Patrik Christian Cmorej, Ondřej Kounovský, Petr Bureš, Dana Rebeka Ralbovská, Jaroslav Pekara
{"title":"The Effect of Physical Restraint on a Violent Patient in the Prone Position on the Quality of Breathing: A Pilot Simulation Study.","authors":"Patrik Christian Cmorej, Ondřej Kounovský, Petr Bureš, Dana Rebeka Ralbovská, Jaroslav Pekara","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>Physical restraint in the prone position is still utilized in healthcare facilities to immobilize violent patients. It is associated with the sudden death of violent patients. The aim of this study is to objectify the impact of physical restraint in the prone position on spirometric and ventilatory parameters.</p><p><strong>Design: </strong>A pilot simulation study.</p><p><strong>Material and methods: </strong>Ten university students were included in the study. They underwent two types of physical restraint: in the prone position with \"chest kneeling\" and in the lateral position. Spirometric parameters (FVC, PEF and FEV1%) and ventilatory parameters (EtCO2 and respiratory rate) were measured before initiation and after five minutes of physical restraint.</p><p><strong>Results: </strong>Both methods of physical restraint resulted in a decrease in FVC (p = 0.005 or p = 0.047) and PEF (p = 0.005 or p = 0.028). No significant changes were observed in EtCO2 and respiratory rate.</p><p><strong>Conclusion: </strong>Physical restraint in the prone position should not be used in healthcare.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"45 2","pages":"91-95"},"PeriodicalIF":0.0,"publicationDate":"2024-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mingkun Yang, Hang Zhang, Minyi Liu, Xindong Jia, Tao Du, Dengpu Wu
{"title":"Expression and Significance of Inflammatory Factors in Idiopathic Spinal Epidural Lipomatosis (Grade III).","authors":"Mingkun Yang, Hang Zhang, Minyi Liu, Xindong Jia, Tao Du, Dengpu Wu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic spinal epidural lipomatosis (iSEL) is frequently associated with the utilization of steroids, endocrine disorders, obesity, and surgical interventions. Nevertheless, the pathogenesis of iSEL remains inadequately understood. The study aimed to investigate the contribution of inflammatory factors to idiopathic epidural lipomatosis.</p><p><strong>Methods: </strong>Thirteen patients with iSEL (Grade III, iSEL group) and 12 patients with lumbar disc herniation (control group) who underwent unilateral biportal endoscopy from March 2020 to April 2023 were enrolled. Histological examination of adipose tissue was the performed to analyze expressions of pro-inflammatory cytokines (TNF-α, IL-1β), and anti-inflammatory factors (arginase-1, IL-10) in serum and epidural adipose cells.</p><p><strong>Results: </strong>Compared with the control group, the number of inflammatory cell infiltrations per field in HE-stained sections was significantly elevated, TNF-α and IL-1β expression in adipocytes of epidural adipose tissue were markedly higher, and arginase-1 and IL-10 expression were significantly lower in the iSEL group (all p < 0.001). However, no statistically significant differences were observed in the serum level of TNF-α, IL-1β, arginase-1, and IL-10 between the two groups (p = 0.963). In addition, there was also no significant disparity in adipocyte size between the two groups (p = 0.739).</p><p><strong>Conclusion: </strong>iSEL demonstrated elevated inflammatory cells and imbalance towards proinflammatory cytokines in adipocytes of epidural adipose tissue that may be associated with the pathogenesis of symptomatic iSEL. These data suggest that inflammatory response could be one of the mechanisms of iSEL. However, further multicenter epidemiological investigations and rigorous basic and clinical research are warranted to elucidate the specific etiology of iSEL.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"45 1","pages":"69-75"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Recurrent Cushing's Disease Caused by a TPIT-Lineage Densely Granulated Corticotroph Pituitary Neuroendocrine Tumor: A Case Report.","authors":"Weiming Wu, Xiaoying Fu, Wenlong Guo, Hongmei Chen","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Recurrent Cushing's disease (recurrent CD) is an uncommon and intricate clinical form of Cushing's syndrome. However, the connection between the pathological types of ACTH-secreting PitNETs and the clinical signs of recurrent CD remains uncertain.</p><p><strong>Case description: </strong>A 64-year-old woman, previously diagnosed with renal carcinoma, was admitted to our hospital due to recent weight gain. Previous endocrine tests indicated fluctuating hypercortisolemia and a recurrent pituitary tumor over the past six years. She underwent two transsphenoidal hypophysectomies, and histopathological analysis of the tumor revealed it as a densely granulated corticotroph tumor (DGCT), a subtype of TPIT-lineage PitNET, accompanied by tumor apoplexy.