Thoracic research and practice最新文献

{"title":"Long-term Effects of COVID-19 on Sleep Patterns","authors":"Salma Batool-Anwar, Olabimpe S Fashanu, Stuart F Quan","doi":"10.5152/ThoracResPract.2024.24013","DOIUrl":"10.5152/ThoracResPract.2024.24013","url":null,"abstract":"<p><strong>Objective: </strong>To examine the long-term impact of Coronavirus disease-2019 (COVID-19) on sleep patterns and the prevalence of sleep disorders and to increase public health awareness of long-term COVID-19.</p><p><strong>Material and methods: </strong>Using the Massachusetts General Brigham Research Patient Data Registry, Severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) positive patients were surveyed about their sleep patterns before and after the viral infection. Information related to comorbid conditions and medications was obtained through chart review.</p><p><strong>Results: </strong>Two hundred and forty-six completed surveys were analyzed. Average age was 53.3±16.3 years, and they were predominantly non-hispanic white (84.1%) and female (74.3%). The mean body mass index (kg/m²) was 29.9±6.9, and a greater proportion were non-smokers (63.2%). After COVID-19, there was an increase in the percentage of participants reporting difficulty initiating (39±49% vs. 31±46% prior to COVID-19 infection <i>P</i> = 0.01). Similarly, the participants reported difficulty in maintaining sleep after COVID infection (57% vs. 43% prior to infection <i>P</i> < 0.001). Additionally, there was an increase in the use of sleep aids (30% vs. 24% before the infection <i>P</i> = 0.003). The participants also reported a decrease in feeling rested and an increase in the need for napping (58% vs. 36%, <i>P</i> < 0.0001) and (27% vs. 40%, <i>P</i> < 0.0001) respectively. The sleep symptoms persisted beyond 12 months in 28% of the participants.</p><p><strong>Conclusion: </strong>SARS-CoV-2 infection had negative effects on sleep, and a significant proportion of adults experienced insomnia and daytime sleepiness beyond 12 months after recovering from the initial infection.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":"1 1","pages":"9-16"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815222","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":"Non-invasive Mechanical Ventilation in Lung Cancer: Physiological Principles and Clinical Utilization in Surgical and Non-surgical Settings.","authors":"Marco Cascella, Antonio M Esquinas","doi":"10.4274/ThoracResPract.2024.23076","DOIUrl":"10.4274/ThoracResPract.2024.23076","url":null,"abstract":"<p><p>Non-invasive mechanical ventilation (NIMV) has emerged as a pivotal intervention for the care of individuals with lung cancer. NIMV offers substantial advantages in enhancing oxygenation, optimizing respiratory function, elevating pulmonary capacities, and facilitating patient comfort. NIMV's utility extends to enhancing clinical conditions that range from chronic obstructive pulmonary disease and emphysematous lung ailments to aiding patients with lung cancer facing acute respiratory failure. Furthermore, NIVM includes perioperative pulmonary rehabilitation. This approach is particularly relevant for individuals with limited lung capacity. Since both non-invasive positive pressure ventilation modes, including BiLevel positive airway pressure and continuous positive airway pressure, address the underlying pathophysiological mechanisms that contribute to postoperative respiratory failure, the proactive and early integration of NIMV has the potential to significantly enhance gas exchange and overall respiratory performance in meticulously chosen patients within the perioperative phase. Although non-intubated video-assisted thoracic surgery represents an interesting field of application for NIMV strategies, further studies are needed to optimize operative modalities. Lastly, NIMV has a pivotal role in the settings of intensive care and palliative care units, thereby cementing its versatile utility across various medical contexts.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":"26 1","pages":"32-39"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392591","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":"Hidden Lethal Hazard: Aluminum Phosphide Incidents in Türkiye.","authors":"Selin Çakmakcı Karakaya, Cavit Işık Yavuz","doi":"10.5152/ThoracResPract.2024.23100","DOIUrl":"10.5152/ThoracResPract.2024.23100","url":null,"abstract":"","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":"25 6","pages":"221-222"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607603","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":"Is There a Correlation Between the Location of the Clot in the Pulmonary Arterial Tree with the Location of the Mucus Plug in the Pulmonary Bronchial Tree in Patients with chronic obstructive pulmonary disease Experiencing Pulmonary Embolism? Novel Findings.","authors":"Neda Akhoundi, Alireza Siami, Zahra Naseri, Mahlagha Amirbakhtiarvand","doi":"10.5152/ThoracResPract.2024.23137","DOIUrl":"10.5152/ThoracResPract.2024.23137","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to investigate the impact of mucus plugs on the localization of clots in pulmonary embolisms among chronic obstructive pulmonary disease (COPD) patients.