BMJ mental health最新文献

{"title":"Addressing youths' climate change-related distress: a qualitative study on the experience of burden, triggering and protective factors.","authors":"Henrik Wasmus,Leonie Fleck,Tim Schmidt,Stefan Scheydt,Frederike Schirmbeck,Evaldas Kazlauskas,Wietse Tol,Ulrich Reininghaus","doi":"10.1136/bmjment-2025-301549","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301549","url":null,"abstract":"BACKGROUND AND OBJECTIVEIn recent years, growing scientific and public awareness has highlighted the negative impacts of climate change on mental health, particularly among young people, who are disproportionately affected. These findings underscore the need for effective and scalable interventions to support individuals experiencing climate change-related distress (CCD). At the initial stage, it is crucial to understand how this distress manifests and what the momentary risk and protective factors are that exacerbate and modulate its dynamic occurrence in everyday life.METHODSIn this context of need, nine qualitative, semistructured interviews with young individuals, aged between 14 and 25 and living in Germany, with CCD were conducted. Interviews centred on individuals' burdens, putative triggers eliciting the experience, as well as putative protective factors. We analysed the data and developed themes via Braun and Clarke's reflexive thematic analysis and electively structured the analysis according to the coding paradigm adopted from Strauss and Corbin.RESULTSParticipants reported experiencing a wide range of negative emotions as well as mental health difficulties associated with climate change, including sleep disturbances, reduced well-being and difficulties concentrating. The experience emerges from the understanding and awareness of the complexity of climate change and its associated consequences for the environment. Protective factors were reported, including positive emotions (eg, hope, finding meaning and purpose), self-efficacy, conceptual knowledge about climate change-related emotions and external factors (ie, social support). Participants employed various strategies to regulate their emotions, ranging from avoidance and distraction to strategies like acceptance, cognitive reappraisal and active engagement in pro-environmental behaviour or activism.CONCLUSION AND CLINICAL IMPLICATIONSOverall, this study enhances our understanding of young individuals' emergence and daily life experience of CCD. The findings suggest that a prolonged or overly extensive occurrence may result in mental health difficulties. Moreover, the results highlight the importance of strengthening factors associated with resilience at a young age, enabling individuals to cope with CCD. The findings have implications for the development of potential intervention components and suggest imparting conceptual knowledge and adaptive regulatory strategies, supporting habit formation and providing networking opportunities with others affected by CCD.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood exposure to particulate matter and nitrogen oxides and associations with mental health disorders in early adulthood: testing mediation by cognition in a UK longitudinal cohort study.","authors":"Thomas Canning,Louise Arseneault,Rachel M Latham,Joanne B Newbury,Aaron Reuben,Ioannis Bakolis,Helen L Fisher","doi":"10.1136/bmjment-2025-301864","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301864","url":null,"abstract":"BACKGROUNDLittle is known about the mechanisms underlying associations between air pollution exposure in childhood and mental health disorders in adulthood.OBJECTIVETo examine the prospective associations between age-10 air pollution exposure and age-18 mental health disorders and to test potential mediation by impaired cognition at age 12.METHODSWe used longitudinal observations of 1969 members of the Environmental Risk Study who were born across England and Wales in 1994-1995. Exposure to nitrogen dioxide, nitrogen oxides (NOx) and particulate matter (PM2.5 and PM10) was modelled for residential addresses at age 10. Past-year prevalence of anxiety, depression, conduct disorder and attention-deficit/hyperactivity disorder was assessed by interview at age 18. Overall cognition (full-scale IQ) and specific domains (fluid ability, crystallised ability and working memory) were assessed at age 12. We employed binary logistic regression to examine pollution-disorder associations and generalised structural equation modelling to examine mediation via impaired cognition.FINDINGSHigher exposure to NOx was associated with greater odds of depression after covariate adjustment (OR=1.25, 95% CI 1.01 to 1.55). No robust associations were evident for the other pollutants or outcomes. Overall cognition (indirect effect (IE): OR=1.00, 95% CI 0.99 to 1.01) and crystallised ability (IE: OR=1.00, 95% CI 0.99 to 1.01) did not mediate the association between NOx and depression.CONCLUSIONSWe found no evidence that impaired cognition mediated associations between childhood residential exposure to NOx and depression in early adulthood.CLINICAL IMPLICATIONSPolicies to reduce childhood exposure to NOx may help reduce depression in early adulthood. Future research should examine alternative mechanisms.