{"title":"A Systematic Review to Explore a Neuropsychological Profile that Predates Anorexia Nervosa.","authors":"Rachel Noon, Tayeem Pathan","doi":"10.1093/arclin/acae072","DOIUrl":"https://doi.org/10.1093/arclin/acae072","url":null,"abstract":"<p><strong>Objective: </strong>Research demonstrates reduced cognitive flexibility and weak central coherence during acute illness and following recovery from anorexia nervosa (AN). This systematic review investigated if these impairments are present in first-degree relatives of individuals with AN, representing a possible neuropsychological risk profile.</p><p><strong>Methods: </strong>A systematic review of electronic databases was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search ended on July 14, 2023. Established search terms and inclusion criteria identified relevant research. Risk of bias was assessed using the Critical Appraisal Skills Program. The review was registered with Prospero international prospective register of systematic reviews (No. CRD42023401268). Study selection, descriptive data, critical appraisal, and risk of bias are presented in tables and figures.</p><p><strong>Results: </strong>The search yielded 10 studies. The included studies conducted neuropsychological assessments of discordant AN relatives and lifetime longitudinal study participants. Most studies found cognitive flexibility and central coherence to be significantly reduced in participants with AN and their relatives compared with controls. One study found decision making to be significantly impaired in AN participants and relatives. Effect sizes were moderate to large.</p><p><strong>Discussion: </strong>Reduced cognitive flexibility and weak central coherence appear to be endophenotypes of AN. Further research is required with relatives concordant for AN to establish whether these biomarkers co-segregate with AN within families. These findings suggest a possibility of developing screeners to identify individuals at risk of AN allowing for early intervention.</p>","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142144904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lucas Emmanuel Lopes-Santos, Diego de Lacerda Ferreira, Geisa de Angelis, Maria Paula Foss, Ana Carolina Trevisan, Kleython José Coriolano Cavalcanti de Lacerda, Vitor Tumas, Fernando Bellissimo-Rodrigues, Lauro Wichert-Ana
{"title":"How Mild Is the Mild Long COVID? A Comprehensive Neuropsychological Assessment of Patients with Cognitive Complaints.","authors":"Lucas Emmanuel Lopes-Santos, Diego de Lacerda Ferreira, Geisa de Angelis, Maria Paula Foss, Ana Carolina Trevisan, Kleython José Coriolano Cavalcanti de Lacerda, Vitor Tumas, Fernando Bellissimo-Rodrigues, Lauro Wichert-Ana","doi":"10.1093/arclin/acae071","DOIUrl":"https://doi.org/10.1093/arclin/acae071","url":null,"abstract":"<p><p>The global impact of the Coronavirus Disease (COVID-19) pandemic has extended beyond physical health, leading to widespread mental health issues. Beyond respiratory symptoms, there is a growing concern about long-term cognitive effects, particularly in individuals who experienced mild cases of the infection. We aimed to investigate the neuropsychological aspects of long-term COVID-19 in non-hospitalized adults compared with a control group. This cross-sectional study included 42 participants, 22 individuals with a history of mild COVID, and 20 healthy controls. The participants were recruited from the community and underwent a comprehensive neuropsychological assessment. Participants from the mild COVID group reported cognitive symptoms persisting for an average of 203.86 days and presented a higher frequency of psychological treatment history (81.8%) compared with the control group (25.0%). History of anxiety disorders was more prevalent in the mild COVID group (63.6%) than in the control group (20.0%). Significant reductions in verbal working memory were observed in the mild COVID group. Levels of anxiety were found to have a significant impact on difficulties with visual recognition memory. This study reveals important neuropsychological alterations in individuals following mild COVID-19, emphasizing executive functions deficits. Our findings underscore the persistence of these deficits even in non-hospitalized cases, suggesting potential inflammatory mechanisms in the central nervous system. The study highlights the need for comprehensive assessments and targeted interventions to address the diverse cognitive impacts on individuals recovering from COVID-19.</p>","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142144905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alejandro García-Rudolph, David Sanchez-Pinsach, Eloy Opisso
