Asian Biomedicine最新文献

{"title":"Disseminated gonococcal infection during two decades in the university hospital, Thailand.","authors":"Kanphai Wongjarit, Sittichai Ukritchon","doi":"10.2478/abm-2024-0018","DOIUrl":"10.2478/abm-2024-0018","url":null,"abstract":"<p><strong>Background: </strong>Disseminated gonococcal infection (DGI) caused by <i>Neisseria gonorrhoeae</i> commonly presents with the classic triad of polyarthritis, tenosynovitis, and dermatitis. There is no clinical and microbiological data of DGI in Thailand.</p><p><strong>Objective: </strong>To study the clinical features, outcomes of treatments, and antimicrobial susceptibility data of DGI patients.</p><p><strong>Methods: </strong>All medical records of DGI patients at King Chulalongkorn Memorial Hospital (KCMH) from January 2002 through September 2019 were reviewed and analyzed. The patients were defined as definite DGI (the clinical features and the evidence of gonococcal infection) and probable DGI (clinical features with response to treatment with third-generation cephalosporins and with no evidence of gonococcal infection).</p><p><strong>Results: </strong>There were 41 patients (27 definite and 14 probable DGI), with a male-to-female ratio of 1:1.4 and median age of 30 years. The middle-age and elderly group accounted for 20% of the patients. The clinical features were fever (90.27%), arthritis (92.7%), tenosynovitis (63.4%), and genitourinary symptoms (29.3%). The most common pattern of joint involvement was oligoarthritis (52.6%). The majority of the patients had good clinical outcomes, while complications occurred in 4.8% of the patients including osteomyelitis and pyomyositis. All 19 antimicrobial-susceptibility results were susceptible to ceftriaxone.</p><p><strong>Conclusions: </strong>During the past 2 decades in KCMH, the age of the DGI patients tends to be older, and there is no gender difference as in the historical studies. The clinical features are still similar to the previous studies. The majority of the patients had good clinical outcomes. There is no case of ceftriaxone-resistant <i>N. gonorrhoeae</i>.</p>","PeriodicalId":8501,"journal":{"name":"Asian Biomedicine","volume":"18 3","pages":"125-132"},"PeriodicalIF":0.4,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11338079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of the immunological effects of escitalopram oxalate in the breast cancer co-culture model.","authors":"Nalan Biriz, Zerrin Canturk","doi":"10.2478/abm-2024-0019","DOIUrl":"10.2478/abm-2024-0019","url":null,"abstract":"<p><strong>Background: </strong>During breast cancer treatment, approximately half of the patients are prescribed psychotropic medication, such as selective serotonin reuptake inhibitors (SSRIs). Escitalopram oxalate is an SSRI used as an antidepressant.</p><p><strong>Objectives: </strong>In this study, by creating a breast cancer microenvironment with THP-1, MCF-7 and MDA-MB-231 breast cancer co-culture models were created.</p><p><strong>Methods: </strong>MCF-7, MDA-MB-231, and THP-1 cell lines to determine the concentration range of the cytotoxic effect of escitalopram oxalate MTS and MTT test were used. IC₅₀ values were determined by the xCELLigence real-time cell analysis (RTCA) system. Apoptotic activities and cytokine levels were determined by flow cytometry.</p><p><strong>Results: </strong>In the xCELLigence real-time analysis made according to the results, the IC₅₀ value of escitalopram oxalate was measured as 13.7 μM for MCF-7 and 10.9 μM for MDA-MB-231. The IC₅₀ value was measured as 54.6 μM for MCF-7 and 58.4 μM for MDA-MB-231 in xCELLigence analysis with tamoxifen. According to the MTS test results, the IC₅₀ value of tamoxifen for THP-1 was 92.03 μM and the IC₅₀ value for escitalopram oxalate was 95.32 μM. In the co-culture model, the immunological effects of escitalopram oxalate on MCF-7 cells were 2.8%, 11.1%, 15.6%, 10.6%, and 12.1% for interleukin (IL)-1β, IL-6, IL-8, IL-10, and TNF-α, respectively, while MDA effects on MB-231 cells, respectively, were 2.1%, 15.9%, 16.2%, 8.8%, and 11.8%.</p><p><strong>Conclusions: </strong>According to the results obtained, it was concluded that the immunological effects of escitalopram oxalate are more effective than tamoxifen and that it can be used as an adjunctive agent in breast cancer treatment.