British Journal of Sports Medicine最新文献

{"title":"Colliding skilfully: preparing female athletes for collision events.","authors":"Elisabeth Oehler, Kirsty Elliott, Zoe L Saynor","doi":"10.1136/bjsports-2024-108527","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108527","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infographic. Multiligament knee injury (MLKI): an expert consensus statement on nomenclature, diagnosis, treatment and rehabilitation.","authors":"Iain Robert Murray, Navnit S Makaram, Chryssa Neo, Andrew G Geeslin, Jorge Chahla, Gilbert Moatshe, Kay Crossley, Michelle E Kew, Aileen Davis, Maria Tuca, Hollis Potter, Dina C Janse van Rensburg, Carolyn A Emery, SeungPyo Eun, Hege Grindem, Frank R Noyes, Robert G Marx, Chris Harner, Bruce A Levy, Enda King, James L Cook, Daniel B Whelan, George F Hatch, Christopher J Wahl, Kristian Thorborg, James J Irrgang, Nicolas Pujol, Michael J Medvecky, Michael J Stuart, Aaron J Krych, Lars Engebretsen, James P Stannard, Peter MacDonald, Romain Seil, Gregory C Fanelli, Travis G Maak, K Donald Shelbourne, Evert Verhagen, Volker Musahl, Michael T Hirschmann, Mark D Miller, Robert C Schenck, Robert F LaPrade","doi":"10.1136/bjsports-2024-109051","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109051","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardising health history and injury surveillance of participants in endurance events: a modified Delphi consensus statement from the AMSSM runner health consortium","authors":"Adam S Tenforde, Emily Kraus, Stephanie A Kliethermes, Mark A Fontana, Michelle T Barrack, Mary Dubon, Ida A Heikura, Karsten Hollander, Emily Kroshus, Mikel R Joachim, Alexandre Dias Lopes, Mitchell J Rauh, Ragen Chastain, Mark Harrast, Bryan Heiderscheit, Brian J Krabak, Emily M Miller, Christopher Napier, William O Roberts, Deborah Roche, Megan Roche, Allison N Schroeder, Dezmond Taylor-Douglas, Kate Tenforde, Evert Verhagen, Stuart J Warden, Richard W Willy, Brett G Toresdahl","doi":"10.1136/bjsports-2023-108059","DOIUrl":"https://doi.org/10.1136/bjsports-2023-108059","url":null,"abstract":"Endurance events are popular worldwide and have many health benefits. However, runners and Para athletes may sustain musculoskeletal injuries or experience other health consequences from endurance events. The American Medical Society for Sports Medicine (AMSSM) Runner Health Consortium aimed to generate consensus-based survey items for use in prospective research to identify risk factors for injuries in runners and Para athletes training and competing in endurance events. The study design employed a modified Delphi approach, with a panel comprising 28 experts, including healthcare professionals, coaches, and athletes. Potential survey items were generated by panel members who subsequently engaged in three rounds of voting using Research Electronic Data Capture. Items were graded by clarity, relevance, and importance. Items achieving 80% consensus on all three aspects were retained. The response rate was 100% in R round 1 and 96% in Rrounds 2 and 3. Of 124 initial survey items, consensus was reached on 53, 34 and 22 items during Rrounds 1, 2, and 3, respectively. Two accepted items were removed due to redundancy. Combined with 10 non-voting items, 117 items covered key domains, including training and injury history, dietary behaviours and associated factors (such as menstrual function), footwear, mental health, and specific considerations for Para athletes. The consensus-based survey items should be considered by researchers to better understand the health of runners and Para athletes who train and compete in endurance sports to identify risk factors for injury.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"195 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elusive ‘usual’ warm-up in injury prevention trials: the problem of comparing apples to beans","authors":"José Afonso, Renato Andrade, Mário Sá, Ricardo Martins, Ivan Baptista, Tania Pizzari","doi":"10.1136/bjsports-2024-108761","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108761","url":null,"abstract":"Comparing apples to oranges is rational when comparing different fruits; comparing apples to beans is something else entirely. Likewise, injury prevention trials proposing warm-up interventions should strive to deliver reasonable comparisons. The contents and dosage of the intervention and control warm-ups may vary, especially in the context of pragmatic trials, but should be appropriately described to afford transparency and comparability. So, what is this elusive entity known as the ‘usual’ warm-up in injury prevention trials? And how may this affect the interpretation of the findings? This editorial explores the context and importance of the ‘usual’ warm-up in injury prevention trials and provides recommendations to harmonise future research. Warm-up protocols focused on injury prevention are often compared with other warm-ups to assess their relative effectiveness. Pragmatic trials often compare a standardised protocol (the intervention) to ‘usual’ warm-up (the comparator), and this is relevant to reflect current real-world practices. However, accurate evaluation of effectiveness requires clear