International Journal of Environmental Research and Public Health最新文献

{"title":"Dietary Nutritional Supplements Are Associated with the Deterioration of Hepatic Fibrosis in Women and Individuals without Underlying Disease.","authors":"Minsu Cha, Sangheun Lee, Kijun Han","doi":"10.3390/ijerph21101298","DOIUrl":"https://doi.org/10.3390/ijerph21101298","url":null,"abstract":"<p><p>Despite the growing societal interest in the health benefits of dietary nutritional supplements, their safety and efficacy remain unclear. We aimed to investigate the correlation between hepatic fibrosis and the consumption of dietary nutritional supplements. This study utilized data from the Korea National Health and Nutrition Examination Survey spanning the period from 2014 to 2022. Significant fibrosis was defined as a fibrosis index based on four factors (FIB-4) ≥1.45 and an aspartate aminotransferase-to-platelet ratio index (APRI) ≥0.30. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were calculated. In a study involving 30,639 participants (supplement consumers [<i>n</i> = 17,772] and non-consumers [<i>n</i> = 12,867]), dietary nutritional supplement consumption was associated with alanine aminotransferase (ALT) elevation and increased hepatic fibrosis biomarkers (APRI and FIB-4). Dietary nutritional supplement consumption was independently linked to ALT elevation (AOR, 1.11; 95% CI, 1.04-1.18), FIB-4 (AOR, 1.07; 95% CI, 1.00-1.15), and APRI (AOR, 1.14; 95% CI, 1.07-1.21). This association was particularly significant in women and subgroups of people who were not diabetic or hypertriglyceridemic. In our comprehensive analysis, the consumption of dietary nutritional supplements was possibly associated with hepatic fibrosis, particularly in specific subgroups. Given the limitations of this study, these findings are not considered definitive conclusions; however, they serve as valuable preliminary data for future research.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142516740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Adoption of a \"Diseased Identity\" in Traditional 12-Step Groups: Exploring the Implications of These Processes for Individuals and Practitioners in Health and Social Care Services.","authors":"William McGovern, Michelle Addison, Ruth McGovern","doi":"10.3390/ijerph21101297","DOIUrl":"https://doi.org/10.3390/ijerph21101297","url":null,"abstract":"<p><p>Self-help groups are increasingly utilised by communities of interest and shared experience, services, and government departments as platforms for supporting and improving health and social care outcomes for drug and alcohol users. Traditional 12-step self-help groups like Narcotics Anonymous and Alcoholics Anonymous (NA and AA) are worldwide organisations and each have their own programme of change, language, criteria for membership, processes for problem resolution, and self-transformation. Within these types of groups, members are openly encouraged to identify with and adopt an (diseased) identity that is consistently invoked to work on the self. In the self-help recovery literature, it is widely recognised that individuals can benefit by thinking about themselves as \"diseased\" and then acting and behaving in a manner which is congruent with their reframed \"identity\". Less is known about the processes involved in this and social-, psychological-, and health-related implications for individuals in drug- and alcohol-specific self-help groups. A thematic analysis of data from (n-36) in-depth qualitative interviews with long-term (6 months-10 years) self-help users identified four themes associated with the adoption of a diseased identity and self-help group processes: (1) normalising the disease and illness; (2) identifying as diseased; (3) living as a diseased individual; and (4) one addict helping another addict. The results of this research should not be interpretated as a critique of the 12-step approach or groups. Instead, it should be recognised that whilst improvements to individual wellbeing are reported, identifying as diseased can exacerbate negative self-perceptions that individuals hold about themselves, their character, capabilities, and ability. Being diseased, accepting disease, and identifying as diseased also has the potential to inhibit their engagement with wider social networks and professional services outside of their own fellowship or group. We conclude this paper by exploring the implications of a \"diseased identity\" and self-help processes for individuals who access self-help groups, and health and social care practitioners who support self-help users as they engage with services and self-help groups.