</p><p><strong>Material and methods: </strong>The retrospective study examined 200 participants diagnosed with both COPD and pulmonary embolism. Of these, 100 patients exhibited mucus plugs in the segmental and subsegmental branches of the pulmonary bronchial tree, while the remaining 100 did not, using computed tomography images for diagnosis. Data collection encompassed a comprehensive review of patient records, including medical history and imaging reports, to determine the presence of mucus plugs and the localization of clots in pulmonary embolism cases.</p><p><strong>Results: </strong>Patients with mucus plugs exhibited a notably longer duration of COPD (P = .021) and a higher mean pulmonary arterial occlusion index (23 vs. 12, P = .001). Moreover, the prevalence of clots in major pulmonary arteries was significantly elevated in the mucus plug group compared to the non-mucus plug group (P < .05). Conversely, patients without mucus plugs displayed a higher incidence of clots in segmental and subsegmental arteries (P < .001). Strong positive correlations existed between mucus plugs in segmental branches and clots in major pulmonary arteries, with moderate to strong correlation coefficients (0.51 to 0.62, P < .05). Additionally, strong negative correlations were observed between mucus plugs in segmental branches and clots in segmental and subsegmental arteries, with correlation coefficients (CC) ranging from -0.74 to -0.76 (P < .05). Similarly, a significant negative correlation was noted between mucus plugs in subsegmental branches and clots in subsegmental arteries (CC: -0.68 and -0.71, P < .05).</p><p><strong>Conclusion: </strong>The results suggest that mucus plugs may be associated with increased severity of COPD, higher pulmonary arterial occlusion index, and altered clot distribution within the pulmonary artery tree. These findings emphasize the importance of recognizing mucus plugs as a key consideration in COPD assessment and management, potentially influencing disease severity, vascular remodeling, and thrombotic risk management.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":"25 6","pages":"203-208"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607607","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 Use of Diuretics in Infants with Established or Evolving Bronchopulmonary Dysplasia and Its Impact on the Duration of Home Oxygen Therapy.","authors":"Andrew Prayle, Yung Ci Chai, Dushyant Batra, Jayesh Mahendra Bhatt","doi":"10.5152/ThoracResPract.2024.24008","DOIUrl":"10.5152/ThoracResPract.2024.24008","url":null,"abstract":"<p><strong>Objective: </strong>Bronchopulmonary dysplasia (BPD), defined according to the level of respiratory support and supplemental oxygen administered at 36 weeks postmenstrual age, has multi-factorial causes. Diuretics have been used to prevent or treat established BPD and are the most frequently prescribed medication for the management of severe BPD. There is significant variation in the use of diuretics, and there is limited evidence showing improvement in medium to long term outcomes. We explored whether the use of diuretics in infants with BPD reduced the duration of HoT in a service that uses a unified protocol-driven pathway to monitor and wean HoT.</p><p><strong>Material and methods: </strong>A retrospective cohort study of 281 infants with BPD discharged home with oxygen therapy between 2001 and 2018. Of the 281 infants, 154 had complete data sets and were included in the study population.</p><p><strong>Results and conclusions: </strong>Forty-nine infants (31.8%) were exposed to at least one diuretic, and 105 infants (68.2%) were not exposed to any. There was no difference in the duration of HoT in infants exposed to diuretics compared to those who were unexposed. Infants exposed to diuretics had a significantly longer length of stay (LoS) in the hospital compared to unexposed infants (P < .001). We conclude that in a setting of a service in which diuretics are actively discontinued post-discharge and in which weaning of HoT is driven by a unified protocol, the use of diuretics pre-discharge does not reduce the duration of HoT.