Ultrasonic ImagingPub Date : 2024-03-01Epub Date: 2023-12-22DOI: 10.1177/01617346231220000
Jie Chen, Zeying Wen, Xiaoqing Yang, Jie Jia, Xiaodong Zhang, Linping Pian, Ping Zhao
{"title":"Ultrasound-Based Radiomics for the Classification of Henoch-Schönlein Purpura Nephritis in Children.","authors":"Jie Chen, Zeying Wen, Xiaoqing Yang, Jie Jia, Xiaodong Zhang, Linping Pian, Ping Zhao","doi":"10.1177/01617346231220000","DOIUrl":"10.1177/01617346231220000","url":null,"abstract":"<p><p>Henoch-Schönlein purpura nephritis (HSPN) is one of the most common kidney diseases in children. The current diagnosis and classification of HSPN depend on pathological biopsy, which is seriously limited by its invasive and high-risk nature. The aim of the study was to explore the potential of radiomics model for evaluating the histopathological classification of HSPN based on the ultrasound (US) images. A total of 440 patients with Henoch-Schönlein purpura nephritis proved by biopsy were analyzed retrospectively. They were grouped according to two histopathological categories: those without glomerular crescent formation (ISKDC grades I-II) and those with glomerular crescent formation (ISKDC grades III-V). The patients were randomly assigned to either a training cohort (<i>n</i> = 308) or a validation cohort (<i>n</i> = 132) with a ratio of 7:3. The sonologist manually drew the regions of interest (ROI) on the ultrasound images of the right kidney including the cortex and medulla. Then, the ultrasound radiomics features were extracted using the Pyradiomics package. The dimensions of radiomics features were reduced by Spearman correlation coefficients and least absolute shrinkage and selection operator (LASSO) method. Finally, three radiomics models using k-nearest neighbor (KNN), logistic regression (LR), and support vector machine (SVM) were established, respectively. The predictive performance of such classifiers was assessed with receiver operating characteristic (ROC) curve. 105 radiomics features were extracted from derived US images of each patient and 14 features were ultimately selected for the machine learning analysis. Three machine learning models including k-nearest neighbor (KNN), logistic regression (LR), and support vector machine (SVM) were established for HSPN classification. Of the three classifiers, the SVM classifier performed the best in the validation cohort [area under the curve (AUC) =0.870 (95% CI, 0.795-0.944), sensitivity = 0.706, specificity = 0.950]. The US-based radiomics had good predictive value for HSPN classification, which can be served as a noninvasive tool to evaluate the severity of renal pathology and crescentic formation in children with HSPN.</p>","PeriodicalId":49401,"journal":{"name":"Ultrasonic Imaging","volume":" ","pages":"110-120"},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138886449","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}
Ultrasonic ImagingPub Date : 2024-03-01Epub Date: 2024-01-10DOI: 10.1177/01617346231225016
{"title":"Corrigendum to \"A Data-Driven Approach for Estimating Temperature Variations Based on B-mode Ultrasound Images and Changes in Backscattered Energy\".","authors":"","doi":"10.1177/01617346231225016","DOIUrl":"10.1177/01617346231225016","url":null,"abstract":"","PeriodicalId":49401,"journal":{"name":"Ultrasonic Imaging","volume":" ","pages":"135"},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418449","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}
Ultrasonic ImagingPub Date : 2024-03-01Epub Date: 2024-02-06DOI: 10.1177/01617346231226224
Mingrui Liu, Zhengchang Kou, Yuning Zhao, James W Wiskin, Gregory J Czarnota, Michael L Oelze
