Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society最新文献

{"title":"Pharmacological Interventions for Managing Acute Geriatric Pain and Delirium: A Systematic Review.","authors":"Chen Zeng, Fengcai Liu","doi":"10.1111/psyg.70066","DOIUrl":"https://doi.org/10.1111/psyg.70066","url":null,"abstract":"<p><p>Delirium and acute pain are significant clinical challenges in the care of hospitalised elderly patients, both of which are associated with increased mortality, functional disability and prolonged hospital stays. The aim of this study was to systematically review and perform both qualitative and quantitative analyses of the effectiveness of various pharmacological interventions in preventing delirium and controlling acute pain in hospitalised elderly individuals. A comprehensive search was conducted in PubMed, Scopus, Embase, Cochrane, Google Scholar and Web of Science databases up to February 2025. Randomised controlled trials (RCTs) and controlled trials focusing on medications used to prevent delirium or alleviate pain in hospitalised elderly patients were selected. Data were extracted qualitatively and categorised and analysed considering delirium and pain outcomes. Among the studies screened, 12 studies were included in the final analysis. Interventions such as iliac fascia block, multi-drug anti-inflammatory bundles, gabapentin and butorphanol were effective in reducing pain intensity and some inflammatory markers. However, most medications had no significant effect on reducing delirium incidence or provided conflicting results. Interventions targeting systemic inflammation, such as methylprednisolone, dexamethasone and preoperative saline solution, showed more promising results in preventing delirium. The findings suggest that single pharmacological approaches are often ineffective in preventing delirium and the use of combined strategies, including anti-inflammatory interventions along with effective pain control, may yield better outcomes. Future study designs should focus on larger sample sizes, more diverse populationsand standardisation of measurement tools.</p>","PeriodicalId":74597,"journal":{"name":"Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society","volume":"25 4","pages":"e70066"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546515","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":"Effects of Individual Cognitive Stimulation Therapy on Cognitive Function and Depressive Mood in Dementia Patients: A Systematic Review and Meta-Analysis.","authors":"Pan Liu, Yue Zhang, Ziying Yu, Xinyu Wang, Qinghui Meng","doi":"10.1111/psyg.70054","DOIUrl":"10.1111/psyg.70054","url":null,"abstract":"<p><p>To assess the effects of individualised cognitive stimulation therapy (ICST) on dementia patients, we searched Chinese and English databases for intervention studies on individual cognitive stimulation therapy in dementia patients and used Review Manager 5.3 software for meta-analysis. The results of the meta-analysis indicated that the Mini-Mental State Examination (MMSE) showed a significant difference in cognitive function (MD: 1.65; 95% CI: 0.06-3.24). However, no significant effect was found in the assessment of the Cognitive Subscale of the Alzheimer's Disease Assessment Scale (ADAS-Cog). Overall, ICST demonstrated improved cognitive function in dementia patients and led to a reduction in depression (MD: -1.18; 95% CI: -2.14 to -0.22). Nevertheless, there were no significant effects on quality of life, neuropsychiatric symptoms, or activities of daily living observed. ICST can effectively improve the cognitive ability of dementia patients and reduce depression. There is a need for further studies to confirm these findings and investigate potential mechanisms.</p>","PeriodicalId":74597,"journal":{"name":"Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society","volume":"25 4","pages":"e70054"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328034","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":"Clinical Characteristics of Older Adults With Late-Onset Suicide Attempts: A Hospital-Based Retrospective Study.","authors":"Daichi Morioka, Ryota Kobayashi, Kazutaka Sakamoto, Toshinori Shirata, Tadahiro Kobayashi, Akihito Suzuki","doi":"10.1111/psyg.70063","DOIUrl":"https://doi.org/10.1111/psyg.70063","url":null,"abstract":"<p><strong>Background: </strong>No previous study has fully described older adults who make a first suicide attempt late in life. We retrospectively reviewed adults ≥ 60 years admitted to a university psychiatric ward after an attempt to (1) detail their demographic and clinical features; (2) compare admission and discharge diagnoses to measure diagnostic shifts-especially from major depressive disorder (MDD) to dementia; and (3) determine whether certain dementia subtypes, notably dementia with Lewy bodies (DLB), are over-represented.</p><p><strong>Methods: </strong>Medical charts of patients transported to the emergency department and hospitalised between April 2015 and March 2024 were screened. After excluding cases with psychiatric disorders before the age of 60 years, 63 late-onset attempters were analysed. Diagnoses were reassessed with DSM-5-TR and standard neurodegenerative criteria; discrepancies were resolved by two senior psychiatrists. Mini-Mental State Examination scores, suicide methods and demographics were compared across final diagnoses.