Bamlak Deju , Hamayl Afzal , Suhana Basnyat , Animesh Dali , Katelin E.J. Scott , Rachel Delancey , Nipun Chopra
{"title":"Accelerometer-based head impact detection in soccer - Where are we?","authors":"Bamlak Deju , Hamayl Afzal , Suhana Basnyat , Animesh Dali , Katelin E.J. Scott , Rachel Delancey , Nipun Chopra","doi":"10.1016/j.hsr.2023.100141","DOIUrl":"https://doi.org/10.1016/j.hsr.2023.100141","url":null,"abstract":"<div><p>Traumatic brain injury (TBI) represents a significant burden on individuals, societies, and healthcare systems as it is associated with long-term neurological and behavioral consequences. Although these effects vary according to severity, events that lead to TBI and mild TBI (mTBI), such as concussions, subconcussive impacts, and non-impact violent head movements, may also lead to similar changes. Soccer players are particularly prone to mTBI as they are exposed to head impacts in various ways during training and gameplay. A commonly-claimed TBI risk is that posed by the \"heading\" technique. Our examination of the literature questions the extent to which heading actually is a risk for TBI and mTBI vs other sources of head impact in soccer. Although headgear may protect against some impacts, it has not been widely adopted due to limited efficacy, practical limitations and potential changes to the heading technique. Nevertheless, accurate assessment of head impacts and other movements that may lead to TBI in soccer would be valuable to players, coaches, athletic and medical personnel. A potential method for accurately detecting head acceleration – a crucial element of most head injuries – is measurements through accelerometers. Here, we survey the different types of accelerometers and recent findings on their accuracy and feasibility among soccer players and offer suggestions for long-term research with these tools.</p></div>","PeriodicalId":73214,"journal":{"name":"Health sciences review (Oxford, England)","volume":"10 ","pages":"Article 100141"},"PeriodicalIF":0.0,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772632023000673/pdfft?md5=67134dd3d76f3c85e81bc1cb20dc7364&pid=1-s2.0-S2772632023000673-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138557212","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}
Skylarr Beerman , Asaad Chaudhry , Kelsi Batioja , Philo Waters , Elizabeth Garrett , Andriana Peña , Matt Vassar
{"title":"Healthcare inequities in lung transplant patients and donors: A scoping review","authors":"Skylarr Beerman , Asaad Chaudhry , Kelsi Batioja , Philo Waters , Elizabeth Garrett , Andriana Peña , Matt Vassar","doi":"10.1016/j.hsr.2023.100139","DOIUrl":"https://doi.org/10.1016/j.hsr.2023.100139","url":null,"abstract":"<div><p>Lung transplantation has proven to be an effective treatment for end-stage lung diseases. Recognizing and acknowledging the effects of health inequities pertaining to lung transplants is important for under-resourced populations. This scoping review aims to map the extent of literature on health inequities corresponding to lung transplantation and point to knowledge gaps to direct future research. This scoping review followed guidelines from the Joanna Briggs Institute and the PRISMA extension for scoping reviews. In July 2022, we searched Ovid Embase and MEDLINE for published articles on lung transplants, published between 2011 and 2021, written in English, and examining at least one health inequity as defined by the NIH. Screening and charting were both performed in a masked, duplicate fashion. The frequency of each health inequity examined was analyzed, and findings from each included study were summarized. After screening, our sample contained 33 studies. Our findings illustrate that patients living further from lung transplant centers were less likely to be placed on the lung transplant waitlist. Further, non-white patients, women, and people who lived in low-income areas were less likely to undergo lung transplantation. Non-white patients also experienced increased mortality post-lung transplantation. Significant research gaps were found regarding the LGBTQ+ community, occupational status, income, and education level. This scoping review highlights the gaps in research regarding lung transplant inequities. To improve existing research gaps, we recommend research into the following: (1) intervention studies, (2) clinical bias, (3) donor education programs and follow-up studies, and (4) geographic information systems.