descriptions of the content of the comparator warm-up protocols. Inadequate and incomplete reporting is more common than desirable, even in recent randomised studies published in high-profile journals.1–3 We describe three examples in detail to illustrate this problem. Example 1 : A cluster randomised trial compared the effectiveness of the warm-up programme ‘VolleyVeilig’ in reducing injuries (35 teams, n=282 players) to ‘usual’ warm-up (31 teams, n=236 players).1 While the ‘VolleyVeilig’ programme was described in detail, there was no information regarding the ‘usual’ …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"79 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sports medicine in the Netherlands – focus and collaboration bring success","authors":"Wes O Zimmermann, Fred Hartgens","doi":"10.1136/bjsports-2024-109345","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109345","url":null,"abstract":"The summer of 2024 was dominated by spectacular sporting events, first and foremost by the Paris Olympic and Paralympic Games. The Netherlands achieved a credible sixth place in the medal ranking of nations in the Olympic Games and a fourth place in the Paralympic Games. How does a small country (18 million inhabitants) achieve such success? The answer may be focus and collaboration. The Netherlands Olympic Committee has been focusing for at least 30 years on supporting those athletes who have a good chance of reaching the finals and preferably winning a medal at the highest international level. Tough choices are not avoided. If an athlete cannot meet the performance requirements, support is no longer provided. A multidisciplinary group of experts is placed around an individual athlete or team, all of whom must collaborate in support of the athletes and contribute to optimise performance. Sports medicine physicians are an integral part of the support teams, managing and preventing injuries and (legally!) facilitating improved performance. Sports medical education is an important component of the support programme. Athletes learn to register their own injuries and illnesses so that they gain insight into which circumstances contribute to overload and injury. In the Netherlands, para-athletes can access the same support as their non-impaired colleagues. A report by the Dutch Sports Council, an independent advisory body that focuses on highlighting the significance of sports and exercise for society, has made an important contribution to further improve the supporting facilities for para-athletes. The name of the 2022 report is ‘Equal and inclusive, advice on …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"1 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142599311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in physical activity and all-cause mortality among individuals with dementia: a cohort study using the National Health Insurance Service Database in Korea","authors":"Kye-Yeung Park, Youn Huh, Ga Eun Nam, Kyungdo Han, Jin-Hyung Jung, Yoon Jeong Cho, Seon Mee Kim, Hwan-Sik Hwang, Yong-Moon Mark Park","doi":"10.1136/bjsports-2024-108264","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108264","url":null,"abstract":"Objective To examine associations between the amount and changes in regular physical activity (PA) before and after diagnosis of dementia and all-cause mortality risk, and whether these associations differ by PA intensity (light, moderate or vigorous). Methods This retrospective cohort study used data from the Korean National Health Insurance Service Database, including 60 252 individuals newly diagnosed with dementia between 2010 and 2016 who underwent health examinations both before and after diagnosis. PA was assessed using the International Physical Activity Questionnaire–Short Form. Multivariable Cox proportional hazards regression models were used to analyse the associations between PA (amount and changes) and all-cause mortality risk. Results During a mean follow-up of 3.7 years, 16 431 (27.3%) deaths occurred. Higher PA levels after dementia diagnosis were associated with a dose-dependent decrease in mortality risk (p for trend <0.001). Maintaining regular PA, compared with remaining inactive, was associated with the lowest mortality risk (HR=0.71, 95% CI 0.65 to 0.79). Sustained engagement in PA of any intensity was associated with decreased mortality risk: light (HR=0.70, 95% CI 0.67 to 0.75), moderate (HR=0.74, 95% CI 0.64 to 0.86) and vigorous PA (HR=0.70, 95% CI 0.61 to 0.79). Initiating any PA intensity after dementia diagnosis was associated with at least 20% reduced mortality risk. These associations were consistent in Alzheimer’s disease. Conclusions Maintaining or initiating regular PA, regardless of intensity, after dementia diagnosis was associated with a reduced risk of all-cause mortality. Lifestyle modifications promoting PA might offer survival benefits for individuals with dementia. No data are available. This study was performed using the National Health Insurance System database in Korea, and the results do not necessarily represent the opinions of the National Health Insurance Corporation. Restrictions apply to the availability of these data, which were used under the licence for this study.