International Journal of Psychiatry in Medicine最新文献

{"title":"Spirituality and people with psychosis: A content analysis of influential primetime television programs.","authors":"David R Hodge, Patricia R Turner","doi":"10.1177/00912174241240305","DOIUrl":"10.1177/00912174241240305","url":null,"abstract":"<p><strong>Objective: </strong>This mixed methods study examined depictions of spirituality among people with psychosis in influential television programming. Spirituality is a central strength for many people with psychosis. Yet, despite the important role media plays in shaping perceptions, little research has examined the intersection between spirituality and psychosis in the popular media.</p><p><strong>Methods: </strong>To address this gap, we conducted a content analysis of the 50 most viewed primetime fictional television shows over a 10-year period as determined by the Nielsen rating organization. Characters with psychosis were identified via keyword searches of online sources (Wikis, IMDb, etc.) and subsequently independently coded by two individuals. Characters were rated on 18 items in three domains related to demographics, life status, and character framing. Inter-rater reliability ranged from good to excellent across variables.</p><p><strong>Results: </strong>Of 120 identified characters with psychosis, just 16% (n = 19) had a spiritual identity. Analysis revealed few differences between spiritual and secular characters on demographic and life status variables. Conversely, an examination of framing variables revealed spiritual characters were comparatively less attractive, exhibited a greater negative impact on society, and were more likely to be referred to pejoratively (as a psychopath) and engage in criminal activity. Trend analysis indicated portrayals of spiritual characters decreased over time.</p><p><strong>Conclusions: </strong>The results suggest media depictions of spirituality contribute to the stigmatization of spirituality among people with psychosis, potentially preventing access to important coping resources and discouraging professional help-seeking. Primary care physicians should consider incorporating a spiritual assessment into care to determine spiritual coping assets and then support these.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"71-86"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140295080","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":"Prevalence and risk factors for chronic kidney disease among older adult patients with schizophrenia in Taiwan.","authors":"Shu-Ting Chang, Jiunn-Ying Liou, Bo-Jian Wu, Hsing-Kang Chen","doi":"10.1177/00912174241256164","DOIUrl":"10.1177/00912174241256164","url":null,"abstract":"<p><strong>Objectives: </strong>There is an increasing incidence and prevalence of patients with chronic kidney disease (CKD) worldwide. Little is known the prevalence of CKD among older patients with schizophrenia. The purpose of this study was to investigate the prevalence of CKD and its risk factors in older adults with schizophrenia.</p><p><strong>Methods: </strong>In this cross-sectional study, a convenience sample of 240 patients with schizophrenia age 50 or older was recruited. In addition to demographic and clinical data, participants' estimated glomerular filtration rate was calculated using the Modification of Diet in Renal Disease equation based on age, sex, ethnicity, and serum creatinine level determined from a blood sample taken from participants.</p><p><strong>Results: </strong>The overall prevalence of CKD was 11.3%. Those with CKD were older, had a longer duration of psychiatric illness, a higher body mass index (BMI), and diagnoses of hypertension compared to those in the non-CKD group. Independent of other risk factors, older age and BMI were significantly associated with CKD.</p><p><strong>Conclusions: </strong>This study found that the overall prevalence of CKD in older patients with schizophrenia was 11.3%. Independent risk factors for CKD in this population were older age and higher BMI. In addition to early identification and early treatment of CKD in older patients with schizophrenia, clinicians should actively manage the risk factors identified in this study.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"87-96"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065582","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":"Systematic review of long-acting injectable antipsychotic medications approved from 2008 to october 2024 and agents in phase 3.","authors":"Ashley Meyer, Kyla Truman, Jayant Totlani, Catherine William, Haze Brown, Shaishav Shah, Drew Hirsch, Mohamed Salem, Tiffany Chang, Rasha Abdelsalam, Sabrina Renteria, Nathalie Murphy, Rebecca Hedrick, Itai Danovitch, Robert N Pechnick, Waguih William IsHak","doi":"10.1177/00912174241310091","DOIUrl":"https://doi.org/10.1177/00912174241310091","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this systematic review is to provide a detailed summary of the long-acting injectable antipsychotic medications approved by the Food and Drug Administration (FDA) between 2008 to October 2024. We aim to provide an overview of the mechanism of action, indications for both labeled and off-label uses, evidence for efficacy, dosing, and the adverse effects of each drug.