</p></div>","PeriodicalId":73214,"journal":{"name":"Health sciences review (Oxford, England)","volume":"9 ","pages":"Article 100139"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277263202300065X/pdfft?md5=1cf55f6dde4c4105c73abf07e68bf2b7&pid=1-s2.0-S277263202300065X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138466576","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":"Piperine loaded drug delivery systems for improved biomedical applications: Current status and future directions","authors":"Sanchit Arora , Baljinder Singh , Sandeep Kumar , Arun Kumar , Arti Singh , Charan Singh","doi":"10.1016/j.hsr.2023.100138","DOIUrl":"10.1016/j.hsr.2023.100138","url":null,"abstract":"<div><p>About 42 % of drugs with market acceptance and 92 % of drugs in the discovery pipeline are imperfectly aqueous soluble with insufficient intestinal absorption and will suffer from low oral bioavailability. Alkaloids are a group of phytonutrients that has been examined broadly due to their various health-related benefits. However, most of the alkaloids are considered as compounds with less aqueous solubility which limits their human usefulness. Piperine (PIP) is a family of nitrogenous aggregates that are extracted from the black pepper (<em>Piper nigrum</em>). It holds various therapeutic effects such as antioxidant, anti-inflammatory, neuroprotective, anti-cancer, anti-microbial, hepatoprotective, anti-depressant, anti-obesity, cardioprotective, P-gp inhibitor, anti-aging, and permeation enhancer. Although both the preclinical and clinical studies confirmed the advantages of PIP, its clinical usefulness is restricted due to its low water solubility and poor bioabsorption. To overcome these limitations nanoformulation is a widely employed approach. Multiple reviews have confirmed PIP health-related benefits, still, there is a lack of comprehensive review focused on its chemistry, pharmacological effects, nanoformulation, toxicity, advantages and challenges of PIP nanosystem, and marketed herbal formulations. However, this study aims to deliver a review of several nanoformulation development and nano-technology-based approaches employed to upregulate the solubility, bioabsorption, and therapeutic efficiency of PIP. We have also reviewed information related to the toxicity of PIP and its formulations.</p></div>","PeriodicalId":73214,"journal":{"name":"Health sciences review (Oxford, England)","volume":"9 ","pages":"Article 100138"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772632023000648/pdfft?md5=75552c8171c55b8c53e74222b18b19cc&pid=1-s2.0-S2772632023000648-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135765795","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}
Faraha Ahmed , Syed Sufian Ahmad , M Mumtaz Alam , Arifa Khatoon , Ruhi Ali , Javed Ahmad , Nishat Amina , Abul Kalam Najmi , Mohammad Ahmed Khan
{"title":"Hyperglycaemia induced osteoporosis: Is there a hope with dipeptidyl peptidase-4 inhibitors?","authors":"Faraha Ahmed , Syed Sufian Ahmad , M Mumtaz Alam , Arifa Khatoon , Ruhi Ali , Javed Ahmad , Nishat Amina , Abul Kalam Najmi , Mohammad Ahmed Khan","doi":"10.1016/j.hsr.2023.100135","DOIUrl":"https://doi.org/10.1016/j.hsr.2023.100135","url":null,"abstract":"<div><p>Diabetes mellitus and osteoporosis are chronic illnesses associated with adverse health outcomes. Studies have reported common linkages between energy and bone metabolism. Specifically, significant effect of glucose metabolism on bone homoeostasis has improved the understanding of hyperglycaemia-induced bone degeneration. The study of skeletal endocrinology has also enabled the elucidation of pathways involved in glucose associated abnormality in bone homoeostasis. Insulin is central molecule in glucose and bone homoeostasis. Bone markers like osteocalcin, bone morphogenic protein and sclerostin control both bone and glucose metabolism. The interaction between gut-bone axis