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"41 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142541246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polygenic risk analysis in physical activity and health: why are the same results interpreted differently?","authors":"Viktor H Ahlqvist, Marcel Ballin","doi":"10.1136/bjsports-2024-108697","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108697","url":null,"abstract":"Polygenic risk scores (PRSs), designed to capture genetic predisposition to specific traits,1 are becoming increasingly accessible at scale and are being used in physical activity research. PRSs are typically calculated by aggregating the effect sizes of single-nucleotide polymorphisms (SNPs) associated with a particular trait or disease, usually derived from genome-wide association studies (GWASs), into a score for each individual to reflect their genetic liability to that trait or disease. Various methodologies exist for constructing PRSs, ranging from simple to more complex.1 The simplest approach often involves selecting a subset of SNPs based on their associated p values from the GWAS, while more sophisticated methods may incorporate additional data, such as linkage disequilibrium patterns or functional genomic information.1 Regardless of the approach, the appeal of PRSs lies in their simplicity and versatility, especially as they can be readily computed in cohorts with existing genetic data. This makes PRSs valuable both for controlling confounding and as a research focus in their own right. This editorial aims to discuss some key challenges in using PRSs for analysing physical activity and health, focusing on the difficulty of distinguishing mechanisms behind associations and the limited clinical interpretability of effect estimates. We also offer some practical recommendations for future research. Recent studies have employed PRSs related to physical activity to investigate various outcomes, finding that high scores are associated with lower risk of cardiometabolic risk factors, coronary heart disease, stroke, hypertension, type 2 diabetes, obesity and all-cause mortality.2–4 However, the interpretation of these results is hampered by several challenges. A fundamental challenge is that several potential explanations exist for why a PRS for physical activity might be associated with health outcomes. These include a true causal effect of physical activity on health outcomes and the influence of shared genetics. Unfortunately, …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"40 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142541146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health problems and injury management in adolescent handball: the Safeplay one-season cohort study of 679 players","authors":"Merete Møller, Stian Isaksen Johansen, Grethe Myklebust, Rasmus Oestergaard Nielsen, Sören Möller, Ulla Mikkelsen, Niels Wedderkopp, Martin Lind","doi":"10.1136/bjsports-2024-108493","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108493","url":null,"abstract":"Objectives To assess (1) the 1-year prevalence of previous shoulder, knee and ankle injuries; (2) the in-season prevalence proportion (prevalence) of injuries and illnesses, injury incidence rate (ir) and injury burden (product of ir and weeks with injuries); (3) initial injury management strategies. Methods We conducted a cohort study of 679 highest-division Danish handball players aged 14–18. Players self-reported past-year shoulder, knee and ankle injuries at baseline, and weekly information on any handball-related injuries (irrespective of time loss and medical attention), illnesses, exposure hours and injury management over 31 weeks. Results At baseline, 46% (95% CI 42% to 49%) of the players reported a past-year shoulder, knee or ankle injury. The weekly average injury and illness prevalence was 21% (95% CI 19% to 23%) and 2% (95% CI 1.7% to 2.3%), respectively, and the ir was 9.4 (95% CI 8.7 to 10.2)/1000 hours. Females experienced the highest injury burden from knee injuries (ir: 1.7 (95% CI 1.3 to 2.2) × 6.7 (95% CI 4.7 to 8.7) weeks with injury/1000 hours), while males experienced the highest injury burden from shoulder injuries (ir: 1.3 (95% CI 1.0 to 1.7) × 5.7 (95% CI 3.6 to 7.8) weeks with injury/1000 hours). Health professionals were consulted in 58% (95% CI 54% to 62%) of injuries, players independently made the return to sport decision in 44% (95% CI 37% to 51%) of injury recurrences, and used analgesics, mainly (91% (95% CI 85% to 95%)) sourced from home, in 24% (95% CI 21% to 28%) of injuries. Conclusion Almost half of highest-division adolescent Danish handball players reported a previous past-year shoulder, knee or ankle injury. Any time during the season, 21% reported an injury and 2% an illness. The highest injury burdens were from knee injuries in females and shoulder injuries in males. Health professionals often managed injuries, but players frequently made return to sport decisions independently and commonly used analgesics sourced from home. Data are available upon reasonable request. All data are available on reasonable request. All personally identifiable information will be deleted or anonymised before data transfer.