</p><p><strong>Methods: </strong>Studies published from 2008 to October 1, 2024, were identified from the PubMed database, using the keywords: 'long-acting injectables' OR 'LAI*'AND 'psychopharm*\" OR 'schizophrenia' The authors conducted a focused analysis independently and reached a consensus on the recently approved long-acting injectable antipsychotic medications to be included in this systematic review. Key findings were derived from the full text in order to create the tables from selected studies.</p><p><strong>Results: </strong>A total of 13 long-acting injectable antipsychotic medications for the treatment of schizophrenia were FDA-approved between 2008 and October 1, 2024. One long-acting injectable antipsychotic is currently being investigated in a Phase 3 clinical trial. The indications, evidence, practical implementation issues, and adverse effects of each drug are discussed in this review.</p><p><strong>Conclusion: </strong>Improved understanding of newly approved long-acting injectables is critical in the management of patients with schizophrenia. The FDA approval of long-acting injectables in the past 15 years creates hopeful options for clinicians to improve clinical outcomes and quality of life for their patients.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"912174241310091"},"PeriodicalIF":1.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866038","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":"Heart rate during moderate exercise and attention among adolescents: An experimental study.","authors":"Krzysztof Janota, Bertrand Janota","doi":"10.1177/00912174241309712","DOIUrl":"https://doi.org/10.1177/00912174241309712","url":null,"abstract":"<p><strong>Background: </strong>Existing studies on the effects of physical activity on cognitive function have predominantly focused on pre- or post-exercise effects, leaving a gap in understanding the immediate cognitive impacts during physical exertion. Understanding cognitive performance during activity could have significant implications for improving productivity and therapeutic strategies.</p><p><strong>Methods: </strong>This study examined the relationship between heart rate and cognitive performance, specifically attention, using the D2 attention test among 32 adolescents aged 12-18 years. Participants underwent attention assessments at rest and while moving at target heart rates of 100 bpm, 120 bpm, and 140 bpm. The influence of body mass index (BMI) and sleep quality on attention has been analysed too.</p><p><strong>Results: </strong>A significant positive correlation between heart rate and attention was observed (r = 0.39, <i>P</i> < .005), indicating enhanced cognitive performance with increased heart rate. Furthermore, a significant negative correlation was found between BMI and attention (r = -0.37, <i>P</i> = .039) and a significant positive correlation was found between sleep quality and attention (r = 0.66, <i>P</i> = .014).</p><p><strong>Conclusion: </strong>These findings suggest that moderate physical activity can enhance attention, which could inform the design of educational, therapeutic, and occupational strategies. Future research should explore the generalizability of these effects across different cognitive domains, age groups, and settings.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"912174241309712"},"PeriodicalIF":1.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848265","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":"Randomized controlled trial of bushen yinao pill combined with conventional therapy on intestinal flora imbalance and cognitive function improvement in older patients with Alzheimer's disease.","authors":"Wei Wang, Ji Zhang, Cangda Li","doi":"10.1177/00912174241290962","DOIUrl":"https://doi.org/10.1177/00912174241290962","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the effects of the Bushen Yinao Pill, combined with standard therapy, on gut flora imbalances, inflammatory markers, and cognitive function in older patients with Alzheimer's disease (AD).</p><p><strong>Methods: </strong>A total of 136 AD patients treated at the Department of Neurology from August 2022 to September 2023 were randomly assigned to two groups: 68 patients received standard treatment (control group, CTG), and 68 patients received the Bushen Yinao Pill plus standard treatment (intervention group, ITG). Outcomes included TCM syndrome scores, gut microbiota composition, inflammatory markers, cognitive function, overall efficacy, and safety.</p><p><strong>Results: </strong>ITG showed significant reductions in syndrome scores as compared to CTG after treatment (<i>P</i> < 0.05). The ITG also showed significant increases in beneficial bacteria and decreases in harmful bacteria compared to the CTG (<i>P</i> < 0.05). Inflammatory markers (Aβ, IL-6, TNF-α) were reduced, and cognitive function improved more significantly in the ITG (<i>P</i> < 0.05). The effective rate was higher in the ITG, with no significant difference in adverse reactions between the groups (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>The Bushen Yinao Pill, when combined with standard therapy, effectively regulates gut microbiota, reduces inflammatory markers, and enhances cognitive function in AD patients, showing a favorable safety profile. Further research is recommended to validate these findings in diverse populations.