Frontiers in child and adolescent psychiatry最新文献

{"title":"Multi-modal approach to preventing suicide in schools: a regionally-based UK pilot study.","authors":"Emma Ashworth, Claire Hanlon, Molly McCarthy, Anna Hunt, Sio Wynne, Rio Foster, Jo Robinson, Samuel McKay, Pooja Saini","doi":"10.3389/frcha.2026.1768052","DOIUrl":"10.3389/frcha.2026.1768052","url":null,"abstract":"<p><strong>Background: </strong>Despite emerging evidence for the effectiveness of school-based suicide prevention programmes worldwide, there are few being implemented in the United Kingdom, and they have not been tested. Cultural transferability of school-based interventions cannot be guaranteed, and adaptations may be required. We aimed to conduct a pilot study of the Australian Multi-Modal Approach to Preventing Suicide in Schools (MAPSS) programme, to assess its feasibility and acceptability for delivery in the UK, and the potential for a future trial. MAPSS consists of three components: a universal workshop, screening to identify at-risk students, and a targeted intervention for students at-risk.</p><p><strong>Methods: </strong>A pilot study following a mixed-method explanatory design was conducted. A pre/post-test quantitative design was used with Year 10 students (aged 14-15 years) from two secondary schools in Northwest England (<i>N</i> = 417). Participants were assessed at three timepoints using online quantitative surveys. A qualitative process evaluation was conducted with 24 students and professionals.</p><p><strong>Results: </strong>MAPSS was generally considered to be acceptable and feasible, although there were issues with student engagement and logistics regarding delivery in schools. There were no issues with safety and missing data were within acceptable limits. Pre/post-test analyses indicated significant improvements in depression, hopelessness, and suicide literacy scores after the universal component. Pre/post-test analyses for at-risk students indicated that suicide ideation and quality of life scores were significantly higher after participating in the targeted component. Qualitative data demonstrated a strong perceived need for suicide prevention efforts in schools, with MAPSS thought to help increase awareness and identify students who were at-risk that schools had not previously been aware of.</p><p><strong>Conclusions: </strong>MAPSS is potentially appropriate to deliver in UK schools and may be beneficial for students, although requires further testing. A larger trial is considered feasible and is required to explore the utility and potential effectiveness of MAPSS. However, further work is needed to refine and adapt the intervention before a future trial can take place, with consideration of the logistical and staffing pressures within schools, and to facilitate student uptake and engagement.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1768052"},"PeriodicalIF":1.5,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"School attendance matters: co-occurring trajectories of school attendance and academic achievement from elementary to secondary school in a Canadian context.","authors":"Heather Brittain, Tracy Vaillancourt","doi":"10.3389/frcha.2026.1729744","DOIUrl":"10.3389/frcha.2026.1729744","url":null,"abstract":"<p><strong>Introduction: </strong>School attendance and academic achievement are central indicators of student engagement and success, and relations between constructs are typically framed as predictors and outcomes, not as co-developing intertwined trajectories across multiple years of schooling. In Canada, where national attendance data are scarce, little is known about how absences and grades co-evolve through critical educational transitions. We examined heterogeneous joint trajectories of school absences and grade point averages (GPAs) from mid-elementary through secondary school (Grade 5 to Grade 12) and examined the transition to secondary school (Grade 8 to Grade 9) as a developmental turning point. We also assessed correlates of academic functioning classes including demographic factors, elementary school type (K-8 vs. middle school), bullying victimization, and depression and anxiety symptoms.</p><p><strong>Methods: </strong>Data were drawn from 701 students (53% girls; <i>M</i> _age = 10.9 years) participating in an eight-year longitudinal study spanning Grades 5-12 in southern Ontario, Canada. Official school-record data on annual absences and GPAs were analyzed using parallel-process piecewise latent growth curve modelling and multi-trajectory (latent class) analysis to identify distinct patterns of co-development and discontinuities at the secondary school transition.</p><p><strong>Results: </strong>On average, absences increased, and GPAs remained relatively stable across Grade 5 to Grade 12, with a significant increase of 2.76% percent days absent at the secondary school transition. Six joint trajectories were identified: three stable groups showed minimal, developmentally appropriate absences with high, moderate, and mid-range GPA and three risk groups showed increasing or chronic absences paired with declining grades (high increasing absences with moderate declining GPA; low-elementary high-secondary absences with low mid-range declining GPA; chronic absences with mid-range declining GPA). Lower socioeconomic status, male gender, and higher depressive symptoms characterized at-risk trajectories.