{"title":"Evaluating AI Models: Performance Validation Using Formal Multiple-Choice Questions in Neuropsychology.","authors":"Alejandro García-Rudolph, David Sanchez-Pinsach, Eloy Opisso","doi":"10.1093/arclin/acae068","DOIUrl":"https://doi.org/10.1093/arclin/acae068","url":null,"abstract":"<p><p>High-quality and accessible education is crucial for advancing neuropsychology. A recent study identified key barriers to board certification in clinical neuropsychology, such as time constraints and insufficient specialized knowledge. To address these challenges, this study explored the capabilities of advanced Artificial Intelligence (AI) language models, GPT-3.5 (free-version) and GPT-4.0 (under-subscription version), by evaluating their performance on 300 American Board of Professional Psychology in Clinical Neuropsychology-like questions. The results indicate that GPT-4.0 achieved a higher accuracy rate of 80.0% compared to GPT-3.5's 65.7%. In the \"Assessment\" category, GPT-4.0 demonstrated a notable improvement with an accuracy rate of 73.4% compared to GPT-3.5's 58.6% (p = 0.012). The \"Assessment\" category, which comprised 128 questions and exhibited the highest error rate by both AI models, was analyzed. A thematic analysis of the 26 incorrectly answered questions revealed 8 main themes and 17 specific codes, highlighting significant gaps in areas such as \"Neurodegenerative Diseases\" and \"Neuropsychological Testing and Interpretation.\"</p>","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daphne Ter Huurne, Inez Ramakers, Nina Possemis, Alexandra König, Nicklas Linz, Johannes Tröger, Kai Langel, Frans Verhey, Marjolein de Vugt
{"title":"User Experience of a (Semi-) Automated Cognitive Phone-Based Assessment Within a Memory Clinic Population.","authors":"Daphne Ter Huurne, Inez Ramakers, Nina Possemis, Alexandra König, Nicklas Linz, Johannes Tröger, Kai Langel, Frans Verhey, Marjolein de Vugt","doi":"10.1093/arclin/acae063","DOIUrl":"https://doi.org/10.1093/arclin/acae063","url":null,"abstract":"<p><strong>Objective: </strong>We examined the user experience in different modalities (face-to-face, semi-automated phone-based, and fully automated phone-based) of cognitive testing in people with subjective cognitive decline and mild cognitive impairment.</p><p><strong>Method: </strong>A total of 67 participants from the memory clinic of the Maastricht University Medical Center+ participated in the study. The study consisted of cognitive tests in different modalities, namely, face-to-face, semi-automated phone-based guided by a researcher, and fully automated phone-based without the involvement of a researcher. After each assessment, a user experience questionnaire was administered, including questions about, for example, satisfaction, simplicity, and missing personal contact, on a seven-point Likert scale. Non-parametric tests were used to compare user experiences across different modalities.</p><p><strong>Results: </strong>In all modalities, user experiences were rated above average. The face-to-face ratings were comparable to the ratings of the semi-automated phone-based assessment, except for the satisfaction and recommendation items, which were rated higher for the face-to-face assessment. The face-to-face assessment was preferred above the fully automated phone-based assessment on all items. In general, the semi- and fully automated phone-based assessments were comparable (simplicity, conceivability, quality of sound, visiting the hospital, and missing personal contact), while on all the other items, the semi-automated phone-based assessment was preferred.</p><p><strong>Conclusions: </strong>User experience was rated high within all modalities. Simplicity, conceivability, comfortability, and participation scores were comparable in the semi-automated phone-based and face-to-face assessment. Based on these findings and earlier research on validation of the semi-automated phone-based assessment, the semi-automated assessment could be useful for screening for clinical trials, and after more research, in clinical practice.</p>","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robert D Melara, James C Root, Jay A Edelman, Maria Camilla Estelle, Isabella Mohr, Tim A Ahles
{"title":"Effects of Breast Cancer Treatment on Neural Noise: a Longitudinal Design.","authors":"Robert D Melara, James C Root, Jay A Edelman, Maria Camilla Estelle, Isabella Mohr, Tim A Ahles","doi":"10.1093/arclin/acae066","DOIUrl":"https://doi.org/10.1093/arclin/acae066","url":null,"abstract":"<p><strong>Objective: </strong>Cognitive dysfunction has been observed consistently in a subset of breast cancer survivors. Yet the precise neurophysiological origins of cancer-related cognitive decline remain unknown. The current study assessed neural noise (1/f activity in electroencephalogram [EEG]) in breast cancer survivors as a potential contributor to observed cognitive dysfunction from pre- to post-treatment.</p><p><strong>Methods: </strong>We measured EEG in a longitudinal design during performance of the paired-click task and the revised Attention Network Test (ANT-R) to investigate pre- versus post-treatment effects of neural noise in breast cancer patients (n = 20 in paired click; n = 19 in ANT-R) compared with healthy controls (n = 32 in paired click; n = 29 in ANT-R).