American Journal of Audiology最新文献

{"title":"Effects of Age on the Frequency Amplitude Ratio of Cervical and Ocular Vestibular Evoked Myogenic Potentials.","authors":"Raghav H Jha, Erin G Piker, Jesus Gomez","doi":"10.1044/2024_AJA-23-00253","DOIUrl":"10.1044/2024_AJA-23-00253","url":null,"abstract":"<p><strong>Purpose: </strong>An increase in the 1000/500 Hz frequency amplitude ratio (FAR) of the cervical and ocular vestibular evoked myogenic potentials (cVEMP and oVEMP, respectively) may serve as a potential biomarker for diagnosing Meniere's disease (MD). However, the aging process can also result in an increased FAR for VEMPs. In older patients, distinguishing whether changes in VEMP FAR are due to MD or aging processes becomes difficult. We aimed to investigate the effects of age on VEMP FARs and establish a FAR-normative range for different age groups.</p><p><strong>Method: </strong>cVEMP and oVEMP were recorded from a total of 106 participants grouped as young, middle-aged, and older adults using air-conducted tone bursts at 500, 750, and 1000 Hz at 125 dB pSPL. The FAR was calculated for the cVEMP and oVEMP for the following frequencies: FAR1 = 1000/500, FAR2 = 1000/750, and FAR3 = 750/500.</p><p><strong>Results: </strong>A significant age-related effect was observed on the cVEMP FAR. Although the oVEMP FAR showed an increasing trend with age, it was not statistically significant. Age-based normative FAR values are provided.</p><p><strong>Conclusions: </strong>Drawing from the normative FAR from this study, there is evidence that the existing MD diagnostic criteria would misidentify a considerable number of older adults. Therefore, to reduce false positives, we recommend a more stringent cVEMP and oVEMP FAR criterion in older adults.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"411-421"},"PeriodicalIF":1.8,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of Hearing Health Care: A Qualitative Analysis of Satisfied and Dissatisfied Online Reviews.","authors":"Sanchia van Bruggen, Rebecca Jane Bennett, Vinaya Manchaiah, Leigh Biagio-de Jager, De Wet Swanepoel","doi":"10.1044/2024_AJA-23-00180","DOIUrl":"10.1044/2024_AJA-23-00180","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to examine the hearing health care experience of satisfied and dissatisfied consumers as reported on Google reviews.</p><p><strong>Method: </strong>Using qualitative thematic analysis, open-text responses from Google regarding hearing health care clinics across 40 U.S. cities were examined. During the original search, 13,168 reviews were identified. Purposive sampling led to a total of 8,420 five-star reviews and 321 one-star reviews. The sample consisted of 500 five-star (satisfied) and 234 one-star (dissatisfied) reviews, describing experiences with audiology clinics, excluding reviews related to ear, nose, and throat services; other medical specialties; and those not relevant to hearing health care.</p><p><strong>Results: </strong>Satisfied and dissatisfied consumer reviews yielded nuanced dimensions of the hearing health care consumer experience, which were grouped into distinct domains, themes, and subthemes. Six and seven domains were identified from the satisfied and dissatisfied reviews, encompassing 23 and 26 themes, respectively. The overall experience domain revealed emotions ranging from contentment and gratitude to dissatisfaction and waning loyalty. The clinical outcomes domain highlights the pivotal contribution of well-being and hearing outcomes to the consumer experience, while the standard of care domain underscores shared expectations for punctuality, person-centered care, and efficient communication. Facility quality, professional competence, and inclusive care were also highlighted across positive and negative reviews.</p><p><strong>Conclusions: </strong>Findings indicate dimensions of satisfied and dissatisfied hearing health care consumer experiences, identifying areas for potential service refinement. These consumer experiences inform person-centric service delivery in hearing health care.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"386-410"},"PeriodicalIF":1.8,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Validity and Reliability of the Turkish Version of Preschool Hearing Environments and Reflection on Quality of Life Questionnaire.","authors":"Sinem Kırseven, Emel Tahir, Özlem Cangökçe Yaşar","doi":"10.1044/2024_AJA-23-00033","DOIUrl":"10.1044/2024_AJA-23-00033","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to assess preschool children's hearing-related quality of life and to introduce the scale, originally titled \"Preschool Hearing Environments and Reflections on Quality of Life Questionnaire\" (Preschool HEAR-QL), to the literature through Turkish adaption, validity, and reliability analyses.</p><p><strong>Method: </strong>Our study included 210 children aged 2-6 years: 110 with hearing loss (56 cochlear implant users and 54 hearing aid users) and 100 with normal hearing. Demographic data were collected and then the Preschool HEAR-QL, which was translated into Turkish, was administered twice at 15-day intervals. Confirmatory factor analysis was used to determine whether the factor structure found in the original scale development study was confirmed in our sample (construct validity). Cronbach's alpha, intraclass correlation scores, and the test-retest method were used to assess the scale's reliability as the findings were analyzed using paired samples <i>t</i> tests.