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"114 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145203888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient engagement in forensic mental health care: a scoping review.","authors":"Junqiang Zhao,Stephanie Junes,Christopher Canning,Janet Jull,Achal Mishra,Andrea Waddell,Yaara Zisman-Ilani,N Zoe Hilton","doi":"10.1136/bmjment-2025-301678","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301678","url":null,"abstract":"QUESTIONThis scoping review aimed to examine the state of research on patient engagement in forensic mental health (FMH) care to inform future research, practice and policy development.STUDY SELECTION AND ANALYSISA systematic literature search was conducted in Medline, Embase, CINHAL, PsycINFO and EBSCO from database inception to June 2024, supplemented by grey literature and reviews. We analysed the included studies descriptively and narratively.FINDINGSOf the 7010 records retrieved, 73 studies were included. Research on patient engagement in FMH has increased since 1999, with all studies conducted in high-income countries and the majority (64%) employing qualitative designs. The focus was primarily on risk assessment and management, recovery and therapeutic or medication interventions. Most patient participants were male, white and diagnosed with schizophrenia, personality disorders or substance use disorders. Nurses were the major staff participants. The levels of engagement were typically involvement and collaboration. Commonly reported outcomes were a sense of engagement and risks of violence and aggression. We identified barriers and potential strategies for patient engagement across five levels: patient, staff, process, organisational and sociopolitical. Barriers to patient engagement included, but were not limited to, patients' mental health conditions, paternalistic staff attitudes and power imbalances. Potential strategies to enhance patient engagement were identified, such as the adoption of recovery-oriented care models.CONCLUSIONSPatient engagement in FMH is hindered by multilevel barriers, requiring coordinated efforts from policymakers, organisational leaders, professionals and patients to facilitate its integration into routine practice. Greater attention is needed to ensure the meaningful engagement of marginalised populations and patients from low and middle-income countries.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of just-in-time adaptive interventions for improving mental health and psychological well-being: a systematic review and meta-analysis.","authors":"Ulrike von Lützow,Nathalie Laura Neuendorf,Sebastian Scherr","doi":"10.1136/bmjment-2025-301641","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301641","url":null,"abstract":"QUESTIONThe rising prevalence of mental health conditions and a global treatment gap demand new solutions that address symptoms and foster psychological well-being. Just-in-time adaptive interventions (JITAIs) and ecological momentary interventions (EMIs) are emerging mobile health approaches, providing real-time, personalised support. However, the effectiveness of current JITAIs/EMIs and the longevity of effects remain uncertain.STUDY SELECTION AND ANALYSISStudies investigating the effectiveness of JITAIs/EMIs for depression, anxiety and indicators of psychological well-being, published between 2018 and May 2025, were eligible. Following the standards for reporting (Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PRISMA) and quality assessment (Risk of Bias; RoB), a total of K=23 studies and N=2563 individuals (71.7% female) were included.FINDINGSJITAIs/EMIs showed a small between-group effect (g=0.15, 95% CI 0.05 to 0.26, p=0.003). Nine studies reported follow-up effects (mean follow-up time M=3.06 months, SD=2.21) with significant results at 1 and 3-6 months. Interventions shorter than 6 weeks yielded greater longevity of effects (g=0.71, 95% CI 0.18 to 1.24, p=0.008). Funnel plots and sensitivity analyses confirmed robustness of findings. Risk of bias was moderate to high for intervention adherence and missing outcome data.CONCLUSIONSCurrently existing JITAIs and EMIs slightly improve mental health, particularly mental illness, with long-term effects up to 6 months. A clear definition of JITAIs and decision rules, research on long-term effects and careful selection of control conditions are needed.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acoustic signatures of depression elicited by emotion-based and theme-based speech tasks.","authors":"Qunxing Lin,Xiaohua Wu,Yueshiyuan Lei,Wanying Cheng,Shan Huang,Weijie Wang,Chong Li,Jiubo Zhao","doi":"10.1136/bmjment-2025-301858","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301858","url":null,"abstract":"BACKGROUNDMajor depressive disorder (MDD) remains underdiagnosed worldwide, partly due to reliance on self-reported symptoms and clinician-administered interviews.OBJECTIVEThis study examined whether a speech-based classification model using emotionally and thematically varied image-description tasks could effectively distinguish individuals with MDD from healthy controls.METHODSA total of 120 participants (59 with MDD, 61 healthy controls) completed four speech tasks: three emotionally valenced images (positive, neutral, negative) and