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":"25 6","pages":"209-214"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607610","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":"Factors Related to Tobacco Cessation Attempts Among Turkish Adolescents: A Structural Equation Model Analysis.","authors":"Cemre Hilal Kesen Yurtcanli, Murat Tuğberk Bakar, Şükran Peker, Pınar Ay","doi":"10.5152/ThoracResPract.2024.23129","DOIUrl":"10.5152/ThoracResPract.2024.23129","url":null,"abstract":"<p><strong>Objective: </strong>The Turkish Global Youth Tobacco Survey (GYTS) 2017 revealed that 17.9% of students aged 13-15 used tobacco products and 7.7% smoked cigarettes. Given the high prevalence of smoking, it is important to evaluate the factors associated with quit attempts among adolescents. This study aimed to identify the factors associated with Turkish adolescents' attempts to quit smoking using Structural Equation Model (SEM) analyses.</p><p><strong>Material and methods: </strong>This study utilized the data from GYTS 2017, which is a cross-sectional, nationally representative, schoolbased study carried out below 18-year-olds. The study population (n = 18 985) consisted of students who had smoked cigarettes within the past year. After excluding inconsistent responses, 9735 students remained for the analysis. The outcome was an attempt to quit smoking within the past year. Structural Equation Model (SEM) was used for data analysis. The model had good fit (CFI = 0.917, TLI = 0.900, RMSEA = 0.032).</p><p><strong>Results: </strong>Of the 9735 students, 66.4% were male. In the past 12 months, 56.3% (95%CI: 55.3%-57.3%) of smokers attempted to quit. Exposure to anti-tobacco policies (β = 0.114. P < .001) had positive direct effects, whereas sociodemographic factors (β = -0.086. P < .001), nicotine dependency (β = -0.037. P = .008) and exposure to second-hand smoke (β = -0.051. P < .001) had negative direct effects on quit attempts.</p><p><strong>Conclusion: </strong>More than half of the smokers attempted to quit, and nicotine dependence predicted quit attempts. Exposure to secondhand smoke decreased cessation attempts. Anti-tobacco policies such as sale restrictions and warnings of the dangers of tobacco products should be given high priority and enforced fully since they are the strongest predictors of quit attempts.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":"25 3","pages":"197-202"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607600","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 Validity and Reliability of the Turkish version of Modified Medical Research Council Dyspnea Scale in Systemic Sclerosis Patients with Interstitial Lung Disease.","authors":"Elif Gur Kabul, Pervin Demir, Berna Cagla Balkisli, Firdevs Ulutas, Sinem Yenil, Bilge Basakci Calik, Veli Cobankara","doi":"10.5152/ThoracResPract.2024.23135","DOIUrl":"10.5152/ThoracResPract.2024.23135","url":null,"abstract":"<p><strong>Objective: </strong>The aim was to investigate the validity and reliability of the Turkish version of the Modified Medical Research Council (mMRC) Dyspnea Scale in Systemic Sclerosis (SSc) patients with Interstitial Lung Disease.</p><p><strong>Material and methods: </strong>Thirty patients diagnosed with SSc according to the 2013 EULAR/ACR criteria were included. After recording the demographic data of the patients, dyspnea was evaluated with the Visual Analogue Scale (VAS), exercise capacity with the 6 Minute Walk Distance (6MWD), fatigue level with the Fatigue Severity Scale (FSS), disease activity with the Medsger Disease Severity Scale, skin involvement with the Modified Rodnan Skin Score, and dyspnea level with the mMRC Dyspnea Scale. The mMRC Dyspnea Scale was administered to the patients with SSc who did not receive any treatment for test-retest reliability at 1-week intervals.</p><p><strong>Results: </strong>The observed scale range in mMRC (TR) was 0-4, and twelve out of the thirty patients (40%) were classified as having \"moderate dyspnea.\" mMRC (TR) showed a significant moderate positive correlation with VAS dyspnea (rho: 0.718), a low negative correlation with 6MWD (rho: -0.445), and a low positive correlation with FSS (rho: 0.385). The weighted kappa statistic, used as an agreement scale for ordinal responses, was found to be 0.587 (indicating moderate agreement).</p><p><strong>Conclusion: </strong>The Turkish version of the mMRC Dyspnea Scale demonstrates validity and reliability in SSc patients with interstitial lung disease.