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"912174241290962"},"PeriodicalIF":1.1,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814843","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":"Depressive symptoms and its relation to all-cause and cardiovascular mortality among United States adults with different diabetic status.","authors":"Hua-Zhao Xu, Xiang-Da Meng, Qian Liu, Yu-Jun Xiong","doi":"10.1177/00912174241303099","DOIUrl":"https://doi.org/10.1177/00912174241303099","url":null,"abstract":"<p><strong>Objective: </strong>The relationship between diabetes, depressive symptoms, and mortality is well established. However, the effect of depressive symptoms on prediabetes and its relationship with mortality remains unclear. This study seeks to investigate the effects of depressive symptoms on mortality across different diabetic statuses.</p><p><strong>Methods: </strong>The study analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, with a final sample size of 36,246 participants. Mortality status and cause of death were determined by cross-referencing records with the publicly accessible National Death Index through 2019. Kaplan-Meier survival curves and Cox regression analysis were utilized to assess the relationship between depressive symptoms and mortality across different diabetic statuses from nondiabetic to prediabetic to diabetic.</p><p><strong>Results: </strong>In the non-diabetic group, no effect of depression severity on all-cause mortality or cardiovascular mortality was found in the final models. In the prediabetic group, however, the hazard ratios were increased for both mild depressive symptoms (HR = 1.349, 95% CI = 1.138-1.600) and moderate-to-severe depressive symptoms (HR = 1.651, 95% CI = 1.309-2.082). In the diabetic group, surprisingly, the risk was somewhat lower than in the pre-diabetic group (HR = 1.279, 95% CI = 1.084-1.509 for mild and HR = 1.285, 95% CI = 1.056-1.563 for moderate-to-severe depressive symptoms). Similar risk patterns were noted for cardiovascular disease (CVD) mortality, where risk of moderate-severe symptoms was even greater in the prediabetic group (HR = 1.834, 95% CI = 1.180-2.851).</p><p><strong>Conclusion: </strong>In this prospective cohort study of a nationally representative sample of U.S. adults, a positive association was found between depressive symptoms and mortality across different diabetic statuses. These findings highlight the importance of evaluating depressive symptoms across the glycemic spectrum, especially among individuals with prediabetes.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"912174241303099"},"PeriodicalIF":1.1,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693516","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":"Effects of chamomile oil inhalation on sleep quality in young adults with insomnia: A randomized controlled trial.","authors":"Y Deepa, A Vijay, L Nivethitha, G Nandhakumar, S Sathiya, A Mooventhan","doi":"10.1177/00912174241301279","DOIUrl":"10.1177/00912174241301279","url":null,"abstract":"<p><strong>Objective: </strong>Insomnia is characterized by difficulty falling asleep, staying sleep, or both. Aromatherapy is a commonly used complementary and alternative medicine practice by persons with insomnia. Previous studies have shown that use of chamomile oil during massage therapy improves the quality of sleep (QoS). However, to our knowledge, no randomized controlled trials have examined the effects of chamomile oil inhalation on the treatment of insomnia. The present study evaluated the effect of chamomile oil inhalation on QoS and insomnia severity in persons with insomnia.</p><p><strong>Methods: </strong>A total of 80-participants ages 18-35 with insomnia were randomly allocated to aromatherapy group (AG; n = 40) or a control group (CG; n = 40). Those in the AG group received chamomile oil inhalation, while those in the CG engaged in their normal routine for 10 minutes a day, daily for 15 days. The Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were administered before and after the intervention.</p><p><strong>Results: </strong>Within-group analysis showed a significant reduction both in PSQI and ISI scores among those in the AG (<i>P</i> < 0.001 for both scores), whereas the CG reported a significant reduction in PSQI score (<i>P</i> = 0.033) and no significant changes in ISI score (<i>P</i> = 0.068). The between groups analysis after the intervention demonstrated a significant reduction in PSQI and ISI scores in the AG group (<i>P</i> < 0.001 for both) compared to the CG. No participant in either group reported adverse events during or after the study.</p><p><strong>Conclusion: </strong>Fifteen days of chamomile oil inhalation before bedtime reduced insomnia severity and enhanced the quality of sleep for young adults suffering from insomnia. Further studies are needed to replicate the results of this study using an active control group.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"912174241301279"},"PeriodicalIF":1.1,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631861","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":"Association of uremic toxins and systemic inflammation with depression and anxiety among hemodialysis patients in Montenegro.","authors":"Batric Babovic, Natasa Belada Babovic, Filip Tomovic, Snezana Radovanovic, Mladen Debeljevic, Jelena Djordjevic, Olgica Mihaljevic","doi":"10.1177/00912174241298837","DOIUrl":"https://doi.org/10.1177/00912174241298837","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to examine the association between uremic toxins, inflammation, depression and anxiety among hemodialysis patients in Montenegro.