</p><p><strong>Results: </strong>At discharge, psychiatric disorders predominated (65.1%), but dementia was present in 31.7%; DLB was the leading subtype (19.0%), followed by Alzheimer's disease (9.5%). Diagnostic revision was common: 17 patients (27.0%) changed diagnosis during hospitalisation, including 15 who shifted from MDD to dementia; 10 of these reclassifications were to DLB and six met criteria for psychiatric-onset DLB. Mini-Mental State Examination scores did not differ between MDD and DLB, although scores were lower in Alzheimer's disease. Suicide methods-most often drug overdose-showed no relation to diagnosis.</p><p><strong>Conclusions: </strong>Almost one-third of older first-time attempters harboured unrecognised dementia, most frequently DLB and over one-quarter of initial MDD diagnoses converted to dementia after full assessment. Brief cognitive screens alone missed these cases. Routine post-attempt care for older adults should therefore include informant history, detailed neuropsychological testing and dementia-specific biomarkers to guide targeted prevention and treatment.</p>","PeriodicalId":74597,"journal":{"name":"Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society","volume":"25 4","pages":"e70063"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546514","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":"The Neural Correlates of Delusions in Dementia: A Scoping Review.","authors":"Adèle Gagnon, Bryn H Manns, Karina Atanasiu, Dominique Lumley, Mallar Chakravarty, Serge Gauthier, Ian Gold","doi":"10.1111/psyg.70060","DOIUrl":"10.1111/psyg.70060","url":null,"abstract":"<p><p>Delusions are common symptoms of dementia and are clinically significant. The objective of this scoping review is to identify possible neural correlates. MEDLINE (OVID), EMBASE (OVID) and Web of Science were searched in December 2020 for the keywords 'delusions' and 'dementia'. Two informal searches were carried out subsequently. Results were limited to those in English. Intervention and study characteristics were extracted using standardised tools. Eighteen published studies, using four distinct experimental methods, were included, and 31 brain regions were identified as correlates of delusions. No region was identified consistently within included studies or found in more than four studies. Despite the range of brain regions identified, a number form part of the default mode network, the salience network or the central executive network. We explore the implications of these findings for understanding delusions in dementia.</p>","PeriodicalId":74597,"journal":{"name":"Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society","volume":"25 4","pages":"e70060"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577196","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":"Determination of Factors Associated With Urinary Incontinence in Older Individuals With Alzheimer's Disease: A Cross-Sectional Study.","authors":"Fatih Özden, Mehmet Özkeskin, Zehra Benzer, İsmail Uysal, Emir İbrahim Işık, Miray Başer","doi":"10.1111/psyg.70058","DOIUrl":"10.1111/psyg.70058","url":null,"abstract":"<p><strong>Background: </strong>The objective of the present study was to examine the demographic and physical predictors of urinary incontinence (UI) in older patients with Alzheimer's disease (AD).</p><p><strong>Methods: </strong>The cross-sectional observational study comprised 55 patients diagnosed with AD, whose disease severity was assessed by a neurologist as mild to moderate. The following instruments were utilised for evaluation: the Mini-Mental State Examination (MMSE), the Incontinence Impact Questionnaire (IIQ-7), the Functional Reach Test (FRT), the Timed Up and Go Test (TUG), the Falls Efficacy Scale-International (FES-I), the Activity-specific Balance Confidence Scale (ABC) and the Urogenital Distress Inventory (UDI-6).</p><p><strong>Results: </strong>The patients' mean age was 76.24 ± 6.66 years. A significant difference was found between educational status and UDI-6 scores. No other significant associations were observed between demographic characteristics and UI measures. In addition, IIQ-7 showed weak correlations with TUG (r = 0.222), FES-I (r = 0.257) and ABC (r = -0.250).</p><p><strong>Conclusions: </strong>A weak correlation was observed between physical performance, fear of falling, and balance confidence in individuals diagnosed with AD. Moreover, individuals with lower educational attainment exhibited a greater propensity to experience UI. Future research is recommended to investigate the relationship between somatosensory symptoms and UI in individuals with AD.</p>","PeriodicalId":74597,"journal":{"name":"Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society","volume":"25 4","pages":"e70058"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295456","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":"A Preliminary Study on the Development of a Virtual Reality-Based Financial Decision-Making Training Tool for Investment Trusts: Usability and Acceptability Among Community-Dwelling Healthy Older People.","authors":"Yuka Kato, Masami Hiyama, Nozomu Oya, Jin Narumoto","doi":"10.1111/psyg.70068","DOIUrl":"https://doi.org/10.1111/psyg.70068","url":null,"abstract":"<p><strong>Background: </strong>As global population ages, financial gerontology is becoming increasingly important in supporting older adults' financial decision-making. The decline in the real asset value of financial assets driven by inflation and social security reforms necessitates investment strategies beyond traditional savings. However, age-related cognitive decline can impair financial decision-making capacity, highlighting the need for effective interventions. Virtual reality (VR)-based training appears promising in enhancing cognitive function, making it an engaging tool for financial education. This study aimed to evaluate the usability and acceptability of a VR-based financial decision-making training tool for investment trust among community-dwelling older adults.