</p><p><strong>Results: </strong>In both paradigms, one sensory (paired click) and one cognitive (ANT-R), we found that neural noise was significantly elevated after treatment in patients, remaining constant from pretest to posttest in controls. In the ANT-R, patients responded more slowly than controls on invalid cuing trials. Increased neural noise was associated with poorer alerting and poorer inhibitory control of attention (as measured by behavioral network scores), particularly for patients after treatment.</p><p><strong>Conclusions: </strong>The current study is the first to show a deleterious effect of breast cancer and/or cancer treatment on neural noise, pointing to alterations in the relative balance of excitatory and inhibitory synaptic inputs, while also suggesting promising approaches for cognitive rehabilitation.</p>","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142085951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christopher Gonzalez, John-Christopher A Finley, Elmma Khalid, Karen S Basurto, Hannah B VanLandingham, Lauren A Frick, Julia M Brooks, Rachael L Ellison, Devin M Ulrich, Jason R Soble, Zachary J Resch
{"title":"The Impact of Adverse Childhood Experiences on Symptom and Performance Validity Tests Among a Multiracial Sample Presenting for ADHD Evaluation.","authors":"Christopher Gonzalez, John-Christopher A Finley, Elmma Khalid, Karen S Basurto, Hannah B VanLandingham, Lauren A Frick, Julia M Brooks, Rachael L Ellison, Devin M Ulrich, Jason R Soble, Zachary J Resch","doi":"10.1093/arclin/acae006","DOIUrl":"10.1093/arclin/acae006","url":null,"abstract":"<p><strong>Objective: </strong>Adverse childhood experiences (ACEs) are commonly reported in individuals presenting for attention-deficit hyperactivity disorder (ADHD) evaluation. Performance validity tests (PVTs) and symptom validity tests (SVTs) are essential to ADHD evaluations in young adults, but extant research suggests that those who report ACEs may be inaccurately classified as invalid on these measures. The current study aimed to assess the degree to which ACE exposure differentiated PVT and SVT performance and ADHD symptom reporting in a multi-racial sample of adults presenting for ADHD evaluation.</p><p><strong>Method: </strong>This study included 170 adults referred for outpatient neuropsychological ADHD evaluation who completed the ACE Checklist and a neurocognitive battery that included multiple PVTs and SVTs. Analysis of variance was used to examine differences in PVT and SVT performance among those with high (≥4) and low (≤3) reported ACEs.</p><p><strong>Results: </strong>Main effects of the ACE group were observed, such that high ACE group reporting demonstrated higher scores on SVTs assessing ADHD symptom over-reporting and infrequent psychiatric and somatic symptoms on the Minnesota Multiphasic Personality Inventory-2-Restructured Form. Conversely, no significant differences emerged in total PVT failures across ACE groups.</p><p><strong>Conclusions: </strong>Those with high ACE exposure were more likely to have higher scores on SVTs assessing over-reporting and infrequent responses. In contrast, ACE exposure did not affect PVT performance. Thus, ACE exposure should be considered specifically when evaluating SVT performance in the context of ADHD evaluations, and more work is needed to understand factors that contribute to different patterns of symptom reporting as a function of ACE exposure.</p>","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139745954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah Garcia, Elodie Foster, Peter J Johnson, Brittany Thomas, Robert L Askew
{"title":"Executive Function as a Predictor of Pain Perception in Healthy Young Adults.","authors":"Sarah Garcia, Elodie Foster, Peter J Johnson, Brittany Thomas, Robert L Askew","doi":"10.1093/arclin/acae009","DOIUrl":"10.1093/arclin/acae009","url":null,"abstract":"<p><strong>Objective: </strong>Pain's impact on executive function is understood and specific cognitive abilities may contribute to coping with pain, though past work is confounded by chronic pain populations. This study aims to understand how executive functioning may predict the experience of pain among healthy adults. It was hypothesized that poorer executive functioning would predict more intense pain perception.</p><p><strong>Method: </strong>A total of 172 young adults were recruited for participation. Three aspects of executive functioning (i.e., impulsivity, cognitive flexibility, working memory) were assessed before randomizing participants to varying types and levels of stimulated pain.</p><p><strong>Results: </strong>Results supported the hypothesis that poorer performance on tasks of working memory predicts more intense pain perception.</p><p><strong>Conclusions: </strong>Findings are counter to past work that has found inhibition may be important for coping, and future research is needed to understand the impact of specific cognitive abilities as well as how this may differ for chronic pain.</p>","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139943798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marialaura Di Tella, Ylenia Camassa Nahi, Gabriella Paglia, Giuliano Carlo Geminiani