</p><p><strong>Discussion: </strong>Findings indicate that school attendance and achievement are dynamically linked, and for some, change sharply during the secondary school transition. Results underscore the need for early, targeted monitoring of both domains and for additional research to guide intervention and policy in the Canadian education context.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1729744"},"PeriodicalIF":1.5,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12992258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary: Framing chronic absenteeism and emotionally based school absenteeism as public health problems.","authors":"Arielle Symone Clarke, Kate Dimond Fitzgerald, Laura Mufson","doi":"10.3389/frcha.2026.1771056","DOIUrl":"10.3389/frcha.2026.1771056","url":null,"abstract":"","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1771056"},"PeriodicalIF":1.5,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The neuroesthetics of music as an alternative therapeutic model for enhancing youth mental wellbeing.","authors":"K Pradeep, Anisha Nishanth, P Lalmohan, Lobo Manuel Alexander, S A Rajalakshmi","doi":"10.3389/frcha.2025.1721717","DOIUrl":"10.3389/frcha.2025.1721717","url":null,"abstract":"<p><p>Youth mental health challenges have escalated worldwide, particularly during adolescence and early adulthood, two critical developmental stages marked by pronounced neural plasticity, effective responsiveness, and the formation of social identity. Drawing on interdisciplinary research published in the last decade, this article critically reviews the neuroesthetics of music as an alternative and complementary therapeutic approach to promoting youth mental wellbeing. Integrating insights from neuroscience, music therapy, psychology, and cultural studies, the review examines how musical engagements activate and regulate interconnected neural systems, including the limbic, prefrontal, motor, and autonomic networks, thereby shaping reward processing, emotional regulation, stress modulation, and social bonding. Empirical studies from the past decade indicate that both passive listening and active music-making encompassing rhythm-centered interventions and movement-based practices are associated with significant reductions in anxiety and depressive symptoms, alongside improvements in attention, emotional resilience, and interpersonal synchrony. The analysis further emphasizes the cultural situatedness of musical experience, demonstrating that therapeutic outcomes are amplified when interventions are grounded in culturally embedded traditions such as Indian <i>raga</i> frameworks, Afro-Brazilian rhythmic practices, and community-oriented musical participation. In addition, the article reviews recent methodological developments, including multimodal neuroimaging, psychophysiological measures, and emerging AI-assisted adaptive sound systems, all of which enhance the precision, scalability, and personalization of music-based therapies. Taken together, this synthesis positions neuroesthetic approaches to music as a neurobiologically informed, culturally responsive, and economically accessible model with considerable potential to strengthen contemporary youth mental health interventions across diverse global contexts.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"4 ","pages":"1721717"},"PeriodicalIF":1.5,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Mothers' eating disorder history and mother and infant attention to food during infant meal times: a candidate for intergenerational transmission of eating disorder behaviours.","authors":"Fay Huntley, Rebecca M Pearson, Ilaria Costantini, Marc H Bornstein, Amy Campbell, Miguel Cordero, Nicky Wright","doi":"10.3389/frcha.2026.1794833","DOIUrl":"10.3389/frcha.2026.1794833","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/frcha.2025.1699643.].</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1794833"},"PeriodicalIF":0.0,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12961409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic variability and response to sertraline in pediatric populations: a review on pharmacogenetics, pharmacokinetics, and the risk of adverse events.","authors":"Jesús Alonso Gándara-Mireles, Verónica Loera Castañeda, Ismael Lares-Asseff, Julio Cesar Grijalva Ávila, Maria Magdalena Rosales Ramos, Ignacio Villanueva Fierro, Leslie Patrón Romero, Horacio Almanza Reyes","doi":"10.3389/frcha.2026.1731268","DOIUrl":"10.3389/frcha.2026.1731268","url":null,"abstract":"<p><p>Anxiety disorders in the pediatric population represent a highly prevalent mental health concern whose pharmacological management has been consolidated through the use of selective serotonin reuptake inhibitors (SSRIs). Among these agents, sertraline is one of the most frequently prescribed; however, its efficacy and safety in children and adolescents exhibit substantial interindividual variability, largely attributed to clinical, physiological, and genetic factors. This review aimed to analyze the current evidence on the efficacy, safety, and optimization strategies