</p><p><strong>Conclusion: </strong>This case highlights the connection between recurrent CD and the pathological subtypes of TPIT-lineage DGCT-PitNETs.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"45 1","pages":"76-80"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Tactile stimulation promotes the recovery of motor function in rats with cerebral ischaemia.","authors":"Changkai Ke, Guangchen Yang, Heng Wang, Jiayi Hu, Chen Li, Chuan Huang, Chunxiao Wan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>Tactile stimulation (TS) can promote neurogenesis and motor function recovery in rats with hypoxic-ischaemic brain injury, but the underlying mechanism is not clear. This study aimed to assess the effects of TS on neurological function in rats after cerebral ischaemia and explore the underlying mechanism.</p><p><strong>Methods: </strong>Adult SD rats were randomly divided into a sham operation (SHAM) group, middle cerebral artery occlusion with tactile stimulation (TS-MCAO) group and middle cerebral artery occlusion with sedentary intervention (SED-MCAO) group. Twenty-four hours after MCAO, rats in the TS-MCAO group received TS for 20 min/d 5 d/w for 4 weeks. Cerebral blood flow (CBF), changes in body weight, behavioural scores, the infarct volume, corticospinal tract integrity, and neurochemical changes were measured, and Golgi-Cox staining, transmission electron microscopy and Western blotting were performed.</p><p><strong>Results: </strong>CBF recovery was improved in the TS-MCAO group compared with the SED-MCAO group. Body weight and behavioural scores in the TS-MCAO group significantly changed after 28 days of intervention. After 14 and 28 days of intervention, the infarct volume decreased significantly, the ratios of fractional anisotropy increased and the ratios of apparent diffusion coefficient decreased, the ratios of Nacetylaspartate (NAA)/creatine (Cr) and glutamate (Glu)/ Cr increased. After 28 days of intervention, the complexity and density of dendrites, the number of synapses and the expression of synaptic plasticity-related proteins increased in the peri-infarct cortex.</p><p><strong>Conclusion: </strong>TS can improve motor performance in rats with cerebral ischaemia and the improvement is correlated with synaptic plasticity. This finding would be helpful to provide a rehabilitation program for patients following stroke.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"45 1","pages":"31-46"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"C-arm CT guided percutaneous vertebroplasty for pain release in cancer patient with cervical 1 vertebral metastases: A case report.","authors":"Zhi-Peng Lin, Xu-Gong Zou, Da-Bei Huang, Yuan Chen, Xiao-Qun Li, Jian Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and treatment outcome of C-arm CT percutaneous vertebroplasty in the treatment of cervical 1 (C1) vertebral metastases.</p><p><strong>Methods: </strong>This report recruited a male patient diagnosed with hepatocellular carcinoma and C1 vertebral metastases, who had suffered from severe neck pain symptoms and the analgesic showed little soothing effect. Under the guidance of C-arm CT, an 18G coaxial needle was used to puncture the left lateral mass of C1 vertebral metastases from lateral space between thyroid cartilage and the left carotid sheath, with 2 ml bone cement injected.</p><p><strong>Results: </strong>Postoperative C-arm CT three-dimensional reconstruction scan showed that the bone cement was well filled and distributed in the left lateral mass of C1 vertebral body, and no leakage of bone cement was observed. The neck pain of the patients was significantly relieved one week after the operation.</p><p><strong>Conclusion: </strong>Under the guidance of C-arm CT, cement augmentation using percutaneous vertebroplasty in an anterior cervical direction could serve as a safe and effective pain relief approach for patients with C1 vertebral metastases.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"45 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jan Prasko, Marie Ociskova, Julius Burkauskas, Jakub Vanek, Ilona Krone, Julija Gecaite-Stonciene, Marija Abeltina, Jelena Holomany, Milos Slepecky, Alicja Juskiene
