Brain Circulation最新文献

{"title":"Moyamoya disease in early infancy: Report of youngest Indian infant.","authors":"Pradeep Kumar Gunasekaran, Arushi Gahlot Saini, Vivek Gupta","doi":"10.4103/bc.bc_115_24","DOIUrl":"10.4103/bc.bc_115_24","url":null,"abstract":"","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"11 2","pages":"169-170"},"PeriodicalIF":2.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301130","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":"Moyamoya syndrome in a patient with pathogenic heterozygous variant in the <i>SETD5</i> gene: A case report.","authors":"Larissa Dams, Dianna M Milewicz, Peter Bauer, Markus Kraemer","doi":"10.4103/bc.bc_78_24","DOIUrl":"10.4103/bc.bc_78_24","url":null,"abstract":"<p><p>A 25-year-old patient with dysmorphic facies presented with tingling in both hands and a speech disorder that occurred for a few hours approximately once a month since the age of 12 years. A magnetic resonance angiography of the brain showed signs of a bilateral moyamoya phenomenon with distal carotid artery occlusions with significant collateral vessel formation and bilateral posterior cerebral artery occlusions. In addition, there was an extracranial, nonatherosclerotic carotid artery stenosis. Genetic testing identified a heterozygous <i>de novo</i>, loss-of-function variant in <i>SETD5</i>, which was classified pathogenic according to the American College of Medical Genetics and Genomics criteria. This case report describes a newfound <i>SETD5</i> pathogenic variant in a patient with moyamoya syndrome, but surprisingly without intellectual disability. Furthermore, our patient suffered from nonarteriosclerotic extracranial carotid artery stenosis, which is distinctly unusual in patients with moyamoya angiopathy. This raises the possibility that the occlusive vascular disease in patients with <i>SETD5</i> variants may extend beyond the cerebrovascular circulation. In summary, this case presents a moyamoya patient with an unusual vascular feature which can be explained with the newfound <i>SETD5</i> mutation variant.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"12 2","pages":"183-186"},"PeriodicalIF":5.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147866972","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":"External ventricular drain-related complications with vascular injury and pseudoaneurysm formation: Mini-case series and review of literature.","authors":"Zachary Wetsel, Aryan Wadhwa, Charles Mackel, Hormuzdiyar H Dasenbrock","doi":"10.4103/bc.bc_92_24","DOIUrl":"10.4103/bc.bc_92_24","url":null,"abstract":"<p><p>External ventricular drain (EVD) placement is a frequent and lifesaving neurosurgical procedure, although it carries known risks such as hemorrhage, infection, and malfunction. In this case series and literature review, we highlight the development of pseudoaneurysms following emergent bedside ventriculostomy in two patients identified at 16-day and 6-month follow-up as examples of this rare, yet significant complication. Given the high likelihood of rupture associated with iatrogenic traumatic pseudoaneurysms, early diagnoses and treatment of such pseudoaneurysms is critical.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"12 2","pages":"187-192"},"PeriodicalIF":5.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147866939","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":"Combination approach of retrograde and antegrade for recanalization of long chronic vertebral artery occlusion without stump of the artery ostium: A novel endovascular technique case report.","authors":"Gang Luo, Dengbin Qi, Zhen Sun, Dapeng Sun, Zhenbo Shi, Feng Gao, Dapeng Mo, Ning Ma, Zhongrong Miao","doi":"10.4103/bc.bc_97_24","DOIUrl":"10.4103/bc.bc_97_24","url":null,"abstract":"<p><p>Stenosis of the extracranial vertebral artery (VA) is known to contribute to approximately 32% of posterior circulation stroke and carries a high risk of recurrence. However, currently, there is no clear consensus on the optimal therapeutic options for treating this condition. Open surgical options, previously used, are now less favored due to their high rates of morbidity and mortality. Fortunately, the advancement of endovascular interventions has made it possible to perform endovascular reconstruction of extracranial VA lesions. The author presented a case of long chronic extracranial VA occlusion (CEVAO) successfully recanalized without a stump of the artery ostium using a combination of retrograde and antegrade approaches. In selected patients, it is technically feasible to perform endovascular revascularization of long CEVAO without any remaining remnants of the artery ostium by combining retrograde and antegrade approaches.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"12 3","pages":"296-301"},"PeriodicalIF":5.