for sertraline therapy in pediatric patients, with a particular focus on pharmacokinetic and pharmacogenetic determinants that modulate therapeutic response. Available evidence indicates that genetic variants in CYP2C19, CYP2D6, and ABCB1 significantly influence hepatic metabolism, plasma exposure, and drug tolerability. These differences support the integration of pharmacogenetic testing as a clinical tool to individualize dosing and prevent adverse effects. In addition, population pharmacokinetic modeling has emerged as a valuable approach to design personalized therapeutic regimens, especially for patients with medical comorbidities or atypical metabolic profiles. In conclusion, the integration of clinical, genetic, and pharmacokinetic information into pediatric psychiatric practice may facilitate the advancement of precision medicine, promoting safer, more effective, and individualized sertraline-based treatments for anxiety disorders in children and adolescents.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1731268"},"PeriodicalIF":1.5,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12953123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What drives EBSA across contexts? evidence from China using BERTopic.","authors":"Hang Chen","doi":"10.3389/frcha.2026.1720890","DOIUrl":"10.3389/frcha.2026.1720890","url":null,"abstract":"<p><p>Emotionally based school avoidance (EBSA) has been extensively studied in Western contexts, yet little is known about its manifestation in non-Western settings. This study applies BERTopic and semantic network analysis to 60,000 counseling-based narratives from Chinese adolescents to examine the psychological, familial, school, and systemic factors underlying EBSA. The analysis identified seven thematic domains: anxiety-driven symptoms, sensory overload, family conflict, peer and teacher difficulties, post-COVID adjustment, systemic barriers, and loss of belonging. These results validate the cross-contextual relevance of established EBSA constructs while also revealing institutional challenges unique to the Chinese context. Methodologically, the study demonstrates how computational text analysis can extend qualitative inquiry to large-scale, culturally grounded data. Substantively, it advances EBSA research by integrating individual, relational, and systemic dimensions, offering both cross-cultural insights and practical implications. The findings suggest that Chinese schools should strengthen teacher-student trust, foster collaborative family-school partnerships, and adopt systemic, preventive strategies to reduce EBSA and promote student well-being.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1720890"},"PeriodicalIF":1.5,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12935965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family-based therapy for eating disorders: from the Milan model to contemporary evidence.","authors":"Johan Vanderlinden","doi":"10.3389/frcha.2026.1765146","DOIUrl":"10.3389/frcha.2026.1765146","url":null,"abstract":"<p><p>Family-oriented therapy has profoundly influenced the conceptualization and treatment of eating disorders over the past five decades. Beginning with systemic pioneers such as Mara Selvini Palazzoli and Salvador Minuchin, clinicians have increasingly viewed eating disorders not solely as intrapsychic disturbances but as relational phenomena embedded within family systems. These ideas led to structured, evidence-based models such as Family-Based Treatment (FBT) and Multifamily Therapy (MFT). This review summarizes historical milestones, theoretical innovations, and empirical findings on family-oriented interventions for eating disorders. The article also discusses mechanisms of change, clinical applications, and contemporary challenges in implementation and cultural adaptation of family based treatments. Some interesting research hypotheses are formulated regarding family support and neural circuitry during refeeding that can inspire future research.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1765146"},"PeriodicalIF":1.5,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of physiotherapy interventions on attention, hyperactivity, motor and cognitive outcomes in children with attention deficit hyperactivity disorder: a systematic review protocol.","authors":"Sakshi Desai, Sharath Hullumani, Irshad Qureshi, Rutuja Sawalkar, Aishik Ghosh","doi":"10.3389/frcha.2026.1717704","DOIUrl":"10.3389/frcha.2026.1717704","url":null,"abstract":"<p><strong>Introduction: </strong>Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder among children who attend school, characterized by symptoms of hyperactivity, impulsivity, and inattention. Despite extensive research, the optimal management of attention deficit hyperactivity disorder remains unestablished. The review intends to present evidence-based findings that will address clinical practice and guide future research directions. By integrating the existing findings, it seeks to improve the quality of life as well as their long-term outcomes of children with attention deficit hyperactivity disorder. This systematic review will assess the effectiveness of physiotherapy interventions on attention, hyperactivity, motor, and cognitive outcomes among children with attention deficit hyperactivity disorder.