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":"25 6","pages":"215-220"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607613","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":"Comments on: Pulmonary Function and Diffusing Capacity of Carbon Monoxide in Hypersensitivity Pneumonitis: An Observational Study of 152 Patients.","authors":"Kundan Nikit Mehta, Hiral Gulab Ramnani","doi":"10.5152/ThoracResPract.2024.24036","DOIUrl":"https://doi.org/10.5152/ThoracResPract.2024.24036","url":null,"abstract":"","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":"25 5","pages":"193-194"},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11391220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514395","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":"Central Sleep Apnea in Children-10 Years Experience at a Tertiary Sleep Laboratory.","authors":"Cansu Yılmaz Yeğit, Mine Kalyoncu, Mürüvvet Yanaz, Aynur Guliyeva, Merve Selçuk, Şeyda Karabulut, Meltem Sabancı, Pınar Ergenekon, Yasemin Gökdemir, Fazilet Karakoç, Refika Ersu, Bülent Karadağ, Ela Erdem Eralp","doi":"10.5152/ThoracResPract.2024.24018","DOIUrl":"https://doi.org/10.5152/ThoracResPract.2024.24018","url":null,"abstract":"<p><strong>Objective: </strong>Central sleep apnea (CSA) is a rare condition in children; however, it can cause significant morbidity if not diagnosed early. We aimed to increase the knowledge about CSA in children by describing the clinical characteristics of children diagnosed with CSA at our sleep center.</p><p><strong>Material and methods: </strong>We retrospectively reviewed 1263 polysomnographies (PSG) performed between 2012 and 2023 at our tertiary sleep center and evaluated the clinical characteristics of the patients with CSA. Underlying diseases, clinical symptoms, sleep parameters, and short-term management of the patients were recorded.</p><p><strong>Results: </strong>Of the 1263 patients aged between 1 month and 18 years, 122 (9.65%) had CSA, with 54.9 % (n = 67) of them being female. Only 56.6% (n = 69) of the patients' parents had reported a symptom indicating sleep-disordered breathing. The most common underlying disease was genetic, including Down and Prader-Willi syndromes, followed by neurological diseases . Obstructive sleep apnea was detected in addition to CSA in 103 of the patients (84.4%). Bi-level positive airway pressure with a backup rate was the most common treatment modality.</p><p><strong>Conclusion: </strong>While CSA is a rare clinical condition in children, it occurs more commonly in those with an underlying disease. Awareness of the disease and timely referral of the patients for sleep studies are critical to prevent long-term sequelae.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":"25 5","pages":"188-192"},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11391226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514393","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":"Clinical Course of Coronavirus disease 2019 C-19 in Patients with Bronchiectasis.","authors":"Ebru Çakır Edis, Aykut Çilli, Deniz Kızılırmak, Ayşın Şakar Coşkun, Abdullah Sayıner, Sedat Çiçek, İnci Gülmez, Meltem Çoban Ağca, Benan Çağlayan, Neslihan Özçelik, Nurdan Köktürk, Birsen Ocaklı, Eyüp Sabri Uçan","doi":"10.5152/ThoracResPract.2024.23054","DOIUrl":"https://doi.org/10.5152/ThoracResPract.2024.23054","url":null,"abstract":"<p><strong>Objective: </strong>Coronavirus disease 2019 (COVID-19) has affected the whole world and caused the death of more than 6 million people. The disease has been observed to have a more severe course in patients with chronic lung diseases. There are limited data regarding COVID-19 in patients with bronchiectasis. The aim of this article is to investigate the course of COVID-19 and factors affecting the clinical outcome in patients with bronchiectasis.</p><p><strong>Material and methods: </strong>This study was conducted using the Turkish Adult Bronchiectasis Database (TEBVEB) to which 25 centers in Türkiye contributed between March 2019 and January 2022. The database consisted of 1035 patients, and COVID-19-related data were recorded for 606 patients.</p><p><strong>Results: </strong>One hundred nineteen (19.6%) of the bronchiectasis patients (64 female, mean age 57.3 ± 13.9) had COVID-19. Patients with bronchiectasis who developed COVID-19 more frequently had other comorbidities (P = .034). They also more frequently had cystic bronchiectasis (P = .009) and their Bronchiectasis Severity Index was significantly higher (P = .019). Eighty-two (68.9%) of the patients who had COVID-19 were followed up in the outpatient clinic, 27 (22.7%) in the inpatient ward and 10 (8.4%) patients in the intensive care unit. There tended to be a higher percentage of males among patients admitted to the hospital (P = .073); similarly, the mean age of the patients admitted to the hospital was also higher (60.8 vs 55.8 years for the outpatients), but these differences did not reach statistical significance (P = .071).</p><p><strong>Conclusion: </strong>In conclusion, this study showed that severe bronchiectasis, presence of cystic bronchiectasis and worse Bronchiectasis Severity Index are associated with the development of COVID-19, but not with the severity of infection.</p>","PeriodicalId":75221,"journal":{"name":"Thoracic research and practice","volume":"25 5","pages":"184-187"},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11391223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514394","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}