is mainly mediated by incretins. These hormones exert anabolic effect and alter bone remodelling process by enhancing bone alkaline phosphatase activity and type-1 collagen levels. Additionally, incretins also exhibit anti-inflammatory and anti-oxidative properties. Incretin degradation is mediated by Dipeptidyl Peptidase-4 (DPP-4), which is reported to be elevated in patients with osteoporosis. This association of incretins and bone homoeostasis possesses untapped therapeutic potential which needs to be further explored. In view of the concomitant occurrence, the present review summarises the correlation between diabetes mellitus, osteoporosis, incretins and DPP-4 and discusses the current evidence on DPP-4 inhibitors as new therapeutic alternative for osteoporosis.</p></div>","PeriodicalId":73214,"journal":{"name":"Health sciences review (Oxford, England)","volume":"9 ","pages":"Article 100135"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772632023000612/pdfft?md5=735980118f8a3dd59ec18cd8a3e2970c&pid=1-s2.0-S2772632023000612-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138466234","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":"Hydrogel-bound cytotoxic drug delivery system for breast cancer","authors":"Parveen Kumar Goyal , Suman Khurana , Arun Mittal","doi":"10.1016/j.hsr.2023.100140","DOIUrl":"https://doi.org/10.1016/j.hsr.2023.100140","url":null,"abstract":"<div><p>Breast cancer was first noted by the ancient Egyptians more than 3500 years ago. In India, the US, and China about 221757, 287750, and 429105 cases of breast cancer were reported in the year 2022. The conventional chemotherapeutic agents used in breast cancer not only kill the cancer cells but the healthy cells also. Hydrogels, composed of different polymers, targeted to deliver natural and synthetic cytotoxic drugs in the microenvironment of breast cancer are reviewed in this manuscript. This manuscript is focused on providing insight into smart hydrogel which improves the efficacy of chemotherapeutic agents used in the treatment of breast cancer. Smart hydrogels, in response to specific stimuli such as pH, temperature, light, etc., release cytotoxic drugs in breast cancer tissue and improve the retention time of the drug at the site of action. The site-specific delivery and retention of anticancer drugs help in reducing the adverse effects. Smart hydrogels have been gaining more attention for delivering cytotoxic drugs to tumor microenvironments in response to specific stimuli. This manuscript emphasizes the stimuli-sensitive hydrogels fabricated especially for breast cancer.</p></div>","PeriodicalId":73214,"journal":{"name":"Health sciences review (Oxford, England)","volume":"9 ","pages":"Article 100140"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772632023000661/pdfft?md5=a81cd2866145baec3d072a66007329a7&pid=1-s2.0-S2772632023000661-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138480111","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":"HDAC inhibitors: A novel approach to hyperglycaemia management and treatment","authors":"M. Suchitra , Kusuma Praveen Kumar , Manjunath.S. Katagi , Garla Venkateswarlu , P.Sree Mahalakshmi","doi":"10.1016/j.hsr.2023.100137","DOIUrl":"10.1016/j.hsr.2023.100137","url":null,"abstract":"<div><p>The field of genomics plays a prominent role in treatment of numerous chronic diseases. Diabetes is a persistent metabolic disorder. Current studies and reports have emphasised the importance of several epigenetic markers in the therapy of type 2 diabetes. Histone Deacetylases(HDAC) enzyme regulate the structure of chromatin and the transcription of genes in the nucleus that produce proteins that regulate metabolic processes in the body. It influences gene expression primarily by removing an acetyl group from its precursor protein, and it regulates acetylation metabolic enzymes in mitochondria and cytoplasm. The balance between histone acetylation and deacetylation is an epigenetic layer that modulates gene expression. Gene transcription is associated with histone acetylation induced by histone acetyl transferases, whereas histone hypoacetylation influenced by histone deacetylase activity is related with gene silencing. This review focuses on the role of histone deacetylase inhibitors as a newly discovered treatment for diabetes and its impediment, defining their use in preventing insulin resistance, cell death, and cytokine-mediated attack on pancreatic cells.