{"title":"The river of life method in a schema therapy groups.","authors":"Jan Prasko, Marie Ociskova, Julius Burkauskas, Jakub Vanek, Ilona Krone, Julija Gecaite-Stonciene, Marija Abeltina, Jelena Holomany, Milos Slepecky, Alicja Juskiene","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Schema therapy is an integrative approach to treat patients with personality disorders and other complex psychological problems. Group schema therapy has been developed to enhance the effectiveness and efficiency of schema therapy by providing a supportive and stimulating environment for change. This article introduces the River of Life Method, a novel technique for facilitating group schema therapy, based on the metaphor of a river of life. The method helps patients to identify and modify their maladaptive schemas and modes in a nurturing process in the group. The article describes the theoretical background, the practical steps, and the clinical applications of the method. It also presents the patients' experience with the method, based on their feedback and self-reports. The results showed that the method was well received by both patients and therapists, and that it had positive effects on schema modes, psychological distress, and coping with adversities and hope for the future.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"45 1","pages":"55-68"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lei Yan, Wenzhao Liang, Bingyang Zhao, Zhongyu Zhao, Kai Zhang, Lingling Wang, Jing Mang
{"title":"Revisiting the role of TEG-PM in stroke prevention by drug selection for mono-antiplatelet medication following dual-antiplatelet treatment.","authors":"Lei Yan, Wenzhao Liang, Bingyang Zhao, Zhongyu Zhao, Kai Zhang, Lingling Wang, Jing Mang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Backgrounds: </strong>Dual-antiplatelet therapy (DAPT) with aspirin and clopidogrel for minor strokes or TIAs has been demonstrated in several RCTs. Whether drug selection for mono-antiplatelet therapy (MAPT) following DAPT may influence stroke recurrence has not been clarified, especially for patients with intracranial atherosclerosis stenosis (ICAS). The Thrombelastography Platelet Mapping (TEG-PM) assay claimed to be capable of monitoring platelet function secondary to antiplatelet therapy.</p><p><strong>Purpose: </strong>The aim of this study was to investigate the preventive role of TEG-PM in individualized drug selection for MAPT following DAPT in patients with minor stroke or TIA.</p><p><strong>Methods: </strong>We retrospectively reviewed our patient database to identify individuals with minor stroke or TIA between February 2019 and July 2022. Patients were divided into ICAS and non-ICAS groups, and the efficacy and safety of TEG-PM-guided MAPT for stroke prevention after minor stroke or TIA were investigated in each group.</p><p><strong>Results: </strong>ICAS patients with TEG-PM-guided MAPT had lower rates of recurrent stroke than patients without TEG-PM guidance during a mean follow-up period of 18.1 months (6.3% vs 15.2%; p = 0.04). Patients without ICAS also tended to benefit from TEG-PM-guided MAPT with lower rates of stroke recurrence (2.6% vs 8.7%; p = 0.02). No difference in the safety outcome of any bleeding events was observed in patients with TEG-PM-guided MAPT and those without (ICAS group, 2.1% vs 3.0%; p = 0.68; non-ICAS group, 1.3% vs 2.3%; p = 0.79).</p><p><strong>Conclusion: </strong>The TEG-PM could be a tangible preprocessing in drug selection for MAPT following DAPT in patients with minor strokes or TIAs, especially for those with non-stented ICASs.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"45 1","pages":"47-54"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jan Prasko, Marija Abeltina, Julija Gecaite-Stonciene, Julius Burkauskas, Ilona Krone, Erika Jurisova, Marta Zatkova, Jakub Vanek, Milos Slepecky, Marie Ociskova
{"title":"Exploring self-care within the context of cognitive behavioural therapy and supervision.","authors":"Jan Prasko, Marija Abeltina, Julija Gecaite-Stonciene, Julius Burkauskas, Ilona Krone, Erika Jurisova, Marta Zatkova, Jakub Vanek, Milos Slepecky, Marie Ociskova","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article emphasizes the critical role of self-care in the professional lives of cognitive behavioural therapy (CBT) therapists and supervisors. It delves into the importance of self-care, elucidating its significance in maintaining therapists' mental health and effectiveness. The article presents a range of practical strategies that promote self-care, providing therapists and supervisors with specific steps to incorporate self-care into their daily routines. Moreover, the article explores common challenges and barriers to self-care, such as a lack of time, feelings of guilt associated with prioritizing one's needs, and a lack of available resources for self-care. The article aims to deepen our understanding of the complexities of practising self-care by shedding light on possible obstacles. In addition, the article includes case vignettes that demonstrate tangible examples of the positive impact of self-care on therapists' mental health and effectiveness. The overarching goal of this article is to encourage ongoing discussion and research on self-care. It advocates a greater emphasis on self-care in CBT and CBT supervision (CBTS), intending to promote the health and well-being of those who dedicate their lives to caring for others. The insights and strategies presented in this article serve as a resource for therapists and supervisors striving to achieve a balanced lifestyle while effectively catering to the needs of their clients.