</p><p><strong>Method: </strong>The cross-sectional study included 88 patients undergoing hemodialysis. Depression and anxiety symptoms were assessed by Patient Health Questionnaire (PHQ-9) and Beck Anxiety Inventory (BAI). The standard laboratory methods were used to measure uremic toxins and systemic inflammation (C-reactive protein, Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR)).</p><p><strong>Results: </strong>Clinically significant depression (PHQ-9 ≥ 10) and anxiety (BAI ≥16) were found in 55.7% and 27.2%, respectively. Logistic regression analyses revealed that serum urea, beta 2-microglobulin (B2M), and systemic inflammation (CRP, NLR, PLR) were significantly and independently associated with depressive symptoms, whereas serum urea, creatinine, uric acid, B2M, and systemic inflammation (CRP nad NLR) were associated with anxiety symptoms.</p><p><strong>Conclusions: </strong>Depressive symptoms and anxiety are common among hemodialysis patients in Montenegro, and are associated with increased levels of systematic inflammation, serum urea, and beta 2-microglobulin.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"912174241298837"},"PeriodicalIF":1.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584885","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":"Association between allostatic load and depression in patients with sleep disorders: Evidence from the National Health and Nutrition Examination Survey (NHANES).","authors":"Yiru Li, Junli Yan, Yuhong Li","doi":"10.1177/00912174241244479","DOIUrl":"10.1177/00912174241244479","url":null,"abstract":"<p><strong>Objective: </strong>Allostatic load (AL) is an indicator of the cumulative wear and tear on the body's physiological systems that can predict onset of a range of health problems. However, the relationship between AL and depression in patients with sleep disorders is unclear. This study explored the association between AL and depression in patients with sleep disorders.</p><p><strong>Methods: </strong>Using data from the 2015-2016 National Health and Nutrition Examination Survey, a total of 4618 adults aged 18 years and older in the United States were included in this cross-sectional analysis. AL was calculated using nine biological markers, with a score of ≥3 indicating a high level. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), with a score of ≥10 indicating risk for depression. Logistic regression models were employed to analyze the relationship between AL and depression.</p><p><strong>Results: </strong>Among the 1309 participants diagnosed with sleep disorders, 212 (16.2%) were identified as being at risk for depression on the PHQ-9. A total of 55.2% (n = 117) of depressed persons had high AL levels. In the unadjusted model, AL levels were associated with depression in those with sleep disorders (<i>OR</i>=1.53, 95% CI = 1.14-2.05, <i>p</i> < 0.01). This relationship remained significant in the adjusted model (<i>OR</i>=1.52, 95% CI=1.11-2.10, <i>p</i> < 0.05), after controlling for potential confounders.</p><p><strong>Conclusion: </strong>High AL levels in patients with sleep disorders were positively associated with depression, indicating that elevated AL may increase the risk of depression in this population, or alternatively, depression may increase the risk of AL.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"670-684"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337474","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":"Social connection and self-neglect: A case for broader exploration.","authors":"Jason Burnett, Gabrielle M Hoyumpa, Jennifer E S Beauchamp, Melba A Hernandez-Tejada, Ronald Acierno, Carla Perissinotto","doi":"10.1177/00912174241240619","DOIUrl":"10.1177/00912174241240619","url":null,"abstract":"<p><strong>Objective: </strong>Self-neglect (SN) is the most common report to Adult Protective Services (APS) and is associated with significant morbidity and mortality risks for older adults. Lack of instrumental support is a well-evidenced etiologic factor in the development and continuation of SN, but little is known about other modifiable social connection characteristics. The social connection framework provides evidence-based characteristics across structure, function, and quality missing from SN studies that could be identified if explored. These factors could provide prevention and intervention targets related to poor health.</p><p><strong>Methods: </strong>A narrative case study is presented using quantitative and qualitative data to explore social connection across structure, function, and quality in the context of SN.</p><p><strong>Results: </strong>The findings highlight the complexity of social connection that may be observed in SN cases reported to APS. Strategic utilization of direct and indirect social interventions to support social connection in this case are presented.</p><p><strong>Conclusion: </strong>The results from this case give rise to considerations that may be generalizable to other SN cases. Recommendations for future research on social connection in this population are provided.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"644-654"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428160","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}