</p></div>","PeriodicalId":73214,"journal":{"name":"Health sciences review (Oxford, England)","volume":"9 ","pages":"Article 100137"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772632023000636/pdfft?md5=9004f2b9cd7c3683b00e29f18bfc76bb&pid=1-s2.0-S2772632023000636-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135763715","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":"Tibia periprosthetic fracture management – A 30-year systematic review","authors":"Assala Abu-Mukh , Giacomo Placella , Francesco Anzano , Salvatore Mosca , Vincenzo Salini , Mattia Alessio-Mazzola","doi":"10.1016/j.hsr.2023.100133","DOIUrl":"https://doi.org/10.1016/j.hsr.2023.100133","url":null,"abstract":"<div><p>Periprosthetic fractures are demanding and though uncommon, tibial periprosthetic fractures are furtherly destined to impact clinical and surgical orthopaedics due to the increasing number of arthroplasties performed yearly.</p><p>Systematic research focusing on periprosthetic tibia fractures reported beginning 1990 until 2022 was conducted on the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE/PubMed, Embase, Scopus, the Science Citation Index Expanded from Web of Science, ScienceDirect, CINAHL, and LILACS.</p><p>A total of 473 records resulted from the research. Following the exclusion process the studies included were twenty-three (23) with a total of 287 patients and 357 treatments. Periprosthetic tibial fractures prevail in women (72.1 %), in the obese and in rheumatoid arthritis affected patients.</p><p>Treatments consist of conservative treatments (22.7 %), osteosynthesis (16.5 %), revision total knee arthroplasty (23.0 %), intramedullary nailing (2.5 %) and other treatments (30.8 %). Stable fractures are treated in various methods, unstable fractures are mainly treated through revision total knee arthroplasty and intraoperative fractures are treated both conservatively and operatively.</p><p>Periprosthetic tibial fractures are destined to heavily burden orthopaedics traumatology. Periprosthetic tibia fractures are complex and commonly afflict obese and elderly women with history of rheumatoid arthritis. These fractures may be managed following the ASAP algorithm. Stable fractures are treated using different methods and unstable fractures are mainly approached through revision total knee arthroplasty prior to other treatments. Intraoperative fractures are treated both conservatively and surgically.</p></div>","PeriodicalId":73214,"journal":{"name":"Health sciences review (Oxford, England)","volume":"9 ","pages":"Article 100133"},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772632023000594/pdfft?md5=84880bb546e544ee8c4b6745aa0eafbc&pid=1-s2.0-S2772632023000594-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91964373","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":"Association of styloid process length with cervical carotid artery dissection: Meta-analysis","authors":"Loay H Abdelnour , Mohammed Kurdy , Abubakr Idris","doi":"10.1016/j.hsr.2023.100134","DOIUrl":"https://doi.org/10.1016/j.hsr.2023.100134","url":null,"abstract":"<div><p>This meta-analysis was conducted to investigate the association of elongated styloid process (Eagle syndrome) and cervical artery dissection (CeAD), particularly carotid. Medline, PubMed Central, CINAHL and ProQuest were searched for case-control studies investigating the association of styloid process length (SPL) and CeAD, particularly carotid. SPL was treated as a continuous variable and mean difference was calculated from means and standard deviations with 95 % confidence interval (CI). SPL >30 mm was compared between cases and controls as a dichotomous variable and odds ratio (OR) was calculated with 95 % CI. Heterogeneity was quantified with χ2-based Cochran's Q-test and I<sup>2</sup>-statistic. Four studies were included comparing 185 dissection cases with 278 controls. Heterogeneity was 50 %, but was reduced to 