</p><p><strong>Methods: </strong>Twenty-eight cognitively healthy older adults (≥ 60 years, Japanese version of the Montreal Cognitive Assessment ≥ 26) participated in a usability study using the Oculus Quest 2. The VR training involved interacting with an avatar that explained investment trust and answered decision-making quizzes. Usability and acceptability were assessed using a System Usability Scale, a Simulator Sickness Questionnaire, Likert-scale ratings on content clarity and content analysis of open-ended responses.</p><p><strong>Results: </strong>The median training session lasted 21.8 min, and most participants (89.3%) completed the task with minimal or no support. The System Usability Scale score was 63.8, slightly below the usability benchmark, whereas Simulator Sickness Questionnaire scores indicated minimal VR-induced discomfort (overall score: median 3.7). Content analysis revealed three major strengths-cognitive support, emotional engagement and learner autonomy-and four key challenges including interface usability, content difficulty, physical comfort, and auditory pacing.</p><p><strong>Conclusions: </strong>This preliminary study suggests that VR-based financial decision-making training is a promising tool for financial education in older adults, as it may reduce psychological barriers to financial learning. However, improvements in usability, including intuitive and interactive feedback, are required. Future studies should explore the long-term impact of VR training on financial decision-making, potential adaptations for vulnerable populations, and its role within hybrid financial education programs.</p>","PeriodicalId":74597,"journal":{"name":"Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society","volume":"25 4","pages":"e70068"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562289","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":"Differences in the Regional T1/T2-Weighted Ratio Index Between Healthy Controls and Patients With Progressive Supranuclear Palsy.","authors":"Miho Ota, Noriko Sato, Yuji Takahashi, Yoko Shigemoto, Yukio Kimura, Hiroyuki Maki, Tomoki Imokawa, Risa Kagaya, Hiroshi Matsuda","doi":"10.1111/psyg.70069","DOIUrl":"https://doi.org/10.1111/psyg.70069","url":null,"abstract":"<p><strong>Background: </strong>Progressive supranuclear palsy (PSP) is a four-repeat tauopathy, and the differentiation of PSP from other neurodegenerative disorders is a common clinical problem. We applied a T1-/T2-weighted ratio imaging technique based on standard clinical MRI to investigate PSP-related changes in neuroimaging data.</p><p><strong>Method: </strong>Twenty patients with PSP and 34 healthy participants underwent an examination to obtain T1- and T2-weighted images at our hospital. We retrospectively computed each subject's T1/T2-weighted ratio index to use as a proxy for the brain's myelin content, and we analyzed the differences in the index values between the PSP and control groups.</p><p><strong>Results: </strong>Our analysis revealed the precise differences in the T1/T2-weighted ratio index between the PSP and control groups and demonstrated that the patients with PSP showed significant reductions of the T1/T2-weighted ratio index in the midbrain, posterior commissure, caudate, thalamus, and bilateral insulae compared to the healthy controls.</p><p><strong>Conclusions: </strong>These results show that the T1/T2-weighted ratio approach is useful to distinguish patients with PSP from healthy subjects.</p>","PeriodicalId":74597,"journal":{"name":"Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society","volume":"25 4","pages":"e70069"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568201","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":"An exploratory study on municipal measures for preventing and addressing incidents of missing older persons with dementia living alone in Japan.","authors":"Kazunori Kikuchi, Tatsuya Ooguchi, Tomoko Ikeuchi, Shuichi Awata","doi":"10.1111/psyg.70022","DOIUrl":"10.1111/psyg.70022","url":null,"abstract":"<p><strong>Background: </strong>It is predicted that the number of older persons with dementia (PwD) living alone in Japan will increase in the future. Consequently, it is also expected that the number of missing older PwD living alone will rise. However, there is little research on missing PwD who live alone. The aim of this study was to clarify the framework of measures that are deemed necessary by municipalities when older PwD who are living alone go missing.</p><p><strong>Methods: </strong>A mail survey was conducted among 1741 municipalities, and we asked about the necessity of 22 measures to address the issue of missing PwD who are living alone. A total of 478 municipalities with no missing values in the analyzed variables were included in the analysis, and factor analysis was conducted.</p><p><strong>Results: </strong>The following five factors were extracted: collaboration (Factor 1), prior agreement (Factor 2), the SOS network (Factor 3), information and communication technology-based solutions (Factor 4), and policy guidelines or protocol frameworks (Factor 5).