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13524389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850130","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":"Protocol for a prospective 1-year follow-up investigation on normobaric hyperoxia in conjunction with endovascular treatment for acute ischemic stroke (OPENS-2L) trial.","authors":"Ming Wei, Xing Wang, Sifei Wang, Shuling Liu, Xunming Ji, Weili Li","doi":"10.4103/bc.bc_29_24","DOIUrl":"10.4103/bc.bc_29_24","url":null,"abstract":"<p><strong>Introduction: </strong>Ongoing research endeavors seek to identify neuroprotective drugs capable of mitigating brain cell necrosis and reperfusion injury by protecting the ischemic penumbra. Despite these efforts, the quest for effective neuroprotective agents remains elusive. Encouragingly, preliminary investigations, including basic experiments and single-center exploratory studies, have demonstrated the neuroprotective properties of normobaric hyperoxia (NBO). In pursuit of validating and expanding upon these findings, we have conducted a multicenter, prospective, randomized, controlled clinical trial known as OPENS-2. However, the OPENS-2 study only assessed outcomes at a 90-day endpoint, leaving uncertainties regarding the potential long-term benefits of NBO in stroke management. Thus, to address this gap in knowledge, we will initiate a long-term follow-up trial, OPENS-2L, building upon the foundation laid by the OPENS-2 study.</p><p><strong>Materials and methods: </strong>This prospective, randomized controlled clinical trial will enroll 280 patients at a 1:1 ratio. Patients will be randomly divided into the NBO combined with the endovascular treatment group, where they will receive 10 L/min of oxygen through a mask, or the control group, where they will receive 1 L/min of oxygen.</p><p><strong>Results: </strong>The primary endpoint of this study is the modified Rankin Scale (mRS) score at 1 year. Secondary endpoints include mRS 0-2, mRS 0-3, mRS 0-1 scores, Barthel index, and the EuroQol-5 Dimension score at 1 year. Safety endpoints encompass all-cause mortality at 1 year and the incidence of major vascular events.</p><p><strong>Conclusion: </strong>If this trial yields positive outcomes, it would furnish crucial evidence for guiding future neuroprotective research endeavors. Overall, the insights gained from this study hold the potential to illuminate the long-term benefits of NBO combined with endovascular treatment in improving stroke outcomes, thereby shaping the landscape of stroke management practices.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05039697.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"11 2","pages":"127-134"},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301131","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":"Delayed destabilization and rupture of a giant anterior circulation aneurysm following flow-diverter placement: A case report.","authors":"Artur Eduardo Martio, Samuel Luís Scaravonatto Baldo Cunha, Luciano Bambini Manzato, Felipe Perini, José Ricardo Vanzin","doi":"10.4103/bc.bc_69_24","DOIUrl":"https://doi.org/10.4103/bc.bc_69_24","url":null,"abstract":"<p><p>Flow-diverting stents have been increasingly utilized for the treatment of intracranial aneurysms, especially when there are factors that go against coil embolization, such as wide neck and large aneurysm size. However, its use does not guarantee success, especially in giant lesions, and failure to obtain aneurysmal obliteration can result in long-term instability of the aneurysmal wall, leading to aneurysmal growth and late rupture. We present the case of a 65-year-old woman who suffered from a late aneurysmal dilation and rupture, 2 years and 4 months after flow-diverting treatment of a giant ophthalmic segment aneurysm. Although not fully understood, the pathophysiology of this phenomenon has one necessary factor: incomplete aneurysmal obliteration. When this scenario is present, two main factors take place: the augmentation of intrasaccular blood flow after stent delivery and the local inflammation caused by partial thrombus formation and the presence of the stent itself. To prevent this complication, complete aneurysmal obliteration must be assured, and the use of combined techniques is encouraged.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"11 1","pages":"89-93"},"PeriodicalIF":2.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970047","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":"Endovascular treatment of infectious intracranial aneurysms: A single-center experience.","authors":"Smit D Patel, Anvesh A Balabhadra, Ethan A Miller, Isha S Gandhi, Neel Patel, James Fowler, Ajay Tunguturi, Fadar Oliver Otite, Charles Bruno, Eric Sussman, Martin Ollenschleger, Tapan Mehta","doi":"10.4103/bc.bc_77_24","DOIUrl":"https://doi.org/10.4103/bc.bc_77_24","url":null,"abstract":"<p><strong>Introduction: </strong>Infectious intracranial aneurysms (IIAs), a notable complication of infective endocarditis (IE), pose significant clinical challenges. This study delineates the outcomes, management strategies, and clinical manifestations of IIAs, drawing from a single-center's experience.