</p><p><strong>Methods: </strong>The review will synthesize randomized controlled trials (RCTs). To assess relevant English language articles published between Inspection to February 2025, we will perform a systematic search across databases, namely PubMed/MEDLINE, the Cochrane Library, and PEDro, CLARIVATE (Web of Science). The search strategy will use Medical Subject Headings (MeSH) terms as well as relevant words, e.g., \"attention deficit hyperactivity disorder\", \"pediatrics\", \"intervention\", and \"physiotherapy\". The risk of bias included in the studies will be evaluated using the Cochrane Risk of Bias Tool (RoB.2). The outcomes regarding attention, hyperactivity, motor function, and cognition for children with ADHD will be synthesized narratively. The variations by study design and characteristics of participants will be further addressed through sensitivity and subgroup analyses.</p><p><strong>Discussion: </strong>The objective of this systematic review protocol is to assess the effectiveness of physiotherapy interventions on the management of attention deficit hyperactivity disorder symptoms. Analyzing Randomized Controlled Trials systematically will establish evidence-based guidance to improve attention, diminish hyperactivity, and improve motor and cognitive function among children with attention deficit hyperactivity disorder. The outcomes of this review will aid clinicians in well-informed decision-making, optimizing therapeutic approaches, and directing research for the improvement of attention deficit hyperactivity disorder care within the pediatric population.</p><p><strong>Clinical trial registration: </strong>PROSPERO CRD420251037307, 21st April 2025, UTC version 1.0.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1717704"},"PeriodicalIF":1.5,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12913538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obsessive-compulsive disorder onset and clinical course in the context and treatment of pineal region germinoma and obstructive hydrocephalus: a case report.","authors":"Andrea Saliba, S Evelyn Stewart","doi":"10.3389/frcha.2026.1718502","DOIUrl":"10.3389/frcha.2026.1718502","url":null,"abstract":"<p><p>Obsessive-compulsive disorder (OCD) secondary to structural brain pathology is rarely described in pediatric populations. This single-case report describes a child with a pineal germinoma and obstructive hydrocephalus who developed prominent obsessive-compulsive symptoms, highlighting a potentially reversible neurobiological contributor to atypical pediatric OCD. The case illustrates the temporal association between symptom evolution, neurosurgical and oncologic management, and subsequent changes in obsessive-compulsive behaviors, contributing to understanding the role of cortico-striato-thalamo-cortical (CSTC) circuit disruption in secondary OCD. A 15-year-old boy initially presented with a 12-month history of mild generalized anxiety and intermittent insomnia, which progressed over the subsequent 8 months to severe obsessive thoughts and compulsive behaviors, including checking and repetition, significantly impairing sleep and food intake. Two months prior to tertiary referral, he developed progressive neurological symptoms, including afternoon headaches, blurred vision, gait instability with falls, polyuria, enuresis, and one witnessed episode of loss of consciousness. A neurological examination demonstrated Parinaud's syndrome, hyperreflexia with ankle clonus, extensor plantar responses, past-pointing, and papilledema. Neuroimaging (CT and MRI) revealed a pineal mass causing aqueductal obstruction with hydrocephalus, periventricular edema, and a suspected vestibular schwannoma. Endoscopic third ventriculostomy with biopsy and external ventricular drainage confirmed germinoma and relieved the cerebrospinal fluid (CSF) obstruction, with postoperative imaging demonstrating restored CSF flow. The patient subsequently received chemotherapy and focal radiotherapy. Following CSF diversion, the patient's caregivers reported a marked reduction in compulsive rituals and improved sleep, with further attenuation of OCD symptoms during oncologic treatment. Residual anxiety and mild obsessive-compulsive symptoms were managed with adjunctive selective serotonin reuptake inhibitor therapy. At the 12-month follow-up, standardized assessments indicated subclinical to mild OCD, and the patient had returned to full academic participation. This case underscores the importance of considering hydrocephalus-related CSTC circuit disruption as a potential, and occasionally reversible, contributor to pediatric OCD. Recognizing hydrocephalus-associated obsessive-compulsive symptoms may significantly influence both psychiatric and neurosurgical management. Clinicians evaluating atypical or treatment-refractory pediatric OCD should consider neuroimaging to identify underlying structural causes, emphasizing the value of interdisciplinary collaboration in optimizing outcomes.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1718502"},"PeriodicalIF":1.5,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12909497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}