</p>","PeriodicalId":8501,"journal":{"name":"Asian Biomedicine","volume":"18 3","pages":"133-145"},"PeriodicalIF":0.4,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11337846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of landmark studies on maintenance immunosuppressive regimens in kidney transplantation.","authors":"Suwasin Udomkarnjananun, Maaike R Schagen, Dennis A Hesselink","doi":"10.2478/abm-2024-0015","DOIUrl":"10.2478/abm-2024-0015","url":null,"abstract":"<p><p>Immunosuppressive medications play a pivotal role in kidney transplantation, and the calcineurin inhibitors (CNIs), including cyclosporine A (CsA) and tacrolimus (TAC), are considered as the backbone of maintenance immunosuppressive regimens. Since the introduction of CNIs in kidney transplantation, the incidence of acute rejection has decreased, and allograft survival has improved significantly. However, CNI nephrotoxicity has been a major concern, believed to heavily impact long-term allograft survival and function. To address this concern, several CNI-sparing regimens were developed and studied in randomized, controlled, clinical trials, aiming to reduce CNI exposure and preserve long-term allograft function. However, more recent information has revealed that CNI nephrotoxicity is not the primary cause of late allograft failure, and its histopathology is neither specific nor pathognomonic. In this review, we discuss the historical development of maintenance immunosuppressive regimens in kidney transplantation, covering the early era of transplantation, the CNI-sparing era, and the current era where the alloimmune response, rather than CNI nephrotoxicity, appears to be the major contributor to late allograft failure. Our goal is to provide a chronological overview of the development of maintenance immunosuppressive regimens and summarize the most recent information for clinicians caring for kidney transplant recipients (KTRs).</p>","PeriodicalId":8501,"journal":{"name":"Asian Biomedicine","volume":"18 3","pages":"92-108"},"PeriodicalIF":0.4,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11338012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucocorticoid use and parenteral nutrition are risk factors for catheter-related <i>Candida</i> bloodstream infection: a retrospective study.","authors":"Lipeng Huang, Shanshan Li, Ronglin Jiang, Shu Lei, Jiannong Wu, Liquan Huang, Meifei Zhu","doi":"10.2478/abm-2024-0016","DOIUrl":"10.2478/abm-2024-0016","url":null,"abstract":"<p><strong>Background: </strong>Catheter-related candidemia (CRC) is a serious catheter-related bloodstream infection (CRBSI) caused by <i>Candida</i> spp., with higher mortality than CRBSIs caused by other organisms.</p><p><strong>Objective: </strong>To identify the risk factors for <i>Candida</i> CRBSI. The clinical characteristics of 297 patients with CRBSI in a local hospital from January 2007 to June 2015 were collected, including 33 <i>Candida</i> CRBSI and 264 non-<i>Candida</i> CRBSI.</p><p><strong>Method: </strong>The associations of <i>Candida</i> CRBSI with the clinical variables were examined using univariate and multivariate analyses.</p><p><strong>Results: </strong>Multivariate analysis showed that glucocorticoid use (odds ratio [OR] = 10.313, 95% confidence interval [CI] = 2.032-52.330, <i>P</i> = 0.005) and parenteral nutrition (OR = 5.400, 95% CI = 0.472-61.752, <i>P</i> = 0.0175) were independent risk factors for <i>Candida</i> CRBSI. The most prevalent species were <i>Candida tropicalis</i> (42.4%) and <i>Candida albicans</i> (36.36%). Of the 33 <i>Candida</i> CRBSI cases, 31 (93.93%) had indwelling central venous catheters (CVC) for ≥14 d. The mortality of <i>Candida</i> CRBSI was remarkably higher than that of bacteria CRBSI. Patients with timely catheter removal and appropriate antifungal treatment had dramatically increased 28-d survival compared with those with untimely catheter removal + inappropriate antifungal treatment (88.89% vs. 0, <i>P</i> = 0.006).</p><p><strong>Conclusion: </strong>The study identified glucocorticoid use and parenteral nutrition as independent risk factors for <i>Candida</i> CRBSI. The outcome of candidemia was associated with the duration of CVC indwelling and antifungal treatment.</p>","PeriodicalId":8501,"journal":{"name":"Asian Biomedicine","volume":"18 3","pages":"109-115"},"PeriodicalIF":0.4,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11337845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In memory of Professor Henry Wilde, MD, FACP: infectious disease physician, clinical and public health investigator, and educator.","authors":"","doi":"10.2478/abm-2024-0013","DOIUrl":"10.2478/abm-2024-0013","url":null,"abstract":"","PeriodicalId":8501,"journal":{"name":"Asian Biomedicine","volume":"18 3","pages":"87-89"},"PeriodicalIF":0.4,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11338009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of cholangiocarcinoma by pGCsiRNA-vascular endothelial growth factor in vivo","authors":"Shenglin Lu, Jun Li","doi":"10.2478/abm-2024-0009","DOIUrl":"https://doi.org/10.2478/abm-2024-0009","url":null,"abstract":"Background The early diagnosis and treatment of cholangiocarcinoma may benefit from specific tumor markers to be used in clinical practice. Objectives To investigate whether the pGCsiRNA-vascular endothelial growth factor (VEGF) can affect the onset and progression of cholangiocarcinoma and its possible mechanism using the targeted therapy of nude mouse model of cholangiocarcinoma with attenuated <jats:italic>Salmonella</jats:italic> carrying the