{"title":"In Response to Finsterer: Before Diagnosing SARS-CoV-2 Vaccination-Associated Immune Encephalitis Alternative Aetiologies Must be Ruled Out.","authors":"Marialaura Di Tella, Ylenia Camassa Nahi, Gabriella Paglia, Giuliano Carlo Geminiani","doi":"10.1093/arclin/acae057","DOIUrl":"10.1093/arclin/acae057","url":null,"abstract":"","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrew M Kiselica, Alyssa N Kaser, Daniel S Weitzner, Cynthia M Mikula, Anna Boone, Steven Paul Woods, Timothy J Wolf, Troy A Webber
{"title":"Development and Validity of Norms for Cognitive Dispersion on the Uniform Data Set 3.0 Neuropsychological Battery.","authors":"Andrew M Kiselica, Alyssa N Kaser, Daniel S Weitzner, Cynthia M Mikula, Anna Boone, Steven Paul Woods, Timothy J Wolf, Troy A Webber","doi":"10.1093/arclin/acae005","DOIUrl":"10.1093/arclin/acae005","url":null,"abstract":"<p><strong>Objective: </strong>Cognitive dispersion indexes intraindividual variability in performance across a battery of neuropsychological tests. Measures of dispersion show promise as markers of cognitive dyscontrol and everyday functioning difficulties; however, they have limited practical applicability due to a lack of normative data. This study aimed to develop and evaluate normed scores for cognitive dispersion among older adults.</p><p><strong>Method: </strong>We analyzed data from 4,283 cognitively normal participants aged ≥50 years from the Uniform Data Set (UDS) 3.0. We describe methods for calculating intraindividual standard deviation (ISD) and coefficient of variation (CoV), as well as associated unadjusted scaled scores and demographically adjusted z-scores. We also examined the ability of ISD and CoV scores to differentiate between cognitively normal individuals (n = 4,283) and those with cognitive impairment due to Lewy body disease (n = 282).</p><p><strong>Results: </strong>We generated normative tables to map raw ISD and CoV scores onto a normal distribution of scaled scores. Cognitive dispersion indices were associated with age, education, and race/ethnicity but not sex. Regression equations were used to develop a freely accessible Excel calculator for deriving demographically adjusted normed scores for ISD and CoV. All measures of dispersion demonstrated excellent diagnostic utility when evaluated by the area under the curve produced from receiver operating characteristic curves.</p><p><strong>Conclusions: </strong>Results of this study provide evidence for the clinical utility of sample-based and demographically adjusted normative standards for cognitive dispersion on the UDS 3.0. These standards can be used to guide interpretation of intraindividual variability among older adults in clinical and research settings.</p>","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11345113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139745951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Development of a Rasch-calibrated emotion recognition video test for patients with schizophrenia.","authors":"Kuan-Wei Chen, Shih-Chieh Lee, Frank Huang-Chih Chou, Hsin-Yu Chiang, I-Ping Hsueh, Po-Hsi Chen, San-Ping Wang, Yu-Jeng Ju, Ching-Lin Hsieh","doi":"10.1093/arclin/acad098","DOIUrl":"10.1093/arclin/acad098","url":null,"abstract":"<p><p>Patients with schizophrenia tend to have deficits in emotion recognition (ER) that affect their social function. However, the commonly-used ER measures appear incomprehensive, unreliable and invalid, making it difficult to comprehensively evaluate ER. The purposes of this study were to develop the Computerized Emotion Recognition Video Test (CERVT) evaluating ER ability in patients with schizophrenia. This study was divided into two phases. First, we selected candidate CERVT items/videos of 8 basic emotion domains from a published database. Second, we validated the selected CERVT items using Rasch analysis. Finally, the 269 patients and 177 healthy adults were recruited to ensure the participants had diverse abilities. After the removal of 21 misfit (infit or outfit mean square > 1.4) items and adjustment of the item difficulties of the 26 items with severe differential item functioning, the remaining 217 items were finalized as the CERVT items. All the CERVT items showed good model fits with small eigenvalues (≤ 2) based on the residual-based principal components analysis for each domain, supporting the unidimensionality of these items. The 8 domains of the CERVT had good to excellent reliabilities (average Rasch reliabilities = 0.84-0.93). The CERVT contains items of the 8 basic emotions with individualized scores. Moreover, the CERVT showed acceptable reliability and validity, and the scores were not affected by examinees' gender. Thus, the CERVT has the potential to provide a comprehensive, reliable, valid, and gender-unbiased assessment of ER for patients with schizophrenia.</p>","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}