Maedica最新文献

{"title":"Gender Differences in Depressive Disorders in Children and Adolescents: Results from a Clinical Sample.","authors":"Lucia Emanuela Andrei, Ilinca Mihailescu, Alexandra Mariana Buica, Mihaela Moise, Iuliana Dobrescu, Florina Rad","doi":"10.26574/maedica.2025.20.1.26","DOIUrl":"10.26574/maedica.2025.20.1.26","url":null,"abstract":"<p><p><b>Objectives:</b> Adolescence is a unique period of significant neurodevelopmental changes that can increase vulnerability to mental health problems. We are currently witnessing an increase in depressive symptoms among adolescents, with suicide being among the top three causes of death for young people aged 10-25 years. In depressive disorders (DD) there are significant differences between genders in terms of symptomatology, risk factors, evolution and prognosis. Thus, the objective of our study is to investigate gender differences among children and adolescent patients admitted for evaluation of depressive symptomatology to our clinic. <b>Material and method:</b>The current study is an analytical, non-experimental, retrospective study on children and adolescents admitted to the Pediatric psychiatry clinic at \"Prof. Dr. Al. Obregia\" Clinical Psychiatry Hospital in Bucharest, Romania, between 1 January 2020 and 30 June 2024, who were diagnosed with DD. Descriptive analysis of the qualitative and quantitative variables was performed. The variables were processed and analyzed using Microsoft Office Excel 2007 and Microsoft Power BI 2024. <b>Results:</b>The present study included 915 patients (77.04% females, 22.96% males) aged 9-17 years, with a mean age of 15.42 ± 1.79. Most patients [43.83% (34.21% females, 9.62% males)] were diagnosed with severe depressive episode without psychotic symptoms. Suicidal ideation or suicidal attempts at admission were identified in 30% of our patients (24% females, 6% males). In the analyzed time period, pediatric patients have been increasingly diagnosed with depressive disorders: from 120 patients diagnosed in 2020 to 265 in 2023 and 120 in the first half of 2024. <b>Conclusions:</b>Our study shows an increase in DD and suicidality in pediatric patients, with important differences among genders in terms of clinical aspects, severity and evolution, thus highlighting the need for early identification and targeted therapeutical interventions.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"20 1","pages":"26-33"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661199","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":"Mapping the Future: Anterior Segment OCT for Corneal Epithelial Thickness in Vernal Keratoconjunctivitis.","authors":"Swarastra Prakash Singh, Ruchi Shukla, Pragati Garg, Ashutosh Kumar Mishra, Mukesh Shukla, Nilakshi Banerjee, Aparajita Shukla","doi":"10.26574/maedica.2025.20.1.19","DOIUrl":"10.26574/maedica.2025.20.1.19","url":null,"abstract":"<p><p><b>Objectives:</b> To compare corneal epithelium parameters in between children with vernal keratoconjunctivitis (VKC) and healthy controls with the help of anterior segment optical coherence tomography (OCT). <b>Material and method:</b> Children aged 5 to 18 years with a diagnosis of VKC were included in this study. A total of 216 eyes were included in the study, which were divided into two groups: the case group comprising 108 eyes of VKC patients and the control one comprising 108 eyes of healthy subjects. Central 5 mm cornea was taken into consideration for evaluation of different epithelial thickness parameters using anterior segment OCT. <b>Results:</b>On analysis of the corneal epithelium parameters, the superior quadrant in VKC patients as compared to controls was found to be significantly thinner (38.69 ± 5.91 μm vs 40.98 ± 3.86 μm). Other noteworthy findings were a reduced minimum (MIN) epithelial thickness and a greater negative (MIN-MAX) value in VKC patients as compared to controls. In a detailed study specifically in patients signifiwith mixed VKC, they had epithelial thinning in the superior quadrant and markedly reduced MIN epithelial thickness than the controls. <b>Conclusions:</b> This study demonstrates that children with VKC exhibit notable changes in corneal epithelial thickness parameters, particularly a significant reduction in superior and minimum epithelial thickness compared to healthy controls. Additionally, the significant correlation between epithelial thickness and disease duration suggests that prolonged duration of VKC may exacerbate epithelial thinning. The results underscore the significance of using anterior segment optical coherence tomography as a useful technique for tracking corneal alterations in children with VKC.