</p><p><strong>Conclusion: </strong>Each of the five factors was unique. The strategies for dealing with missing persons include both relatively easy and challenging measures. Municipalities that have not yet made significant progress should begin with the easier measures and gradually implement the more challenging measures.</p>","PeriodicalId":74597,"journal":{"name":"Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society","volume":"25 3","pages":"e70022"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617952","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":"Fear of falling is a top issue for older adults with a history of falling: multidimensional perspective.","authors":"Arzu Demircioglu-Karagoz, Ulku Kezban Sahin, Osman Dag, Ilker Fatih Sari","doi":"10.1111/psyg.70029","DOIUrl":"https://doi.org/10.1111/psyg.70029","url":null,"abstract":"<p><strong>Backround: </strong>Fear of falling is a frequently encountered psychological phenomenon, especially in older adults with a history of falling. Many psychological, physical, and social factors affect the fear of falling. The aim of this research is to examine the physical, psychological and social factors that affect the fear of falling in older adults.</p><p><strong>Methods: </strong>One hundred and fifty-two older adults with a history of falling in the last year were included in this cross-sectional study. In addition to variables such as age, educational status, use of mobility aids, fall frequency and comorbidity in individuals, physical, psychological and social variables were examined. Fear of falling was assessed with the Modified Fall Efficacy Scale.</p><p><strong>Results: </strong>The Modified Fall Efficacy Scale's score was significantly predicted by gait speed (P < 0.001), muscle strength (P = 0.006), balance (P < 0.001), physical activity (P = 0.032), pain (P = 0.004), depression (P = 0.007), and community integration (P < 0.001). Physical, psychological and social variables explain 78% of the Modified Fall Efficacy Scale's score in older adults with a history of falling in the last 1 year.</p><p><strong>Conclusions: </strong>Increased pain and depressive mood, in addition to decreased walking speed, lower extremity muscle strength, balance, physical activity and social participation, have negative impacts on the fear of falling in older adults. Especially, older adults with a history of falling should be evaluated physically, psychologically and socially and the factors affecting their fear of falling should be determined. In this way, suitable rehabilitation protocols for older adults will be developed.</p>","PeriodicalId":74597,"journal":{"name":"Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society","volume":"25 3","pages":"e70029"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060658","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":"Study of Disease Self-Management and Social Activity Status of Older Adults With Chronic Disease.","authors":"Esra Türker, Meltem Meriç","doi":"10.1111/psyg.70042","DOIUrl":"https://doi.org/10.1111/psyg.70042","url":null,"abstract":"<p><strong>Background: </strong>Older adults with chronic health conditions, disease-related self-management is of great importance for maintaining the balance between daily activities and social interactions that are often disrupted by chronic disease. The purpose of this study was to examine the relationship between disease self-management and social activity status of older adults with chronic disease.</p><p><strong>Methods: </strong>This descriptive and correlational study was carried out with 379 older adults between April and July 2024. Data were collected using three instruments: Patient Information Form, Self-Management Scale in Chronic Diseases (CDSMS) and Social Activities Scale for Community-Dwelling Older People Requiring Support (SASOS).</p><p><strong>Results: </strong>The mean age of the older adults with chronic diseases who participated in the study was 70.74 ± 4.91 years. Forty percent of the older adults had two or more chronic diseases, and 72.56% of them rated their health status as good. It was found that the total score of the social activities scale for the older adults showed a positive significant relationship with coping with stigmatisation (r = 0.492, p < 0.001), health care effectiveness (r = 0.290, p < 0.001) and treatment compliance (r = 0.384, p < 0.001), and a negative significant relationship with self-stigmatisation (r = -0.350, p < 0.001). Four distinct 'simple linear regression analyses' were carried out to examine the structure of SASOS and CDSMS sub-dimensions. All models were significant and explained the cumulative variance in the dependent variable.</p><p><strong>Conclusions: </strong>The results of this study lend support to the notion that an increase in chronic disease self-management has a psycho-social impact on social relationships. These results are deemed to contribute to the development of new interventions that facilitate self-care practices and increase socialisation at both individual and social levels. To more accurately capture the dimensions of this experience and its consequences for health, measures of chronic disease self-management should be developed based on the collaboration between patients and health professionals and aimed at providing social incentives for patients.</p>","PeriodicalId":74597,"journal":{"name":"Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society","volume":"25 3","pages":"e70042"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047007","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}