</p><p><strong>Results: </strong>The children with hearing loss had lower scores than their normal-hearing peers, and the difference was significant in the subdomains of behavior and attention, hearing environments, and communication. The subscale of the Preschool Period Listening Environments and their Reflections on Quality of Life Scale consists of 23 items, and Cronbach's alpha value was found as 0.922 in the first application and 0.926 in the second application (high reliability). In the model established for validity analysis, χ²/<i>df</i> = 2.156, root-mean-square error of approximation = 0.074, standard root-mean-square residual = 0.078, goodness-of-fit index = 0.830, adjusted goodness-of-fit index = 0.789, comparative fit index = 0.895, and Tucker-Lewis index = 0.881 (good model fit). In terms of test-retest reliability, the correlation between the two measurements was 0.837, and there was no statistical difference between the test-retest scores (<i>p</i> = .15).</p><p><strong>Conclusion: </strong>The Turkish version of the Preschool HEAR-QL scale was proven to be a valid and reliable scale for assessing the hearing-related quality of life of children aged 2-6 years.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.25236949.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"343-353"},"PeriodicalIF":1.8,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Cognitive Abilities and Basic Auditory Processing in Young Adults.","authors":"Akshay R Maggu, Bhamini Sharma","doi":"10.1044/2024_AJA-23-00261","DOIUrl":"10.1044/2024_AJA-23-00261","url":null,"abstract":"<p><strong>Purpose: </strong>The diagnosis of auditory processing disorder (APD) is controversial particularly due to the influence of higher order factors of language and cognition on the diagnostic APD testing. As a result, there might be a need for testing for other domains (e.g., cognition) along with conducting the diagnostic APD testing to rule out the influence of other domains. In order to make recommendations on whether cognitive testing is needed along with the auditory processing testing, as a starting point, the current study was conducted to examine the relationship between cognitive abilities and basic auditory processing in young adults.</p><p><strong>Method: </strong>A total of 38 young adults with normal audiometric thresholds between 250 and 8000 Hz participated in this study. They were tested on their executive function, language, processing speed, working memory, and episodic memory components of cognitive testing and tests for temporal fine structure and spectrotemporal sensitivity for auditory processing testing.</p><p><strong>Results: </strong>No significant correlation was found between the cognitive tests and the tests for basic auditory processing in young adults.</p><p><strong>Conclusions: </strong>These findings present contrast to the existing findings in children and older adults where a stronger correlation between cognitive abilities and auditory processing has been found. The current findings suggest that testing for cognitive abilities may not be needed when testing for basic auditory processing in young adults.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"422-432"},"PeriodicalIF":1.8,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140159287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies of Hearing Preservation With Military Personnel: A Scoping Review.","authors":"Adriana Betes Heupa, Pierângela Nota Simões, Cristiano Miranda de Araújo, Karinna Veríssimo Meira Taveira, Maria Renata José, Claudia Giglio de Oliveira Gonçalves, Débora Lüders","doi":"10.1044/2024_AJA-23-00160","DOIUrl":"10.1044/2024_AJA-23-00160","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to map the strategies used in hearing health education with military personnel during the Hearing Preservation Program (HPP).</p><p><strong>Method: </strong>This study is a scoping review, with electronic searches conducted in online databases and gray literature: Latin American and Caribbean Literature in Health Sciences, PubMed/Medline, Scopus, Web of Science, ASHAWire, Google Scholar, and ProQuest Dissertation & Theses. Only studies describing, analyzing, or evaluating the application of the HPP to active duty or training military personnel were included.</p><p><strong>Results: </strong>A total of 3,478 references were retrieved, and 12 studies met the inclusion criteria. The strategies were classified into five categories: focus group aimed at exploring knowledge and perceptions regarding hearing health (five studies), training on the proper fitting of hearing protection devices (four studies), the utilization of audiovisual materials (seven studies), questionnaires administrated before and after educational intervention (five studies), and feedback survey concerning the implemented hearing health education (three studies).</p><p><strong>Conclusion: </strong>There are five strategies that aimed at assessing knowledge and attitudes, improving hearing health education, facilitating information access, and evaluating the applied actions.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.25219589.