{"title":"Spectral-based Quantitative Ultrasound Imaging Processing Techniques: Comparisons of RF Versus IQ Approaches.","authors":"Mingrui Liu, Zhengchang Kou, Yuning Zhao, James W Wiskin, Gregory J Czarnota, Michael L Oelze","doi":"10.1177/01617346231226224","DOIUrl":"10.1177/01617346231226224","url":null,"abstract":"<p><p>Quantitative ultrasound (QUS) is an imaging technique which includes spectral-based parameterization. Typical spectral-based parameters include the backscatter coefficient (BSC) and attenuation coefficient slope (ACS). Traditionally, spectral-based QUS relies on the radio frequency (RF) signal to calculate the spectral-based parameters. Many clinical and research scanners only provide the in-phase and quadrature (IQ) signal. To acquire the RF data, the common approach is to convert IQ signal back into RF signal via mixing with a carrier frequency. In this study, we hypothesize that the performance, that is, accuracy and precision, of spectral-based parameters calculated directly from IQ data is as good as or better than using converted RF data. To test this hypothesis, estimation of the BSC and ACS using RF and IQ data from software, physical phantoms and in vivo rabbit data were analyzed and compared. The results indicated that there were only small differences in estimates of the BSC between when using the original RF, the IQ derived from the original RF and the RF reconverted from the IQ, that is, root mean square errors (RMSEs) were less than 0.04. Furthermore, the structural similarity index measure (SSIM) was calculated for ACS maps with a value greater than 0.96 for maps created using the original RF, IQ data and reconverted RF. On the other hand, the processing time using the IQ data compared to RF data were substantially less, that is, reduced by more than a factor of two. Therefore, this study confirms two things: (1) there is no need to convert IQ data back to RF data for conducting spectral-based QUS analysis, because the conversion from IQ back into RF data can introduce artifacts. (2) For the implementation of real-time QUS, there is an advantage to convert the original RF data into IQ data to conduct spectral-based QUS analysis because IQ data-based QUS can improve processing speed.</p>","PeriodicalId":49401,"journal":{"name":"Ultrasonic Imaging","volume":" ","pages":"75-89"},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10962227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Application Value of Ultrasound Elastography Combined With Contrast-Enhanced Ultrasound (CEUS) Quantitative Analysis in Differentiation of Nodular Fibrocystic Changes of the Breast From Invasive Ductal Carcinoma.","authors":"Jiajia Li, Yunfeng Wu, Zhaoyu Tian, Linfeng Shu, Siru Wu, Zuohui Wu","doi":"10.1177/01617346231217087","DOIUrl":"10.1177/01617346231217087","url":null,"abstract":"<p><p>This study aimed to compare the value of ultrasound elastography combined with contrast-enhanced ultrasound (CEUS) quantitative analysis in the differentiation of nodular fibrocystic breast change (FBC) from breast invasive ductal carcinoma (BIDC). We selected 50 patients each with nodular FBC and BIDC, who were admitted to the Affiliated Hospital of Zunyi Medical University from January 2018 to December 2021. Their ultrasonic elastic images and CEUS videos were collected, their ultrasound elastography scores and the ratio of strain rate (SR) of the lesions were determined, and the exported DICOM format videos of CEUS were quantitatively analyzed using VueBox software to obtain quantitative perfusion parameters. The differences between the ultrasound elastography score and SR while comparing nodular FBC and BIDC cases were statistically significant (<i>p</i> < .05). The sensitivity, specificity, and accuracy of ultrasound elastography scores in the differential diagnoses of nodular FBC and BIDC were 74%, 88%, and 81%, respectively. Additionally, the sensitivity, specificity, and accuracy of SR in the differential diagnosis of nodular FBC and BIDC were 94%, 78%, and 86%, respectively. Statistically significant differences were observed in the CEUS quantitative perfusion parameters PE, AUC (WiAUC, WoAUC, WiWoAUC), and WiPI in both nodular FBC and BIDC according to the VueBox software (<i>p</i> < .05). The sensitivity, specificity, and accuracy of CEUS quantitative analysis in the differential diagnoses of nodular FBC and BIDC were 66%, 82%, and 74%, respectively. Using the pathological findings as the gold standard, ROC curves were established, and the area under the curve (AUC) of the CEUS quantitative analysis, elasticity score, SR, and ultrasound elastography combined with CEUS quantitative analysis were 0.731, 0.838, and 0.892, as well as 0.945, respectively. Ultrasound elasticity scoring, SR and CEUS quantitative analysis have certain application value for differentiating nodular FBC cases from BIDC; however, ultrasound elasticity imaging combined with CEUS quantitative analysis can help in improving the differential diagnostic efficacy of nodular FBC cases from BIDC.</p>","PeriodicalId":49401,"journal":{"name":"Ultrasonic Imaging","volume":" ","pages":"102-109"},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812370","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}