one Thematic Apperception Test (TAT) stimulus. Speech responses were segmented, and 23 acoustic features were extracted per sample. Classification was performed using a long short-term memory (LSTM) neural network, with SHapley Additive exPlanations (SHAP) applied for feature interpretation. Four traditional machine learning models (support vector machine, decision tree, k-nearest neighbour, random forest) served as comparators. Within-subject variation in speech duration was assessed with repeated-measures Analysis of Variance.FINDINGSThe LSTM model outperformed traditional classifiers, capturing temporal and dynamic speech patterns. The positive-valence image task achieved the highest accuracy (87.5%), followed by the negative-valence (85.0%), TAT (84.2%) and neutral-valence (81.7%) tasks. SHAP analysis highlighted task-specific contributions of pitch-related and spectral features. Significant differences in speech duration across tasks (p<0.01) indicated that affective valence influenced speech production.CONCLUSIONSEmotionally enriched and thematically ambiguous tasks enhanced automated MDD detection, with positive-valence stimuli providing the greatest discriminative power. SHAP interpretation underscored the importance of tailoring models to different speech inputs.CLINICAL IMPLICATIONSSpeech-based models incorporating emotionally evocative and projective stimuli offer a scalable, non-invasive approach for early depression screening. Their reliance on natural speech supports cross-cultural application and reduces stigma and literacy barriers. Broader validation is needed to facilitate integration into routine screening and monitoring.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Work absence in parents of youth who self-harm.","authors":"Moa Karemyr,Ester Gubi,Anna Ohlis,Gergö Hadlaczky,David Mataix-Cols,Clara Hellner,Ralf Kuja-Halkola,Johan Bjureberg","doi":"10.1136/bmjment-2025-301833","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301833","url":null,"abstract":"BACKGROUNDSelf-harm is a prevalent health concern among youths, with significant psychosocial impacts on both youths and their parents. The aim of this study is to describe the impact of offspring self-harm on parental work absence.METHODSThis cohort study included 176 472 mothers and 161 833 fathers of 17 726 youths with a first self-harm diagnosis between the years of 2006 and 2016 and 177 260 matched youths without self-harm. It examined work absence due to family leave to care for a sick child and sick leave, before and after the child's self-harm. Data were sourced from Swedish population-based registers. Conditional Poisson regression, adjusting for potential confounders, was used to analyse associations between self-harm and work absence in parents of youth with and without self-harm after the self-harm event, as well as in parents of self-harming youth before and after the self-harm event.RESULTSParents of both sexes experienced work absence. Nevertheless, mothers were particularly affected. Youth self-harm was linked to increased family leave (rate ratios: mothers 3.47 (95% CI 3.25 to 3.72), fathers 2.71 (2.47 to 2.98)) and sick leave (mothers 1.25 (1.20 to 1.31), fathers 1.25 (1.17 to 1.33)). Parents of affected youth took more family leave during the self-harm year compared with the previous year (mothers 1.65 (1.55 to 1.75), fathers 1.41 (1.29 to 1.54)), with no corresponding rise in sick leave.CONCLUSIONSParents of self-harming youths experience increased work absence, especially family leave, peaking around self-harm events. These results highlight the broader impact of youth self-harm on families and the need for support systems addressing both youth and caregiver well-being and work-life balance.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpreting psychiatric digital phenotyping data with large language models: a preliminary analysis.","authors":"Matthew Flathers,Winna Xia,Christine Hau,Benjamin W Nelson,Jiaee Cheong,James Burns,John Torous","doi":"10.1136/bmjment-2025-301817","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301817","url":null,"abstract":"BACKGROUNDDigital phenotyping provides passive monitoring of behavioural health but faces implementation challenges in translating complex multimodal data into actionable clinical insights. Digital navigators, healthcare staff who interpret patient data and relay findings to clinicians, provide a solution, but workforce limitations restrict scalability.OBJECTIVEThis study provides one of the first systematic evaluation of large language model performance in interpreting simulated psychiatric digital phenotyping data, establishing baseline accuracy metrics for this emerging application.METHODSWe evaluated GPT-4o and GPT-3.5-turbo across over 153 test cases covering various clinical scenarios, timeframes and data quality levels using simulated test datasets currently employed in training human digital navigators. Performance was assessed on the model's capacity to identify clinical patterns relative to human digital navigation experts.FINDINGSGPT-4o demonstrated 52% accuracy (95% CI 46.5% to 57.6%) in identifying clinical patterns based on standard test cases, significantly outperforming GPT-3.5-turbo (12%, 95% CI 8.4% to 15.6%). When analysing GPT-4o's performance