</p><p><strong>Methods: </strong>We conducted a retrospective observational analysis at our institution, focusing on patients diagnosed with IE between 2016 and 2022 who were also found to have IIAs. Data analysis was performed utilizing SAS statistical software alongside Microsoft Excel to execute descriptive statistical operations.</p><p><strong>Results: </strong>Among 862 IE patients, 25 (2.9%) were diagnosed with IIAs, totaling 41 mycotic aneurysms. Of these, 18 patients had a single aneurysm, while 7 had multiple. The cohort's median age was 45 years, with an interquartile range of 27-65 years, and a predominance of male patients (68.3%). Ischemic and hemorrhagic strokes were observed in 58.6% and 87.8% of the cases, respectively. Ruptured IIAs were noted in 58.5% of instances, with the remainder unruptured. The average diameter of ruptured IIAs was 3.3 mm, compared to 2.1 mm for unruptured aneurysms, although this difference was not statistically significant (<i>P</i> = 0.324). The most frequent IIA locations were the distal segments of the posterior and middle cerebral arteries. Patients with ruptured IIAs experienced higher in-hospital mortality rates (29.1%) relative to those with unruptured IIAs (11.7%). Treatment was administered to 58.3% of ruptured IIAs, with no interventions for unruptured aneurysms (<i>P</i> = 0.001). Treatment modalities included surgical resection, n-butyl cyanoacrylate, coils, and Onyx embolization. The treated ruptured IIAs had an average size of 4.4 mm, versus 2.0 mm for untreated aneurysms. Among those treated, the majority were either discharged home (21.4%) or to other facilities (78.6%), with no in-hospital mortalities reported in this group.</p><p><strong>Conclusion: </strong>The findings suggest that endovascular treatment is a viable and effective option for managing ruptured IIAs, with decisions tailored to individual patient comorbidities. Further multicenter studies are recommended to corroborate these findings and refine treatment strategies for IIAs associated with infective endocarditis.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"11 1","pages":"24-29"},"PeriodicalIF":2.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980941","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":"Congestive heart failure and its associations with cognition and cerebral blood flow.","authors":"Sandra Kong, Emma Gootee, Nicole Williams, Rebecca F Gottesman, Michelle C Johansen","doi":"10.4103/bc.bc_86_24","DOIUrl":"https://doi.org/10.4103/bc.bc_86_24","url":null,"abstract":"<p><strong>Background: </strong>Congestive heart failure (CHF) has been linked to dementia but for reasons not well understood. Our retrospective cohort study aims to determine if specific measures of CHF severity are associated with cognitive performance or cerebral blood flow velocity (CBFV) among decompensated CHF outpatients.</p><p><strong>Materials and methods: </strong>One hundred and thirty-eight patients with transthoracic echocardiogram ≤1-year preceding consent were included. Forty-nine patients had concurrent transcranial Doppler ultrasonography administered by a trained technician assessing anterior cerebral artery, middle cerebral artery, and internal carotid artery (ICA) CBFV. CHF characteristics considered were NYHA classification, CHF type (heart failure with preserved ejection fraction vs. heart failure with mildly reduced/reduced ejection fraction), and left ventricular ejection fraction (LVEF; continuous [per 5%] or categorized [≤40%, 40%-55%, and ≥55%]). A trained psychometrist administered a standardized cognitive battery including Rey Auditory Verbal Learning Test, Rey Complex Figure Copy and Immediate Recall test, Letter-Number Sequencing (LNS) test, and Trail Making Tests. Adjusted multivariable linear regression models determined the association between CHF characteristics and standardized cognitive tests as well as between CHF characteristics and standardized CBFV, in distinct models.</p><p><strong>Results: </strong>On average, NYHA Class 1-2 patients had better LNS scores than NYHA Class 3-4 patients (β: 0.47; 95% CI: 0.09, 0.84). Patients with LVEF 40%-55% had higher ICA CBFVs than those with LVEF ≤40% (β: 13.7; 95% CI: 1.01, 26.39). No associations between other CHF characteristics and either cognitive performance or CBFV were found.</p><p><strong>Conclusion: </strong>Blood flow may be an important mechanism behind CHF-related cognitive decline, but studies with larger sample sizes and a control group without CHF are needed.