Ultrasonic ImagingPub Date : 2024-01-01Epub Date: 2023-12-01DOI: 10.1177/01617346231205810
Luiz F R Oliveira, Felipe M G França, Wagner C A Pereira
{"title":"A Data-Driven Approach for Estimating Temperature Variations Based on B-mode Ultrasound Images and Changes in Backscattered Energy.","authors":"Luiz F R Oliveira, Felipe M G França, Wagner C A Pereira","doi":"10.1177/01617346231205810","DOIUrl":"10.1177/01617346231205810","url":null,"abstract":"<p><p>Thermal treatments that use ultrasound devices as a tool have as a key point the temperature control to be applied in a specific region of the patient's body. This kind of procedure requires caution because the wrong regulation can either limit the treatment or aggravate an existing injury. Therefore, determining the temperature in a region of interest in real-time is a subject of high interest. Although this is still an open problem, in the field of ultrasound analysis, the use of machine learning as a tool for both imaging and automated diagnostics are application trends. In this work, a data-driven approach is proposed to address the problem of estimating the temperature in regions of a B-mode ultrasound image as a supervised learning problem. The proposal consists in presenting a novel data modeling for the problem that includes information retrieved from conventional B-mode ultrasound images and a parametric image built based on changes in backscattered energy (CBE). Then, we compare the performance of classic models in the literature. The computational results presented that, in a simulated scenario, the proposed approach that a Gradient Boosting model would be able to estimate the temperature with a mean absolute error of around 0.5°C, which is acceptable in practical environments both in physiotherapic treatments and high intensity focused ultrasound (HIFU).</p>","PeriodicalId":49401,"journal":{"name":"Ultrasonic Imaging","volume":" ","pages":"3-16"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138471139","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":"Automatic Detection of Thyroid Nodule Characteristics From 2D Ultrasound Images.","authors":"Dongxu Han, Nasir Ibrahim, Feng Lu, Yicheng Zhu, Hongbo Du, Alaa AlZoubi","doi":"10.1177/01617346231200804","DOIUrl":"10.1177/01617346231200804","url":null,"abstract":"<p><p>Thyroid cancer is one of the common types of cancer worldwide, and Ultrasound (US) imaging is a modality normally used for thyroid cancer diagnostics. The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TIRADS) has been widely adopted to identify and classify US image characteristics for thyroid nodules. This paper presents novel methods for detecting the characteristic descriptors derived from TIRADS. Our methods return descriptions of the nodule margin irregularity, margin smoothness, calcification as well as shape and echogenicity using conventional computer vision and deep learning techniques. We evaluate our methods using datasets of 471 US images of thyroid nodules acquired from US machines of different makes and labeled by multiple radiologists. The proposed methods achieved overall accuracies of 88.00%, 93.18%, and 89.13% in classifying nodule calcification, margin irregularity, and margin smoothness respectively. Further tests with limited data also show a promising overall accuracy of 90.60% for echogenicity and 100.00% for nodule shape. This study provides an automated annotation of thyroid nodule characteristics from 2D ultrasound images. The experimental results showed promising performance of our methods for thyroid nodule analysis. The automatic detection of correct characteristics not only offers supporting evidence for diagnosis, but also generates patient reports rapidly, thereby decreasing the workload of radiologists and enhancing productivity.</p>","PeriodicalId":49401,"journal":{"name":"Ultrasonic Imaging","volume":" ","pages":"41-55"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684194","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}