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11507594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Child Fatalities in Tractor-Related Accidents in Rural Iceland, 1918-2024: A Historical Analysis.","authors":"Jónína Einarsdóttir, Geir Gunnlaugsson","doi":"10.3390/ijerph21101295","DOIUrl":"https://doi.org/10.3390/ijerph21101295","url":null,"abstract":"<p><p>Children on farms face high risks of work- and non-work-related fatalities, with tractors being a significant contributor. This study examines children's involvement in fatal tractor-related accidents within agriculture in Iceland from 1918 to 2024, explores adult reflections on childhood tractor-driving experiences, and analyses Members of Parliament's arguments against setting a minimum age for off-road tractor driving. The data are based on parliamentary debates on tractor-related legislation, fatal tractor-related accidents documented in newspaper archives and supplementary sources, and narrative interviews with former summer children who stayed at farms during their childhoods. Over half of the 81 registered accidents involved children-primarily boys-with 75% occurring between 1958 and 1988, when no minimum age for off-road tractor driving existed. The fatality incidence rate for children was more than four times higher than for adults. Arguments against minimum age requirements for off-road driving included the need for child labour, children's superior driving skills, and the denial that children were more often victims than adults. Since 1988, no child has died while driving a tractor. A human-centred approach focusing on the working conditions, driver capacity, and adherence to safety procedures and legal frameworks is needed to prevent future accidents.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11508177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the Mental Health of Police Officers: A Systematic Review of Specific Instruments.","authors":"Davi Oliveira Teles, Raquel Alves de Oliveira, Anna Luísa de Oliveira Parnaíba, Mariana Araújo Rios, Melissa Bezerra Machado, Priscila de Souza Aquino, Purdenciana Ribeiro de Menezes, Samila Gomes Ribeiro, Paula Renata Amorim Lessa Soares, Camila Biazus Dalcin, Ana Karina Bezerra Pinheiro","doi":"10.3390/ijerph21101300","DOIUrl":"10.3390/ijerph21101300","url":null,"abstract":"<p><strong>Objective: </strong>The objective was to identify validated instruments from the literature that assess the mental health of police officers.</p><p><strong>Methods: </strong>This is a systematic review of validated instruments used to assess the mental health of police officers. Searches were conducted in the MEDLINE, Web of Science, Scopus, Embase, CINAHL/EBSCO, and Virtual Health Library databases. This review follows the JBI Manual for Systematic Reviews and the PRISMA statement. The methodological quality of the articles and the risk of bias were assessed.</p><p><strong>Results: </strong>A total of 1530 studies were identified across the six databases, with 158 studies read in full by the authors after excluding duplicates and those that did not meet the inclusion criteria. The final 29 studies were analyzed for methodological quality and risk of bias using the AXIS and SFS-D tools.</p><p><strong>Conclusion: </strong>This review identified 27 self-administered validated instruments useful for assessing various mental health outcomes in police officers, with the most frequently used being the Police Stress Questionnaire. These findings may help guide security force administration, occupational health professionals, and mental health researchers in selecting and implementing psychometrically reliable instruments for screening the mental health of police officers.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11507048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"It Is Time to Take Complaints Seriously? An Exploratory Analysis of Communications Sent by Users to a Public Healthcare Agency before, during and after the COVID-19 Pandemic.","authors":"Claudia Venuleo, Tiziana Marinaci, Camilla Cucugliato, Sonia Giausa","doi":"10.3390/ijerph21101299","DOIUrl":"https://doi.org/10.3390/ijerph21101299","url":null,"abstract":"<p><p>Taking due account of users' perspectives is crucial for improving the quality of healthcare services. This study aimed to analyse the representations and evaluation criteria that users of a public health agency express towards care and treatment services and to explore whether and how the content and meaning of their communications varied according to pre-pandemic, pandemic or post-pandemic periods. A total of 501 communications sent to the public relations office of an Italian health agency were collected. An automatic content analysis procedure was applied to the textual corpus. Four main thematic cores were identified concerning the request for care and respect, the value of the doctor-patient relationship and the difficulties in contacting services and accessing care. Two main latent dimensions of meaning were identified, which capture the dialectic between the demand for relationships and the demand for access to care, and between attention to the relational competence of health workers and attention to the needs and rights of users. Communications collected during the pre-pandemic and post-pandemic periods mainly concern the difficulty of access to care; those collected during the pandemic period mainly concern the doctor-patient relationship. Interpersonal aspects and timely access to care appear to be crucial in users' assessment of the quality of care.