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"126 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142541162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of the ‘weekend warrior’ physical activity pattern with mild dementia: findings from the Mexico City Prospective Study","authors":"Gary O'Donovan, Fanny Petermann-Rocha, Gerson Ferrari, Catalina Medina, Carolina Ochoa-Rosales, Olga L L Sarmiento, Agustín Ibáñez","doi":"10.1136/bjsports-2024-108460","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108460","url":null,"abstract":"Objectives To investigate associations of the ‘weekend warrior’ physical activity pattern with mild dementia. Methods Participants in the Mexico City Prospective Study were surveyed from 1998 to 2004 and re-surveyed from 2015 to 2019. Participants were asked about leisure time physical activity at baseline. Those who exercised up to once or twice per week were termed ‘weekend warriors’ and those who exercised more often were termed ‘regularly active’. A Mini Mental State Examination (MMSE) was used to assess mild dementia at re-survey. Cox models were adjusted for age, sex, education, income, blood pressure, smoking, body mass index, civil status, sleep, diet and alcohol at baseline. The attributable fraction was defined as the proportion of cases that would not exist if all adults were to exercise once or twice per week or more often. Results The analysis included 10 033 adults of mean (SD) age 51 (10) years followed for 16 (2) years. There were 2400 cases when mild dementia was defined as a score of ≤22 on the MMSE. Compared with the group that reported no sport or exercise, the hazard ratio was 0.75 (95% CI 0.61 to 0.91) in the weekend warrior group, 0.89 (95% CI 0.78 to 1.02) in the regularly active group and 0.84 (95% CI 0.75 to 0.95) in the combined group. The attributable fraction was 13% (95% CI 5% to 21%). Similar results were observed when mild dementia was defined as a score of ≤23 on the MMSE. Conclusions This longitudinal analysis suggests that the weekend warrior physical activity pattern is associated with a reduced risk of mild dementia. Data are available upon reasonable request. Mexico City Prospective Study data are available for open-access data requests. The data access policy is described online: <http://www.ctsu.ox.ac.uk/research/mcps>.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"15 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142541155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participation, barriers, facilitators and bullying experiences of trans people in sport and fitness: findings from a national community survey of trans people in Australia","authors":"Sasha Bailey, Benjamin Trevitt, Sav Zwickl, Beau Newell, Emma Staples, Ryan Storr, Ada S Cheung","doi":"10.1136/bjsports-2023-107852","DOIUrl":"https://doi.org/10.1136/bjsports-2023-107852","url":null,"abstract":"Objectives This study aimed to assess participation rates of transgender and gender diverse (trans) people in sport/fitness activities, compare mental health outcomes for trans people participating in sport/fitness with those who do not and explore internal/external barriers and bullying experiences faced by trans people in sport/fitness contexts. Methods A cross-sectional online survey open to trans people aged ≥16 years living in Australia was conducted between February and April 2023 and it assessed rates of sport/fitness participation, barriers to participation and bullying experiences through multiple-choice questions. Mental health measures comprised the Kessler Psychological Distress Scale (K10) and self-reported history of self-harm and suicidality. Covariate-adjusted binary logistic regression models tested associations between interpersonal factors, sport/fitness variables and mental health outcomes. Results Of 664 respondents (median age 32 years), around one-third (32.8%) regularly participated in sport/fitness. Common internal barriers to participation included anxiety about others’ reactions (63.9%), body dissatisfaction/dysphoria (56.5%) and fears about feeling accepted/affirmed by others (54.7%). Respondents commonly reported experiencing inadequate bathroom/changing facilities (44.4%), exclusionary rules and regulations surrounding gender (36.7%), and invasive or uncomfortable policies or procedures (23.3%). Over one-third (34.4%) of trans people had experienced gender-based bullying or exclusion. Regular sport/fitness participation was associated with significantly lower K10 scores (mean difference=−4.4, 95% CI−5.8, –2.9, p<0.001) and a 40% reduction in odds of recent thoughts of self-harm and suicide (aOR 0.6, 95% CI 0.5, 0.9, p=0.01; aOR 0.6, 95%CI 0.4, 0.9, p=0.02). Conclusion Trans people face significant barriers to sport/fitness despite experiencing significant mental health and personal benefits from participation. Affirming and including trans people in sport and fitness should be a key priority for sport and fitness federations, organisations and policy-makers.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"26 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142519446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}