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"11 1","pages":"30-38"},"PeriodicalIF":2.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983245","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":"Long-term outcomes and prognostic factors after surgery alone for brain arteriovenous malformation.","authors":"Zhao-Ying Zhu, Wei Zhang, Li-Chuan Gao, Gui-Jun Zhang, Jing Chen","doi":"10.4103/bc.bc_95_24","DOIUrl":"https://doi.org/10.4103/bc.bc_95_24","url":null,"abstract":"<p><strong>Objectives: </strong>There is a paucity of data regarding the long-term hemorrhage/progression outcomes of brain arteriovenous malformation (BAVM). The purpose of this study was to examine the outcomes of surgical treatment alone over a long follow-up period.</p><p><strong>Materials and methods: </strong>All patients (<i>n</i> = 356) harboring Grade I-III BAVMs who had been surgically treated alone between January 2010 and December 2019 were included. Univariate analysis and multivariate analysis with proportional hazard models were implemented to identify the predictors of hemorrhage-free survival (HFS) (<i>n</i> = 356) and progression-free survival (PFS) (<i>n</i> = 334).</p><p><strong>Results: </strong>Of the 356 BAVM patients, 233 were male and 123 were female (male-to-female ratio of 1.89:1). Rehemorrhage was observed in 22 (6.2%) patients. The overall HFS rates at 5, 10, and 15 years in the entire cohort were 96.0%, 92.4%, and 91.1%, respectively. A 1 cm³ increase in lesion volume (hazard ratio [HR] = 1.049, 95% confidence interval [CI] = 1.013-1.085; <i>P</i> = 0.007) was a significant adverse factor for HFS. The probabilities of PFS at 5, 10, and 15 years were 94.9%, 90.6%, and 85.5%, respectively. With respect to clinical predictors of PFS, only male sex (HR = 3.146, 95% CI = 1.088-9.098; <i>P</i> = 0.034) was a significant predictor of PFS after surgical treatment in the univariate analysis.</p><p><strong>Conclusions: </strong>For the majority of patients, surgery remains the first-line treatment for BAVMs. Our study included a significant subset of patients who were successfully managed by surgery alone.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"11 1","pages":"57-63"},"PeriodicalIF":2.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966097","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":"Association of Systemic Inflammatory Response Index with the cardiometabolic multimorbidity among US adults: A population-based study.","authors":"Jing Li, Songfeng Zhao, Xiaowen Zhang, Mengyan Fan, Jiaxin Wan, Rijin Lin, Feng Fan, Guo Liu, Sheng Guan, Aihua Liu","doi":"10.4103/bc.bc_32_24","DOIUrl":"https://doi.org/10.4103/bc.bc_32_24","url":null,"abstract":"<p><strong>Background: </strong>Chronic inflammation plays an essential role in the occurrence and progression of cardiometabolic diseases (CMDs). We aim to examine the association between a novel inflammatory biomarker Systemic Inflammatory Response Index (SIRI) and different cardiometabolic multimorbidity (CMM) statuses.</p><p><strong>Methods: </strong>This was a cross-sectional study that includes general participants of the National Health and Nutrition Examination Survey database from 1999 to 2018. SIRI was calculated as neutrophil count × lymphocyte count/monocyte count. The CMDs were defined as a series of diseases including diabetes mellitus (DM), heart disease (HD), and stroke. We explored the association of SIRI with outcomes with weighted multivariable logistic regression models weighted restricted cubic spline. The diagnostic value of SIRI was evaluated using weighted receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>A total of 43,345 participants were enrolled with a mean age of 45.86 years. The weighted prevalence of CMD and CMM was 17.14% and 2.94%, respectively. Compared to those without CMD, the adjusted odds ratios (95% confidence interval) for each unit increase in SIRI were 1.14 (1.09-1.19) for DM, 1.13 (1.07-1.19) for HD, 1.11 (1.04-1.19) for stroke, 1.17 (1.12-1.22) for CMD, and 1.16 (1.10-1.23) for CMM, according to the weighted multivariable logistic regression. Elevated SIRI level was independently associated with increased CMM. There was no interaction found in subgroup analysis. According to the ROC analysis, SIRI had a superior diagnostic ability to neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and monocyte-lymphocyte ratio for CMD (area under the curve [AUC] =0.581) and CMM (AUC = 0.633).</p><p><strong>Conclusions: </strong>Elevated level of SIRI was positively associated with the prevalence of DM, coronary artery disease, stroke, CMD, and CMM, suggesting that SIRI could be a potential noninvasive biomarker for CMD and CMM.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"11 1","pages":"39-47"},"PeriodicalIF":2.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959907","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}