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11507578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric Properties of the PLAY<i>self</i> in a Cohort of Secondary School Student-Athletes.","authors":"Monica R Lininger, Hayley J Root","doi":"10.3390/ijerph21101294","DOIUrl":"https://doi.org/10.3390/ijerph21101294","url":null,"abstract":"<p><strong>Background: </strong>Physical literacy is the motivation, confidence, physical competence, knowledge, and understanding, enabling individuals to value and take responsibility for engagement in physical activities for life. While tools exist to measure physical literacy in most populations, the psychometric properties of the Physical Literacy Assessment for Youth (PLAY) tool in an older adolescent age group are currently unknown. The purpose of this work was to determine the psychometric properties of the PLAY tool, specifically the PLAY<i>self,</i> in an older adolescent age group (~14-18 years).</p><p><strong>Methods: </strong>One hundred and fifty-one secondary school in-season student-athletes completed the PLAY<i>self</i>, with construct validity assessed using an Exploratory Factor Analysis (EFA).</p><p><strong>Results: </strong>Results from the EFA yielded a 7-factor model across the three subsections (environment, physical literacy self-description, relative rankings of literacies) of the PLAY<i>self</i>, all with acceptable levels of internal consistency.</p><p><strong>Conclusions: </strong>The PLAY<i>self</i> produced acceptable estimates for construct validity and reliability, making it a useful tool for measuring physical literacy in secondary school student-athletes.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11507620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-Based Differences in Pulmonary Function and Cardiopulmonary Response 30 Months Post-COVID-19: A Brazilian Multicentric Study.","authors":"Cássia da Luz Goulart, Guilherme Peixoto Tinoco Arêas, Mauricio Milani, Fernanda Facioli Dos Reis Borges, Juliana Ribeiro Magalhães, Guilherme Dionir Back, Audrey Borghi-Silva, Luciano Fonseca Lemos Oliveira, André Ribeiro de Paula, Carolina Coimbra Marinho, Déborah Pereira Prado, Celso Nascimento de Almeida, Cristiane Maria Carvalho Costa Dias, Vinícius Afonso Gomes, Luiz Eduardo Fonteles Ritt, Leandro Tolfo Franzoni, Ricardo Stein, Mansueto Gomes Neto, Gerson Cipriano Junior, Fernando Almeida-Val","doi":"10.3390/ijerph21101293","DOIUrl":"https://doi.org/10.3390/ijerph21101293","url":null,"abstract":"<p><p><b>Aim</b>: (I) to verify if there are sex differences in respiratory function, respiratory muscle strength, and effort limitation in individuals recovered from severe acute COVID-19 30 months after the initial infection, and (II) to evaluate the influence of length of stay on cardiorespiratory capacity among men and women. <b>Methods</b>: Cross-sectional observational multicentric study with participants from five Brazilian states (São Paulo, Amazonas, Minas Gerais, Bahia, and Brasília). We assessed lung function and respiratory muscle strength by maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), and cardiorespiratory fitness by cardiopulmonary exercise test (CPET). <b>Results</b>: 86 individuals were stratified by sex (48 women and 38 men). Females had significantly longer hospitalization for acute COVID-19 (<i>p</i> < 0.05) and showed a marked reduction in MIP (cmH₂O and % predicted). Regarding the CPET, women presented lower V˙O₂% predicted, O₂ pulse, and oxygen uptake efficiency slope (OUES, % predicted) (<i>p</i> < 0.05). In addition, women also had greater abnormal combinations between RER < 1.10, OUES < 80% predicted, VE/VVM < 15% [3 (6.2%)] and V˙O₂% predicted < 80%, V˙E/V˙CO₂ slope and V˙O₂/workload < 8.4 mL/min/W [8 (17%)]. The regression analysis showed a significant influence of age, length of hospitalization (< and >10 days), and FEV₁/FVC (%) on the V˙O₂ peak (mL·kg^-1·min^-1). Secondarily, we found that women hospitalized for more than 10 days had worse O₂ pulse (<i>p</i> = 0.03), OUES % predicted (<i>p</i> < 0.001), and worse V˙O₂% predicted (<i>p</i> < 0.009). <b>Conclusion</b>: Women exhibited more pronounced impairments in several key indicators of cardiopulmonary function 30 months post-infection.