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"20 1","pages":"19-25"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661201","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":"Artificial Intelligence and Copyright.","authors":"Mircea Cinteza Md PhD","doi":"10.26574/maedica.2025.20.1.1","DOIUrl":"10.26574/maedica.2025.20.1.1","url":null,"abstract":"","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"20 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661191","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 Yoga on Pulmonary Function Tests and Arterial Stiffness in Post-COVID-19 Mild Moderate Cases.","authors":"Ragini Mundhe, Vidya Ganji, Veerisetty Neeraja, Madhuri Taranikanti, Nitin Ashok John, M Kalpana, Madhusudhan Umesh, Archana Gaur","doi":"10.26574/maedica.2025.20.1.48","DOIUrl":"10.26574/maedica.2025.20.1.48","url":null,"abstract":"<p><p><b>Background:</b> COVID-19 caused by the novel coronavirus SARS-CoV-2 has resulted in significant morbidity and mortality worldwide. Long term respiratory complications secondary to COVID-19 have been described, which were not fully explored. The severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) directly infects endothelial cells, with inducing marked endothelial damage and inflammation contributing to increased arterial stiffness. Yoga is a holistic psychosomatic approach that leads to improvement of pulmonary and cardiovascular functions. Hence, this study aimed to evaluate the effect of yoga on pulmonary functions and arterial stiffness who have suffered from COVID-19. <b>Objectives:</b> The aim of the present interventional study was to measure and investigate the effect of yoga on the pulmonary function tests and arterial stiffness in post-COVID-19 mild and moderate cases. <b>Material and method:</b>After taking the approval of the Institutional Ethical Committee (IEC), 30 post-COVID-19 patients were recruited into the study. The baseline arterial stiffness (oscillometric method) and baseline pulmonary functions tests were assessed (using computerized spirometer HELIOS 70). The study participants were then subjected to a yoga intervention for eight weeks. Pulmonary function tests and arterial stiffness was assessed after the yoga intervention and findings were compared with the baseline data. <b>Results:</b>After eight weeks of yoga intervention, there was a statistically significant increase in the mean values of FEV1, FEV3, FVC and percentage of FEV1/FVC ratio (p<0.05), and a highly significant decrease in two arterial stiffness parameters, including brachial-ankle pulse wave velocity (baPWV) (p<0.001) and carotid-femoral pulse wave velocity (cfPWV) (p<0.001). This shows that performing yoga regularly has a significant effect on the body vasculature and arterial stiffness. Pearson correlation test showed a positive correlation between systolic blood pressure (SBP) and baPWV (r=0.45) (p<0.001). There was also a positive correlation observed between cfPWV (r=0.37) and systolic blood pressure (SBP) (p<0.05). <b>Conclusions:</b>The study indicates that pulmonary function tests and arterial stiffness improve in post-COVID-19 mild and moderate cases with eight weeks of regular yoga practice.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"20 1","pages":"48-55"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661194","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 Experience of SARS-CoV-2 in Patients with Benign Prostatic Hyperplasia: Is There Any Correlation between Them?","authors":"S Balacescu, B Geavlete, C Ungureanu, C Ene, C D Ene, C Bulai, C Mares, A Punga, A Militaru, P Geavlete","doi":"10.26574/maedica.2025.20.1.112","DOIUrl":"10.26574/maedica.2025.20.1.112","url":null,"abstract":"<p><p><b>Introduction:</b> Recent studies suggest that the international prostate symptom score (IPSS), especially in older men, may result from COVID-19, and that LUTS may be high in the early stages of the illness. The primary goal of the present review is to ascertain the true impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the development of patients with benign prostatic hyperplasia (BPH) by analyzing the body of available literature. <b>Materials and methods:</b> By May 2023, a comprehensive and categorized search of the literature was conducted utilizing the following global databases: the Cochrane Library, Web of Science, PubMed, Embase and Scopus. To assess their eligibility, all English-language records were included, including peer-reviewed online publications and published works. Additional sources were identified using the retrieved material's citations. There were no limitations on the sample size. <b>Results:</b> SARS-CoV-2 penetrates cells by attaching itself to the angiotensin-converting enzyme 2 (ACE2) receptor of the prostate. This combination may cause direct harm to the prostate and accelerate the development of BPH. The pathophysiology of BPH involves androgen receptors, and the infection caused by SARS-CoV-2 may be androgen-mediated. This may cause the symptoms of BPH to worsen and progress. Pro-inflammatory pathways can be triggered and cytokine release increased by SARS-CoV-2 infection. This inflammation can exacerbate lower urinary tract symptoms (LUTS) and cause the prostate gland to become inflamed. Benign prostatic hyperplasia may occur because of metabolic disturbances brought on by the coronavirus disease caused by SARS-CoV-2 (COVID-19), such as newly diagnosed diabetes and cardiovascular issues. <b>Conclusion:</b> To illustrate the impact of COVID-19 on the onset of these symptoms and quantify the changes in them, it is desirable to identify the factors that contribute to the worsening of BPH-related LUTS after COVID-19 recovery.