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"45 1","pages":"7-21"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Association between COVID-19 vaccination and hair cortisol concentrations.","authors":"Yuemin Ding, Yuxuan Xiong, Jingru Zhao, Ying Zhang, Qiang Zheng, Zulun Gao, Liuyi Lu, Kai Guo, Zhihao Bai, Hangdi Chen, Jiali Zhang, Meiyin Zhong, Aiwu Huang, Shiwei Duan, Xiong Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Cortisol is a steroid hormone secreted mainly by the adrenal cortex and is associated with chronic stress levels in the body. Hair cortisol concentration (HCC) is a reliable index to assess human stress levels. So far, no study has reported whether COVID-19 vaccination is associated with the changes of HCC.</p><p><strong>Methods: </strong>Hair samples were collected from 114 college students at Hangzhou City University and Zhejiang University. Among them, 57 cases completed COVID-19 vaccination and others did not. HCCs were measured by the chemiluminescence immunoassay (CLIA). The psychological stress levels were evaluated using the Chinese College Student Psychological Stress Scale (CCSPSS). General information and adverse reactions of the subjects were collected by questionnaire.</p><p><strong>Results: </strong>Compared with the vaccinated college students, the unvaccinated students had higher HCC levels in both A and B hair segments respectively corresponding older or six weeks before and newer or six weeks after vaccination (p < 0.05), reflecting higher stress levels. Besides, the vaccinated group had significantly higher HCCs in segment B compared with segment A (p < 0.05). Further analysis showed that the value of ΔHCC (HCCseg.B - HCCseg.A) of the vaccinated group was strongly associated with COVID-19 vaccination (p < 0.05), but was not associated with age, gender, BMI, CCSPSS score, hormone use, exercise frequency, hair washing frequency, or hair treatment. Finally, the number of self-reported systemic adverse reactions in the vaccinated group was associated with ΔHCC (p < 0.01).</p><p><strong>Conclusion: </strong>The COVID-19 vaccination had an impact on the value of HCC, which might be linked to the occurrence of systemic adverse effects following vaccinations.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"45 1","pages":"22-30"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lin Cong, Meiqing Huang, Jinghua Yang, Shan Cheng, Chaolin Teng, Kaiwen Xiong, Taihui Zhang, Weitao Dang, Cui Liu, Jin Ma, Wendong Hu
{"title":"Standard low-resolution electromagnetic tomography imaging of brain for the analysis of mental fatigue during a simulated air traffic control task.","authors":"Lin Cong, Meiqing Huang, Jinghua Yang, Shan Cheng, Chaolin Teng, Kaiwen Xiong, Taihui Zhang, Weitao Dang, Cui Liu, Jin Ma, Wendong Hu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Standard low-resolution electromagnetic tomography (sLORETA) was used to accurately detect EEG changes in mental fatigue of air traffic controllers (ATCo) under a simulated air traffic control (ATC) task. We explored the changes in standard current density, activated cortical intensity, and brain source location.</p><p><strong>Methods: </strong>The participants were instructed to use the tower flight command simulation training system for three hours of uninterrupted ATC task. The 3-hour EEG signal was divided into four stages: task start, 1st hour, 2nd hour, and task end. Each stage was preprocessed for 3 minutes to explore the EEG changes and then processed by sLORETA in a statistical non-parametric mapping analysis.</p><p><strong>Results: </strong>The current density distribution of δ and α oscillations differed significantly during the four tasks, while θ, β and γ oscillations did not. Changes in δ oscillations of the brain during mental fatigue were detected mainly in the postcentral gyrus (BA2 and BA3), precentral gyrus (BA4 and BA6), inferior temporal gyrus (BA20), and superior temporal gyrus (BA38). The α oscillations were found mainly decreased in the postcentral gyrus (BA2) and inferior parietal lobule (BA40) when the task was in progress compared with the end of the task.</p><p><strong>Conclusion: </strong>The superior temporal gyrus and somatosensory cortex were the main activated cortical regions during the simulated ATC task. The α and δ oscillations showed contrasting activity during simulated ATC task, which might reflect the release of task-relevant brain's areas from inhibition and enhance the neural activity.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":"44 8","pages":"491-499"},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}