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11507074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Disposable Diaper Collection Project in Langa, Cape Town, South Africa: A Pilot Study.","authors":"Catherina Schenck, Hugh Tyrrell, Lizette Grobler, Rissa Niyobuhungiro, Alexander Kimani","doi":"10.3390/ijerph21101292","DOIUrl":"https://doi.org/10.3390/ijerph21101292","url":null,"abstract":"<p><p>In developing countries, there is currently no established waste management plan that includes resource recovery from used disposable diapers (DDs) apart from incineration and landfilling. In low-income areas with limited storage space, the complex composition and odour of used DDs make it impossible to manage properly if not supported by effective waste management systems. In the absence of effective waste management, DDs are dumped in open spaces, burned or buried. These actions pose threats to the safety and health of humans, animals and the environment. Separation and collection of DDs are critical preliminary steps to landfilling, recycling or beneficiation. In this article, we describe a case study of two pilot collection projects in Langa township in Cape Town, South Africa, to determine whether and how a source-separated collection system can work in low-income, resource-constrained areas. The lessons learned highlighted the following: The eagerness of parents to participate for the benefit of their own and their children's health; the complementarity of the two pilot collection models to serve the needs of the community; the important role non-government organisations play in the implementation of waste management projects; the significance of the possible job creation opportunities and the unintended benefits of enhancing social cohesion. The financial sustainability of these projects needs further exploration.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To See and Be Seen: A Swedish Register Study on Children Who Witness Family Violence.","authors":"Sven Trygged, Tove Bylund Grenklo, Anneli Marttila, Niklas Halin","doi":"10.3390/ijerph21101291","DOIUrl":"https://doi.org/10.3390/ijerph21101291","url":null,"abstract":"<p><p>Authorities and civilians can make a report-of-concern to Social Services if they suspect a child is experiencing or witnessing violence. In 2021, Sweden implemented new legislation that considers children as victims of crime not only when abused but also when witnessing family violence, i.e., Barnfridsbrott. This study aimed to describe and analyze reports-of-concern regarding children witnessing family violence. Are there any changes in number of reports over the years? Who is reporting? And what interventions are most frequent? This is a register-based study of reports-of-concern in Gävle municipality in Sweden for the years 2018-2022. This unique register makes it possible to identify and follow up reported cases as long as they are active by Social Services. Results show there was already a major increase in the number of reports-of-concern in 2020. Most reports are made by Social Services and the police. Of all reports related to family violence, an increasing number lead to further investigations. In most of those cases, the children stay with their families, and Social Services offer counselling. Conclusion: there was a distinct increase in reports related to children witnessing family violence already starting in 2020 in the studied municipality, before the new legislation was implemented.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11507186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating Pregnant Women's Attitudes toward Herbal Remedies: A Cross-Sectional Study.","authors":"Deniz Al-Tawalbeh, Falastine Hamdan, Eshraq Al-Momani, Huda Atiyeh, Amal Mayyas","doi":"10.3390/ijerph21101290","DOIUrl":"https://doi.org/10.3390/ijerph21101290","url":null,"abstract":"<p><strong>Background: </strong>Herbal remedies play a significant role in daily life, regardless of region or ethnicity. While they offer various health benefits, they may also pose risks, including toxicity and undesirable side effects. Pregnant women, one of the most vulnerable populations, frequently use herbal remedies, often without informing their healthcare providers, which can lead to unforeseen consequences for both the mother and the fetus.</p><p><strong>Method: </strong>A total of 590 women participated in an online survey designed to assess demographic factors, awareness of herbal remedies during pregnancy, and the potential impact of these remedies on maternal and fetal health.</p><p><strong>Results: </strong>The survey revealed that 35.8% of the participants used herbal remedies during pregnancy. The most common reasons for their use were beliefs in their safety and family recommendations. Anise (<i>Pimpinella anisum</i> L.) was the most frequently used herb.</p><p><strong>Conclusions: </strong>The findings indicate that pregnant women generally have limited knowledge about herbal remedies and their potential risks. To mitigate this, it is essential to develop and disseminate comprehensive safety and efficacy guidelines. Both physicians and pregnant women should be well-informed to ensure the protection of maternal and fetal health.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}