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"586-605"},"PeriodicalIF":1.4,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adults With Cochlear Implants: Residual Hearing, Musical Perception, and Temporal Skills.","authors":"Nuriye Yıldırım Gökay, Emre Orhan, Volkan Tutar, Hakan Tutar, Recep Karamert, Bülent Gündüz","doi":"10.1044/2024_AJA-23-00266","DOIUrl":"10.1044/2024_AJA-23-00266","url":null,"abstract":"<p><strong>Purpose: </strong>The main purpose of the study is to investigate whether the presence of residual hearing before cochlear implantation has an effect on temporal pattern recognition skills and musical perception in adults.</p><p><strong>Method: </strong>The study included adults with cochlear implants who were between the ages of 20 and 45 years. Adults with cochlear implants were divided into two groups: absent (<i>n</i> = 20) and available (<i>n</i> = 20) groups according to residual hearing before implantation. Frequency Pattern and Duration Pattern tests were applied to evaluate temporal pattern recognition, and the \"Music-Related Quality of Life Questionnaire\" was applied to evaluate musical perceptions.</p><p><strong>Results: </strong>There were no statistically significant differences between the groups in terms of cochlear-implanted hearing thresholds and speech recognition scores, musical perception, and musical activities, according to their residual hearing. On the other hand, the frequency and duration pattern recognition skills were statistically significantly better in adults with residual hearing. Also, statistically significant correlations were obtained in terms of temporal skills and musical perception subskills.</p><p><strong>Conclusions: </strong>The presence of residual hearing before cochlear implantation may affect temporal auditory processing skills. It is concluded that the integration of cochlear implants may affect temporal processing skills in adults as well as quality of life. It is recommended that experts be aware of this issue and pay attention to residual hearing.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"379-385"},"PeriodicalIF":1.8,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining Barriers to Early Hearing Diagnosis.","authors":"Ursula M Findlen, Holly Gerth, Angie Zemba, Nicole Schuller, Gina Guerra, Chloe Vaughan, Madeline Brimmer, Jason Benedict","doi":"10.1044/2024_AJA-23-00174","DOIUrl":"10.1044/2024_AJA-23-00174","url":null,"abstract":"<p><strong>Purpose: </strong>Many factors create barriers for early hearing detection and intervention (EHDI), especially those related to unfavorable social determinants of health (SDOH). The primary aim of this study was to evaluate diagnostic timing of infants at risk for congenital hearing loss in consideration of known barriers. Understanding the specific barriers to early diagnosis can inform interventions to improve timeliness of diagnosis and subsequent habilitation.</p><p><strong>Method: </strong>A retrospective chart review was completed for infants referred for diagnostic audiologic testing at a tertiary urban-setting Children's Hospital from 2018 to 2021. After exclusion criteria were applied, 1,488 infants were included in the analysis. Various factors were recorded from electronic medical records including those specific to SDOH. Time to diagnosis was derived and compared across five factors of interest that have previously been shown to impact diagnostic timeline, including (a) insurance type, (b) race/ethnicity, (c) presence of middle ear dysfunction at first auditory brainstem response (ABR), (d) proximity to diagnostic center, and (e) diagnostic timing before and during/after the COVID-19 pandemic.</p><p><strong>Results: </strong>Across the study time period, 77% of infants referred for diagnostic testing had confirmed diagnosis by the EHDI benchmark of 3 months. Analysis of time to diagnosis across factors of interest revealed no clinically significant differences for insurance type, race/ethnicity, proximity to diagnostic center, or timing in reference to the COVID-19 pandemic. Presence of middle ear dysfunction on first ABR was found to significantly protract final diagnostic timing.</p><p><strong>Conclusions: </strong>Although some known barriers for EHDI can be universal, other factors may have a differential impact on an infant's timeline to diagnosis based on their specific location, which can interact differently with additional known barriers. Understanding local challenges will serve to better guide programs in implementing facilitators that will address their specific needs for improved outcomes.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"369-378"},"PeriodicalIF":1.8,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing and Functioning in Everyday Life Questionnaire: Psychometric Evaluation and Revision.","authors":"Elin Karlsson, Vinaya Manchaiah, Elina Mäki-Torkko, Sarah Granberg, Johanna Gustafsson, Örjan Dahlström, Stephen Widén","doi":"10.1044/2024_AJA-23-00171","DOIUrl":"10.1044/2024_AJA-23-00171","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the current study was to explore the construct validity and internal consistency reliability of the International Classification of Functioning, Disability and Health (ICF)-based original English version of the Hearing and Functioning in Everyday Life Questionnaire (HFEQ) and to revise the HFEQ based on the results.