Ultrasonic ImagingPub Date : 2024-01-01Epub Date: 2023-11-20DOI: 10.1177/01617346231207404
Yuanshan Wu, Victor Barrere, Aria Ashir, Xiaojun Chen, Livia T Silva, Saeed Jerban, Aiguo Han, Michael P Andre, Sameer B Shah, Eric Y Chang
{"title":"High-frequency Quantitative Ultrasound Imaging of Human Rotator Cuff Muscles: Assessment of Repeatability and Reproducibility.","authors":"Yuanshan Wu, Victor Barrere, Aria Ashir, Xiaojun Chen, Livia T Silva, Saeed Jerban, Aiguo Han, Michael P Andre, Sameer B Shah, Eric Y Chang","doi":"10.1177/01617346231207404","DOIUrl":"10.1177/01617346231207404","url":null,"abstract":"<p><p>This study evaluated the repeatability and reproducibility of using high-frequency quantitative ultrasound (QUS) measurement of backscatter coefficient (BSC), grayscale analysis, and gray-level co-occurrence matrix (GLCM) textural analysis, to characterize human rotator cuff muscles. The effects of varying scanner settings across two different operators and two US systems were investigated in a healthy volunteer with normal rotator cuff muscles and a patient with chronic massive rotator cuff injury and substantial muscle degeneration. The results suggest that BSC is a promising method for assessing rotator cuff muscles in both control and pathological subjects, even when operators were free to adjust system settings (depth, level of focus, and time-gain compensation). Measurements were repeatable and reproducible across the different operators and ultrasound imaging platforms. In contrast, grayscale and GLCM analyses were found to be less reliable in this setting, with significant measurement variability. Overall, the repeatability and reproducibility measurements of BSC indicate its potential as a diagnostic tool for rotator cuff muscle evaluation.</p>","PeriodicalId":49401,"journal":{"name":"Ultrasonic Imaging","volume":" ","pages":"56-70"},"PeriodicalIF":2.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11170563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ultrasonic ImagingPub Date : 2024-01-01Epub Date: 2023-11-20DOI: 10.1177/01617346231208709
Mohammed Ahmed, Hongbo Du, Alaa AlZoubi
{"title":"ENAS-B: Combining ENAS With Bayesian Optimization for Automatic Design of Optimal CNN Architectures for Breast Lesion Classification From Ultrasound Images.","authors":"Mohammed Ahmed, Hongbo Du, Alaa AlZoubi","doi":"10.1177/01617346231208709","DOIUrl":"10.1177/01617346231208709","url":null,"abstract":"<p><p>Efficient Neural Architecture Search (ENAS) is a recent development in searching for optimal cell structures for Convolutional Neural Network (CNN) design. It has been successfully used in various applications including ultrasound image classification for breast lesions. However, the existing ENAS approach only optimizes cell structures rather than the whole CNN architecture nor its trainable hyperparameters. This paper presents a novel framework for automatic design of CNN architectures by combining strengths of ENAS and Bayesian Optimization in two-folds. Firstly, we use ENAS to search for optimal normal and reduction cells. Secondly, with the optimal cells and a suitable hyperparameter search space, we adopt Bayesian Optimization to find the optimal depth of the network and optimal configuration of the trainable hyperparameters. To test the validity of the proposed framework, a dataset of 1522 breast lesion ultrasound images is used for the searching and modeling. We then evaluate the robustness of the proposed approach by testing the optimized CNN model on three external datasets consisting of 727 benign and 506 malignant lesion images. We further compare the CNN model with the default ENAS-based CNN model, and then with CNN models based on the state-of-the-art architectures. The results (error rate of no more than 20.6% on internal tests and 17.3% on average of external tests) show that the proposed framework generates robust and light CNN models.