0 % with sensitivity analysis. Styloid process was significantly longer in dissection group with a mean difference of 2.50 [-0.35, 5.35], <em>P</em> = 0.09. Elimination of one study with high risk of bias resulted in a mean difference of 3.61 [1.47, 5.75], <em>P</em> = 0.0009, and a heterogeneity of 0 %. Two studies showed SPL >30 mm to be more significant in dissection group (OR = 1.53 [0.84,2.80], <em>P</em> = 0.17). With sensitivity analysis the pooled OR was 2.09 [1.04, 4.19], <em>P</em> = 0.04. Three studies showed that mean SPL was significantly longer ipsilateral compared to contralateral side of dissection (mean difference 2.63 [0.46, 4.79], <em>P</em> = 0.02. This meta-analysis suggests that CeAD is significantly associated with styloid process mean length and SPL >30 mm. Case-control studies with bigger numbers are required to substantiate this association.</p></div>","PeriodicalId":73214,"journal":{"name":"Health sciences review (Oxford, England)","volume":"9 ","pages":"Article 100134"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772632023000600/pdfft?md5=a5552dd47a0e300b4fce7d21bdd8cddd&pid=1-s2.0-S2772632023000600-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92044311","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}
Prakash Raj Oli , Dhan Bahadur Shrestha , Shreeja Shikhrakar , Jurgen Shtembari , Monodeep Biswas , Muhammad Omer Zaman , Laxmi Regmi , Toralben Patel , Yub Raj Sedhai , Nimesh K. Patel
{"title":"Intravenous iron therapy for iron deficiency in patients with heart failure: An updated systematic review and meta-analysis","authors":"Prakash Raj Oli , Dhan Bahadur Shrestha , Shreeja Shikhrakar , Jurgen Shtembari , Monodeep Biswas , Muhammad Omer Zaman , Laxmi Regmi , Toralben Patel , Yub Raj Sedhai , Nimesh K. Patel","doi":"10.1016/j.hsr.2023.100131","DOIUrl":"https://doi.org/10.1016/j.hsr.2023.100131","url":null,"abstract":"<div><p>Iron deficiency with or without anemia is a common comorbidity co-existing with heart failure patients and is an independent risk factor for heart failure exacerbation and worse prognosis. A growing number of randomized clinical trials and meta-analysis evaluated the clinical efficacy and safety of intravenous iron use in heart failure patients. However, the findings from them are inconsistent and often conflicting. This meta-analysis was performed based on PRISMA (Preferred Reporting Items or Systematic Reviews and Meta-Analyses) guidelines after registering in PROSPERO (CRD42023395888). A literature search was conducted using a systematic search of PubMed, Embase, and Scopus databases until September 30, 2023. Pertinent data from the included studies were extracted and analyzed using RevMan v5.4. Out of 4585 studies evaluated, 16 randomized control trials with 6739 acute or chronic heart failure patients were included for analysis. The intravenous iron therapy significantly lowered the composite HF hospitalization or cardiovascular death (OR 0.56; 95 % CI 0.40 to 0.79; I<sup>2</sup> = 83 %, <em>P =</em>= 0.001), HF hospitalization (OR 0.69, 95 % CI 0.54 to 0.90; I<sup>2</sup>=57 %, <em>P =</em>= 0.005), improved 6-minute walk test (MD: 20.02 (95 % CI 8.16 to 31.87; I<sup>2</sup>=40 %, <em>P =</em>= 0.0009), and the change in mean LVEF (MD: 2.03, 95 % CI 0.49–3.58; <em>P =</em>= 0.010). The risks of total and serious adverse events were not significantly increased with the iron therapy compared to the placebo/standard of care group. Based on this meta-analysis, the intravenous iron intervention among heart failure patients with iron deficiency significantly reduced the risk of hospitalization from heart failure exacerbation. In addition, there was improved exercise performance and left ventricular function from baseline with no significant increased risk of serious adverse events.</p></div>","PeriodicalId":73214,"journal":{"name":"Health sciences review (Oxford, England)","volume":"9 ","pages":"Article 100131"},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772632023000570/pdfft?md5=d089735d4ac6900ce6f3a2c51aad1719&pid=1-s2.0-S2772632023000570-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92044309","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}