plasmid pGCsiRNA-VEGF. Methods The nude mouse model of cholangiocarcinoma was established by tail vein injection of QBC939 cells and given attenuated <jats:italic>Salmonella</jats:italic> carrying the plasmid pGCsiRNA-VEGF. One month later, the tumor volume of nude mice was observed, and the tumor growth curve was plotted. The harvested tumors were weighed and detected for tissue structural changes and cell death status by hematoxylin–eosin staining. The protein and mRNA expressions of VEGF, matrix metalloproteinase 2 (MMP2), and MMP9 were detected by Western blotting and PCR, respectively. Results The tumor volume and weight of the pGCsiRNA-VEGF group were significantly smaller than those of the mock and the si-scramble groups (<jats:italic>P</jats:italic> &lt; 0.05). The expressions of VEGF, MMP2, and MMP9 at the transcriptional and translational levels were inhibited by pGCsiRNA-VEGF. PGCsiRNA-VEGF promoted tissue apoptosis and destroyed the tissue structure. Conclusions In vivo silencing of VEGF can affect cell survival and inhibit cell migration, invasion, and development, probably by enhancing apoptosis and inhibiting the expressions of MMP2 and MMP9.","PeriodicalId":8501,"journal":{"name":"Asian Biomedicine","volume":"113 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140834644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal final adult height achieved by low-dose recombinant human growth hormone therapy","authors":"Tansit Saengkaew, Suparb Aroonparkmongkol, Suttipong Wacharasindhu","doi":"10.2478/abm-2024-0011","DOIUrl":"https://doi.org/10.2478/abm-2024-0011","url":null,"abstract":"Background Thailand has been administering the recombinant human growth hormone (rhGH) treatment for &gt;20 years. Due to limited resources being available, efforts have been directed toward utilizing rhGH at the lowest feasible dose. However, there is currently a lack of evidence in terms of the efficacy and outcomes. Objective To evaluate the auxological outcomes of growth hormone (GH) treatment and the GH secretion ability after reaching final adult height (FAH) and discontinuing rhGH. Methods Data of 40 patients were retrospectively reviewed. The clinical characteristics, auxological data, and results of biochemical and endocrine investigations before and during rhGH treatment were evaluated. In addition, GH retesting was performed in 24 patients using the insulin tolerance test. Results Twenty patients (50%) had complete growth hormone deficiency (GHD), defined as peak stimulated GH level &lt;5 ng/mL, and the remaining patients had partial GHD. Most patients were male (n = 25, 62.5%). The mean age at which rhGH was initiated was 8.9 years. Patients with partial GHD received a higher dose of rhGH than those with complete GHD (30.9 µg/kg/d vs. 26.2 µg/kg/d, <jats:italic>P</jats:italic> = 0.02). Patients with complete and partial GHD reached FAH at height standard deviation scores (SDSs) of −0.65 and −1.47, respectively. The factors associated with obtaining a good clinical response in terms of height gain included peak-stimulated GH level, age of puberty, and age of discontinuing rhGH. After completing the rhGH treatment, 13 of the 24 patients showed normal GH secretion. Patients with multiple pituitary hormone deficiency (MPHD) were likely to have persistent GHD through adulthood (n = 8, 88.9%). Conclusion This study has demonstrated that the use of low-dose rhGH could result in healthy populations achieving optimal FAHs. Patients with MPHD might not require retesting as they were likely to have persistent GHD. The results obtained in this research highlight the benefits of the treatment. This treatment can be applied in resource-limited countries.","PeriodicalId":8501,"journal":{"name":"Asian Biomedicine","volume":"24 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140835061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic resonance imaging findings of a case with Wolffian tumor and related literature review","authors":"Can Cui, Dawei Cui, Jiangfeng Pan, Shaobin Zhou, Xiujuan Zheng","doi":"10.2478/abm-2024-0012","DOIUrl":"https://doi.org/10.2478/abm-2024-0012","url":null,"abstract":"Background Wolffian tumors in females are rare gynecological neoplasms, with fewer than 100 cases reported. Existing literature primarily focuses on the pathology, and reports involving imaging are limited. Objective This study presents a case of Wolffian tumor, emphasizing its magnetic resonance imaging (MRI) characteristics to enhance preoperative diagnostic accuracy. Case report A 56-year-old woman presented with a year-long history of irregular vaginal bleeding. MRI revealed a solid mass in the right adnexal region. On T2-weighted images, the mass exhibited slightly elevated signal intensity with a distinctive low-signal intensity rim. Diffusion-weighted imaging displayed markedly increased signal intensity, and the contrast enhancement was moderate. The patient underwent laparoscopic right adnexectomy