across different scenarios, strongest results were observed for worsening depression (100%) and worsening anxiety (83%) patterns while weakest performance was seen for increased home time with improving symptoms (6%). Accuracy declined with decreasing data quality (69% for high-quality data vs 39% for low-quality data) and shorter timeframes (60% for 3-month data vs 43% for 3-week data).CONCLUSIONSGPT-4o's 52% accuracy in zero-shot interpretation of psychiatric digital phenotyping data establishes a meaningful baseline, though performance gaps and occasional hallucinations confirm human oversight in digital navigation tasks remains essential. The significant performance variations across models, data quality levels and clinical scenarios highlight the need for careful implementation.CLINICAL IMPLICATIONSLarge language models could serve as assistive tools that augment human digital navigators, potentially addressing workforce limitations while maintaining necessary clinical oversight in psychiatric digital phenotyping applications.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Need to address mental health within climate change education.","authors":"Fionnuala Mottishaw,Sarah MacQuarrie","doi":"10.1136/bmjment-2025-301548","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301548","url":null,"abstract":"Education plays a crucial role in equipping young people with the skills and knowledge necessary to navigate the challenges of adulthood. In the context of the escalating climate crisis, climate change education (CCE) has an essential role in this aim. Despite an increase of research in the area, where young people have been identified as being particularly concerned about climate change, CCE continues to be under-represented in the UK curriculum. This article explores critical considerations for developing an effective approach to CCE. It emphasises the importance of young people's emotional responses to this aspect of their education that can shape their engagement with the topic. It addresses the need to consider how informal learning through social media and online platforms can have a significant impact on views of the crisis, as well as behaviour. Finally, the article proposes several evidence-based strategies to enhance the integration of CCE into formal education, fostering both critical engagement and actionable understanding among students.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in daily living dependency and incident depressive symptoms among older individuals: findings from four prospective cohort studies.","authors":"Juxiang Yang,Gang Song,Minheng Zhang,Hongwei Liu,Miaomiao Hou","doi":"10.1136/bmjment-2025-301749","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301749","url":null,"abstract":"BACKGROUNDWith rapid population ageing, depressive symptoms in older adults have become a pressing public health concern. While functional dependency is a known risk factor, the impact of changes in dependency over time remains unclear.OBJECTIVETo examine the association between changes in daily living dependency and incident depressive symptoms in older adults across international cohorts.METHODSWe used data from 46 327 adults aged ≥50 years across four longitudinal ageing studies: China Health and Retirement Longitudinal Study (China), Health and Retirement Study (USA), English Longitudinal Study of Ageing (England) and Survey of Health, Ageing and Retirement in Europe (Europe). Daily living dependency was classified into three levels based on difficulties in activities of daily living (ADLs) and instrumental ADLs (IADLs). Change in dependency was assessed using baseline and 2-year follow-up data. Depressive symptoms were measured using the Center for Epidemiologic Studies depressive symptoms Scale or the European Depression Scales (EURO-D). Cox proportional hazard models estimated HRs and 95% CIs for incident depressive symptoms over a median follow-up of 4.2-5.1 years.FINDINGSA total of 12 902 new depressive symptom cases occurred during follow-up. Compared with participants whose dependency status remained unchanged, those who recovered to independency had a significantly reduced risk of depressive symptoms. Functional deterioration, including transitions from independency to ADL or IADL dependency, was associated with increased risk of depressive symptoms (both pooled HRs 1.55), while functional improvement, from ADL or IADL dependency to independency, was linked to reduced risk (HRs 0.83 and 0.80, respectively).CONCLUSIONSImprovement in ADL dependency is linked to a lower risk of depressive symptoms, while worsening dependency significantly increases depressive symptoms risk.CLINICAL IMPLICATIONSRoutine assessment of functional status and early interventions to maintain or restore daily living independency may help prevent depressive symptoms in older adults. Targeted rehabilitation and support services could play a key role in reducing the mental health burden of ageing populations.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BMJ Connections Mental Health, a new BMJ journal.","authors":"Andrea Cipriani","doi":"10.1136/bmjment-2025-302078","DOIUrl":"https://doi.org/10.1136/bmjment-2025-302078","url":null,"abstract":"","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}