</p>","PeriodicalId":49401,"journal":{"name":"Ultrasonic Imaging","volume":" ","pages":"17-28"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048256","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":"A Novel Method for Prediction of Raised Intracranial Pressure Through Automated ONSD and ETD Ratio Measurement From Ocular Ultrasound.","authors":"Maninder Singh, Vishal Gupta, Rajeev Gupta, Basant Kumar, Deepak Agrawal","doi":"10.1177/01617346231197593","DOIUrl":"10.1177/01617346231197593","url":null,"abstract":"<p><p>The paper presents a novel framework for the prediction of the raised Intracranial Pressure (ICP) from ocular ultrasound images of traumatic patients through automated measurement of Optic Nerve Sheath Diameter (ONSD) and Eyeball Transverse Diameter (ETD). The measurement of ONSD using an ocular ultrasound scan is non-invasive and correlates with the raised ICP. However, the existing studies suggested that the ONSD value alone is insufficient to indicate the ICP condition. Since the ONSD and ETD values may vary among patients belonging to different ethnicity/origins, there is a need for developing an independent global biomarker for predicting raised ICP condition. The proposed work develops an automated framework for the prediction of raised ICP by developing algorithms for the automated measurement of ONSD and ETD values. It is established that the ONSD and ETD ratio (OER) is a potential biomarker for ICP prediction independent of ethnicity and origin. The OER threshold value is determined by performing statistical analysis on the data of 57 trauma patients obtained from the AIIMS, New Delhi. The automated OER is computed and compared with the conventionally measured ICP by determining suitable correlation coefficients. It is found that there is a significant correlation of OER with ICP (<i>r</i> = .81, <i>p</i> ≤ .01), whereas the correlation of ONSD alone with ICP is relatively less (<i>r</i> = .69, <i>p</i> = .004). These correlation values indicate that OER is a better parameter for the prediction of ICP. Further, the threshold value of OER is found to be 0.21 for predicting raised ICP conditions in this study. Scatter plot and Heat map analysis of OER and corresponding ICP reveal that patients with OER ≥ 0.21, have ICP in the range of 17 to 35 mm Hg. In the data available for this research work, OER ranges from 0.17 to 0.35.</p>","PeriodicalId":49401,"journal":{"name":"Ultrasonic Imaging","volume":" ","pages":"29-40"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10268363","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}
Ultrasonic ImagingPub Date : 2023-09-01Epub Date: 2023-08-29DOI: 10.1177/01617346231195598
Charles F Babbs, Mary V Lang
{"title":"Rapid and Efficient Computation of Cell Paths During Ultrasonic Focusing.","authors":"Charles F Babbs, Mary V Lang","doi":"10.1177/01617346231195598","DOIUrl":"10.1177/01617346231195598","url":null,"abstract":"<p><p>This biophysical analysis explores the first-principles physics of movement of white blood cell sized particles, suspended in an aqueous fluid and experiencing progressive or standing waves of acoustic pressure. In many current applications the cells are gradually nudged or herded toward the nodes of the standing wave, providing a degree of acoustic focusing and concentration of the cells in layers perpendicular to the direction of sound propagation. Here the underlying biomechanics of this phenomenon are analyzed specifically for the viscous regime of water and for small diameter microscopic spheroids such as living cells. The resulting mathematical model leads to a single algebraic expression for the creep or drift velocity as a function of sound frequency, amplitude, wavelength, fluid viscosity, boundary dimensions, and boundary reflectivity. This expression can be integrated numerically by a simple and fast computer algorithm to demonstrate net movement of particles as a function of time, providing a guide to optimization in a variety of emerging applications of ultrasonic cell focusing.</p>","PeriodicalId":49401,"journal":{"name":"Ultrasonic Imaging","volume":" ","pages":"227-239"},"PeriodicalIF":2.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10113289","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}