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"20 1","pages":"112-116"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661217","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":"Vitamin K-Dependent Inhibition Mechanisms in Human Aortic Valve Calcification.","authors":"Symeon-Evangelos Mavroudeas, Anastasios Apostolos, Despoina Spyropoulou, George Matthaiopoulos, Odysseas Katsaros, Nikolaos Kafkas, Evangelos Tsiambas, Konstantina Aggeli, Dimitrios Tousoulis, Constantinos Tsioufis, Konstantinos Toutouzas","doi":"10.26574/maedica.2025.20.1.99","DOIUrl":"10.26574/maedica.2025.20.1.99","url":null,"abstract":"<p><p><b>Introduction:</b> Stenosis of the aortic valve is a leading cause of severe cardiovascular lesions. Progressive calcification, rheumatic modifications and also congenital events are the main etiopathogenetic factors. Extended fibrotic changes and aberrant ectopic calcification of the specific aortic valve interstitial cells are the most recognizable histopathological features. In fact, the previously referred cells are transformed from their initial myofibroblast phenotype to an osteoblast-like cell formation mediated by an inflammatory process. Concerning the potentially effective anti-calcification, inhibition strategies, some molecules are under investigation. Among them, vitamins seem to be involved in this process by preventing aortic wall extensive calcification. <b>Objective:</b> The purpose of the current review was to explore the involvement of Vitamin K complex in the inhibition mechanisms of the human aortic valve calcification process. <b>Material and method:</b> A systematic retrospective review of the literature was carried out based on PubMed international medical database. The following keywords were used: vitamin, calcification, cardiovascular, stenosis, aorta. <b>Results:</b> A broad spectrum of seventy (n=70) significant articles - focused on the vitamin K complex structural and functional aspects and its implication in anti-calcification mechanisms - were selected for the current review study. The majority of medical data referred to after 2015 published articles, whereas specific references of great importance and value were also included. <b>Conclusions:</b> Specific vitamin K members play a crucial role by regulating the activity of proteins such as osteocalcin that induces endothelial calcification. Interestingly, vitamin K also modifies the function of the matrix-Gla proteins that are implicated in this process. In fact, vitamin K-related molecular and biochemical mechanisms in the human aortic valve calcification inhibition are crucial and represent an interesting field for research.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"20 1","pages":"99-105"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661219","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":"Historical Review of Euthanasia. From Ancient Times until before Modern Times.","authors":"A Spinthouraki, S N Michaleas, I Nikolakakis, G Marinos, I Dimitriadis, M Karamanou","doi":"10.26574/maedica.2025.20.1.117","DOIUrl":"10.26574/maedica.2025.20.1.117","url":null,"abstract":"<p><p>The historical review of euthanasia shows the pivotal role played by Christianity in the perceptions and attitudes towards it. In ancient Greece and Rome, euthanasia was rejected by medicine, but philosophy and ethics supported it as an attitude to life. Euthanasia was synonymous with an honorable and good death, and as a means of avoiding the sufferings that old age might bring. These attitudes and perceptions changed with the establishment of Christianity. Euthanasia was characterized as a forbidden act and as an insult to God against the gift of life that was given to man.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"20 1","pages":"117-119"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661200","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":"Neuroplasticity in Action: Transforming Brain Function through Neurorehabilitation.","authors":"Estelle Havila Earl, Archana Gaur, Sakthivadivel Varatharajan, Afna Ansari, Anala Billa, Naveen Ravi, Medala Kalpana, Prafull Kamble, Vandana Daulatabad, Anish Singhal, Vidya Ganji, Madhusudhan Umesh, Madhuri Taranikanti, Nitin Ashok John","doi":"10.26574/maedica.2025.20.1.81","DOIUrl":"10.26574/maedica.2025.20.1.81","url":null,"abstract":"<p><p>The capability of the human brain to redeploy in accordance to the activities and experiences is deemed as neuroplasticity. As a result, neuroplasticity