and received a Wolffian tumor diagnosis. No recurrence was observed during a 6-month follow-up. Conclusions Wolffian tumors exhibit distinctive MRI presentations. Notably, the prominent low-signal intensity rim on MRI may aid in accurate preoperative tumor diagnosis.","PeriodicalId":8501,"journal":{"name":"Asian Biomedicine","volume":"11 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140835062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bedside clinical assessment of patients with common upper limb tremor and algorithmic approach","authors":"Pattamon Panyakaew, Warongporn Phuenpathom, Roongroj Bhidayasiri, Mark Hallett","doi":"10.2478/abm-2024-0008","DOIUrl":"https://doi.org/10.2478/abm-2024-0008","url":null,"abstract":"The diagnostic approach for patients with tremor is challenging due to the complex and overlapping phenotypes among tremor syndromes. The first step in the evaluation of tremor is to identify the tremulous movement and exclude the tremor mimics. The second step is to classify the tremor syndrome based on the characteristics of tremor from historical clues and focused examination (Axis 1). Comprehensive tremor examinations involve the assessment of tremor in different conditions (rest, action or mixed, position or task-specific), distribution of tremor (upper limb, lower limb, head, jaw), positive signs for functional tremor (FT) if suspected (distractibility, entrainment, co-contraction), and associated neurological signs including parkinsonism, dystonic posture, cerebellar/brainstem signs, neuropathy, and cognitive impairment. A pivotal feature in this step is to determine any distinct feature of a specific isolated or combined tremor syndrome. In this review, we propose an algorithm to assess upper limb tremors. Ancillary testing should be performed if clinical evaluation is unclear. The choice of investigation depends on the types of tremors considered to narrow down the spectrum of etiology (Axis 2). Laboratory blood tests are considered for acute onset and acute worsening of tremors, while structural neuroimaging is indicated in unilateral tremors with acute onset, nonclassical presentations, and a combination of neurological symptoms. Neurophysiological study is an important tool that aids in distinguishing between tremor and myoclonus, etiology of tremor and document specific signs of FT. Treatment is mainly symptomatic based depending on the etiology of the tremor and the patient’s disabilities.","PeriodicalId":8501,"journal":{"name":"Asian Biomedicine","volume":"64 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140834821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated level of neuroserpin is an indication for the resistance to gambogic acid-induced apoptosis and oxidative stress in triple-negative breast cancer cells","authors":"Ertan Kucuksayan, Hakan Kucuksayan, Mehmet Enes Sozen, Aslinur Sircan-Kucuksayan","doi":"10.2478/abm-2024-0010","DOIUrl":"https://doi.org/10.2478/abm-2024-0010","url":null,"abstract":"Background The triple-negative breast cancer (TNBC) subtype, characterized by loss of HER2, estrogen, and progesterone receptors, displays aggressive phenotype and poor prognosis compared to other BC subtypes. Since the TNBC cells are devoid of receptors, endocrine therapy is an ineffective option for TNBC patients, necessitating canonical chemotherapy strategies to treat TNBC. It is crucial to use alternative and natural agents to support chemotherapy in TNBC. Objectives To clarify the molecular mechanism of the tumorigenic effects of gambogic acid (GA) on TNBC cells with different epithelial character since GA has a wide spectrum of anticancer activity for most cancer types. Methods We determined the cytotoxic dose of GA incubation of TNBC cells (MDA-MB-231 and BT-20 cells) for 24 h. We performed the MTT test and toluidine blue (TB) staining protocol for TNBC cells. We analyzed E-cadherin, N-cadherin, Bax, and neuroserpin mRNAs in both cells by qPCR. We evaluated apoptosis using DAPI staining and assessed the ROS using the 2ʹ,7ʹ-dichlorofluorescin diacetate (DCFH-DA) method. Results We determined the IC<jats:sub>50</jats:sub> concentrations of GA in MDA-MB-231 and BT-20 cells to be 315.8 nM and 441.8 nM, respectively. TB staining showed that BT-20 cells survive at excessive cytotoxic doses of GA, while most of the MDA-MB-231 cells were killed. Also, we found that BT-20 cells are more resistant to GA-induced apoptosis and oxidative stress than the MDA-MB-231 cells. qPCR results showed that GA upregulated neuroserpin, an oxidative stress-relieving factor in the BT-20 cells, but not in the MDA-MB-231 cells. Conclusions The elevated level of neuroserpin could be a predictive marker to determine the development of resistance to chemotherapeutic agents.","PeriodicalId":8501,"journal":{"name":"Asian Biomedicine","volume":"33 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140834790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}