paula Negreiros Nunes Alves PhD ,&nbsp;Paulo Goberlânio de Barros Silva PhD","doi":"10.1016/j.oooo.2024.08.013","DOIUrl":"10.1016/j.oooo.2024.08.013","url":null,"abstract":"<div><h3>Objective</h3><div>The study aimed to evaluate digoxin, an RORγt inhibitor, in Medication-Related Osteonecrosis of the Jaws (MRONJ) in male rats treated with zoledronic acid (ZA).</div></div><div><h3>Study Design</h3><div>Forty male Wistar rats were divided into a negative control group (0.1 mL/kg saline), a positive control group (ZA, 0.20 mg/kg), and three test groups treated with ZA and digoxin at 1 (DG1), 2 (DG2), or 4 (DG4) mg/kg. These groups received treatment three times weekly. ZA was administered intravenously on days 0, 7, and 14, followed by extraction of the left lower first molar on day 42, a final ZA dose on day 49, and euthanasia on day 70. Analyses included radiographic, histomorphometric, and immunohistochemical evaluation of the mandibles, western blotting of gingiva, and mechanical tests on femurs. Statistical analysis was performed using ANOVA/Bonferroni tests (<em>P</em> &lt; .05).</div></div><div><h3>Results</h3><div>Digoxin reduced radiolucency of MRONJ (<em>P</em> &lt; .001), inflammatory cells, empty osteocyte lacunae (<em>P</em> &lt; .001), apoptotic osteoclasts (<em>P</em> &lt; .001), and Caspase-3-positive osteocytes (<em>P</em> = .021). ZA increased immunoreactivity for most markers except c-Fos, while digoxin reduced interleukin 17, TNF-α, IL-6, IL-2, FOXP3, c-Jun, NFκB (<em>P</em> &lt; .001), TGF-β (<em>P</em> = .009), RANKL (<em>P</em> = .035), and OPG (<em>P</em> = .034). Digoxin also reversed RORγt expression (<em>P</em> &lt; .001), increased diarrhea scores (<em>P</em> = .028), renal and cardiac indexes (<em>P</em> &lt; .001), and enhanced femur mechanical properties (<em>P</em> &lt; .013).</div></div><div><h3>Conclusions</h3><div>Digoxin attenuated MRONJ by inhibiting RORγt and reducing the Th17 response.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"138 6","pages":"Pages 781-793"},"PeriodicalIF":2.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}