can be visualized as a required adaptation to all brain processes. Broadly classified into structural, functional, biochemical and behavioural neuroplasticity, structural neuroplasticity includes neurogenesis and synaptogenesis. Functional neuroplasticity operates with long term potentiation (LTP) and long term depression (LTD). Biochemical neuroplasticity avails the usage of genes such as apoE and Brain derived neurotrophic factor. Behavioural neuroplasticity utilizes the prefrontal cortex and nucleus accumbens, two parts of the brain that contribute to the rewarding properties of certain psychotropic drugs, showing plastic changes. Mirror neurons play an important role in neurorehabilitation by employing the process of functional synaptic plasticity. Non-invasive brain stimulation, including transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), deep brain stimulation and scrambler therapy for pain, utilize neuroplasticity for treatment in several disorders such as stroke, autism, Parkinsons, depression, etc.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"20 1","pages":"81-89"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661202","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":"\"Sandwich\" Technique for the Management of Chronic and Hemorrhagic Cervicitis Vs Antibiotics Alone: a Case-Control Clinical Study.","authors":"Stefanos Zervoudis, Georgios Iatrakis, Panagiotis Eskitzis, Anisa Markja, Vasiliki Michou, Myrsini Balafouta, Giannoula Kyrkou, Panagiotis Tsikouras","doi":"10.26574/maedica.2025.20.1.11","DOIUrl":"10.26574/maedica.2025.20.1.11","url":null,"abstract":"<p><p><b>Objectives:</b> Cervicitis is commonly caused by sexually transmitted infections. This study compares the standard antibiotic treatment with antibiotics plus cryocoagulation in cases of chronic and hemorrhagic cervicitis. Although antibiotics are typically the first line of treatment, persistent cases often require additional interventions, like cryosurgery to obtain a cure. <b>Material and method:</b> Fifty women (mean age 38 years) with chronic cervicitis - based on clinical evaluations, cytology and vaginal culture - were enrolled in the present study. Twenty three participants were treated with combination therapy consisting of an initial course of antibiotics, followed by cryocoagulation and a subsequent round of antibiotics post-procedure, using a \"sandwich\" technique, while 27 subjects received antibiotics alone. <b>Results:</b>Our study showed that the \"sandwich\" technique achieved a success rate of 76.2% (p<0.005) after a single session for treating chronic cervicitis and hemorrhagic cervicitis (normalization in Pap smear) and 95.7% (p<0.05) success rate in clinical improvement after intervention. <b>Conclusions:</b> The combination of antibiotic treatment followed by cryosurgery and then another prophylactic course of antibiotics presents a promising approach for managing chronic cervicitis and recurrent cervical hemorrhage.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"20 1","pages":"11-18"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661189","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":"Penetrating Brain Injury through a Pre-existing Skull Defect: Case Report.","authors":"Athina Zarachi, Evrysthenis Vartholomatos, Alkistis Tsikou, Ioannis Komnos, Alexandra Papoudou-Bai, Evangelia Lampri, Angelos Liontos, Vasilios Ragos","doi":"10.26574/maedica.2025.20.1.120","DOIUrl":"10.26574/maedica.2025.20.1.120","url":null,"abstract":"<p><p><b>Introduction:</b> Penetrating brain trauma represents about 0,4% of traumatic brain injuries. In the literature, there is a number of case studies and case-series on non-missile penetrating injuries management, but reports on penetrating brain injuries through a craniectomy are lacking. <b>Case presentation:</b>A 44-year-old male was transferred to the Emergency Room in a comatose state after being stabbed on the head by a sharp object at an area where a previous decompressive craniectomy took place years ago. Computed tomography of the head showed an extensive intracerebral hemorrhage with intraventricular extension and diffuse subarachnoid bleeding. He was immediately transferred to the operating room for hematoma evacuation and hemostasis. Postoperatively, a slight improvement in his neurological status was initially noted, but the patient's clinical course was complicated by a central nervous system infection. Following a long stay and multiple re-operations, he eventually died due to septic shock and multiorgan failure. <b>Conclusion:</b>Non-missile penetrating brain injuries can be life threatening. Prognosis is dismal in those with pre-existing skull defect and severe brain damage despite aggressive medical and surgical treatment.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"20 1","pages":"120-123"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661212","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}