</p><p><strong>Method: </strong>This study used a cross-sectional survey design. The data were collected using an online survey. Adults with self-reported hearing disability (<i>n</i> = 513) from the United States were included. The ICF components of body functions, activity and participation, and environmental factors were tested as the underlying structure of the HFEQ using confirmatory factor analysis and then adjusted by triangulation with previous content validation.</p><p><strong>Results: </strong>The results of the current study confirmed the ICF components of body functions, activity and participation, and environmental factors as underlying constructs of the HFEQ. However, after triangulation with previous content validation, fine adjustments were made. The revised version of the HFEQ includes two removed items and a fine-tuned factor structure.</p><p><strong>Conclusion: </strong>The results confirm that the structure of the HFEQ aligns with the ICF, and the overall results indicate that HFEQ has acceptable construct validity and internal consistency.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"330-342"},"PeriodicalIF":1.8,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discussing Patient Emotions in Audiology: Provider Experiences With the Implementation Process of Hearing Loss Psychological Inflexibility Screenings.","authors":"Sydnee Grigsby, Karen Muñoz, Guadalupe G San Miguel, Michael P Twohig","doi":"10.1044/2024_AJA-23-00198","DOIUrl":"10.1044/2024_AJA-23-00198","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate barriers and facilitators experienced by clinical educators and graduate students when talking with patients about difficult emotions and thoughts related to their hearing.</p><p><strong>Method: </strong>A longitudinal observational design was used and an Implementation Research Logic Model guided the process. Five clinical educators and five graduate students participated in the study. Participants completed pre- and postmeasures and attended individual debriefing sessions during the 8-month study period.</p><p><strong>Results: </strong>Four themes emerged from the debriefing sessions: (a) learning process, (b) confidence, (c) barriers, and (d) supervision. Participants described that the Acceptance and Action Questionnaire-Managing Child Hearing Loss and Acceptance and Action Questionnaire-Adult Hearing Loss served as a reminder to ask about patients' internal barriers and increased awareness of their discomfort in talking about patient emotions. Participants also described barriers and struggles related to supporting students in gaining counseling skills.</p><p><strong>Conclusions: </strong>Screening for internal challenges helped clinicians remember to talk with patients about their difficult thoughts and emotions. Clinician hesitancy to engage in conversations with patients about their emotions can interfere with opportunities for patients to share their struggles and with training student in these skills.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"354-368"},"PeriodicalIF":1.4,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial Hearing in Children With and Without Hearing Loss: Where and What the Speech Is Matters for Local Speech Intelligibility.","authors":"Andrea L Pittman, M Torben Pastore","doi":"10.1044/2024_AJA-23-00250","DOIUrl":"10.1044/2024_AJA-23-00250","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined children's ability to perceive speech from multiple locations on the horizontal plane. Children with hearing loss were compared to normal-hearing peers while using amplification with and without advanced noise management.</p><p><strong>Method: </strong>Participants were 21 children with normal hearing (9-15 years) and 12 children with moderate symmetrical hearing loss (11-15 years). Word recognition, nonword detection, and word recall were assessed. Stimuli were presented randomly from multiple discrete locations in multitalker noise. Children with hearing loss were fit with devices having separate omnidirectional and noise management programs. The noise management feature is designed to preserve audibility in noise by rapidly analyzing input from all locations and reducing the noise management when speech is detected from locations around the hearing aid user.</p><p><strong>Results: </strong>Significant effects of left/right and front/back lateralization occurred as well as effects of hearing loss and hearing aid noise management. Children with normal hearing experienced a left-side advantage for word recognition and a right-side advantage for nonword detection. Children with hearing loss demonstrated poorer performance overall on all tasks with better word recognition from the back, and word recall from the right, in the omnidirectional condition. With noise management, performance improved from the front compared to the back for all three tasks and from the right for word recognition and word recall.</p><p><strong>Conclusions: </strong>The shape of children's local speech intelligibility on the horizontal plane is not omnidirectional. It is task dependent and shaped further by hearing loss and hearing aid signal processing. Front/back shifts in children with hearing loss are consistent with the behavior of hearing aid noise management, while the right-side biases observed in both groups are consistent with the effects of specialized speech processing in the left hemisphere of the brain.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"442-454"},"PeriodicalIF":1.8,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}