Nurse Education Today最新文献

{"title":"Internet addiction and depressive symptoms among nursing students: A network analysis with implications for nursing education","authors":"Yuan Li ,&nbsp;Biru Luo ,&nbsp;Jing Shi ,&nbsp;Miao Chen ,&nbsp;Mei Rosemary Fu ,&nbsp;Shujuan Liao","doi":"10.1016/j.nedt.2025.106913","DOIUrl":"10.1016/j.nedt.2025.106913","url":null,"abstract":"<div><h3>Background</h3><div>Internet addiction and depressive symptoms co-occur frequently among nursing students, threatening their well-being and academic success in a demanding educational environment. The underlying symptom dynamics, however, remain unclear. Network analysis can identify key symptom interactions, providing an empirical basis for targeted interventions and support strategies within nursing education.</div></div><div><h3>Objectives</h3><div>This study aimed to (1) identify central symptoms within the Internet addiction-depressive symptom network, (2) detect bridge symptoms connecting distinct symptom clusters, and (3) examine gender-specific network patterns among nursing students.</div></div><div><h3>Design</h3><div>A multicenter cross-sectional study.</div></div><div><h3>Setting</h3><div>Fourteen universities across seven major geographical regions of China.</div></div><div><h3>Participants</h3><div>6019 nursing students recruited through two-stage sampling.</div></div><div><h3>Methods</h3><div>Data were collected between April and July 2024 using the 6-item Internet Addiction Test and the 9-item Patient Health Questionnaire. Network analysis was performed to estimate symptom networks, identify central and bridge symptoms, and examine gender-specific patterns.</div></div><div><h3>Results</h3><div>Analysis of 5984 valid responses revealed a stable network comprising 15 nodes with 80 non-zero edges. Fatigue/low energy (Expected Influence [EI] = 1.497) and Internet preoccupation (EI = 1.211) emerged as the most central symptoms in the network, while offline emotional dysregulation (bridge EI = 0.234) served as the primary bridge symptom. Gender comparisons revealed significant structural differences (<em>P</em> = 0.049); regarding local connectivity patterns, males showed stronger connections in behavioral control failure and physiological-emotional instability, and females exhibited elevated connectivity in academic impairment and self-concept preservation.</div></div><div><h3>Conclusions</h3><div>Fatigue/low energy and Internet preoccupation emerged as central symptoms, with offline emotional dysregulation as the primary bridge. Gender-specific network patterns demonstrated distinct symptom interactions, suggesting that targeted interventions should be designed respectively for males and females. These findings advance understanding of symptom-level dynamics and provide evidence-based implications for developing targeted psychological and behavioral interventions within nursing education to enhance students' mental health, academic success, and professional development.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"157 ","pages":"Article 106913"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “The mediating effect of advanced health assessment on the relationship between self-directed learning and clinical thinking among master of nursing specialist postgraduate students: A structural equation model” [Nurse Educ. Today, 144 (2025)106480]","authors":"Lulu Wang ,&nbsp;Yuqing Zhang ,&nbsp;Chunjing Zhang ,&nbsp;Biaoxin Zhang","doi":"10.1016/j.nedt.2025.106904","DOIUrl":"10.1016/j.nedt.2025.106904","url":null,"abstract":"","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"157 ","pages":"Article 106904"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the effectiveness of teaching political activism to undergraduate nursing students: A scoping review","authors":"Jack Cornish ,&nbsp;Yunjing Qiu ,&nbsp;Suzanne Sheppard-Law ,&nbsp;Tracy Levett-Jones","doi":"10.1016/j.nedt.2025.106908","DOIUrl":"10.1016/j.nedt.2025.106908","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this scoping review was to identify, examine and synthesise published literature reporting on the teaching of political activism to undergraduate nursing students.</div></div><div><h3>Introduction</h3><div>As frontline healthcare professionals, nurses are well-positioned to address complex sociopolitical issues that influence the healthcare landscape. Nurses have a known history of activism, including advocating for and acting to influence policy changes that improve healthcare access, health justice and patient outcomes. Activism requires competence or astuteness to be enacted successfully, so it is, therefore, essential to understand how nursing education programs currently develop students' skills in activism to prepare graduates to meet professional expectations.</div></div><div><h3>Methods</h3><div>A scoping review was conducted according to PRISMA-ScR and JBI guidelines. Comprehensive searches were performed in CINAHL, MEDLINE, ERIC and EMBASE databases. The data from the included papers were analysed inductively, with findings presented narratively.</div></div><div><h3>Results</h3><div>Of the 401 studies identified, eight met the inclusion criteria. Varied approaches for teaching politics and political activism to nursing students were reported in the included papers. Key outcomes included knowledge acquisition, attitudinal change and increased confidence in activism. Few of the papers described rigorous evaluation methods, with only two using validated instruments to measure effectiveness, and three having conducted formal data analysis.</div></div><div><h3>Conclusions</h3><div>Political activism education is purported to be effective in developing undergraduate nursing students' political astuteness and capacity for political participation. However, the current evidence base is limited, highlighting the need for more rigorous research to support this assertion and to inform curricula.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"157 ","pages":"Article 106908"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moral distress among nursing students during clinical practice: A qualitative systematic review and meta-synthesis","authors":"Zhengjun Zhu ,&nbsp;Meicao Wang ,&nbsp;Zixuan Li ,&nbsp;Yuhan Li ,&nbsp;Kexin Xue ,&nbsp;Yanping Sun ,&nbsp;Yanli Zeng","doi":"10.1016/j.nedt.2025.106923","DOIUrl":"10.1016/j.nedt.2025.106923","url":null,"abstract":"<div><h3>Background</h3><div>Moral distress arises when nursing students recognize the ethically appropriate action but are constrained from acting due to institutional or interpersonal barriers. During clinical placements, they frequently encounter unethical practices, hierarchical dynamics, and value dissonance that evoke emotional strain and ethical disillusionment. Such experiences can undermine moral competence and hinder professional identity formation. Although moral distress among students has gained increasing scholarly attention, prior reviews often lacked conceptual coherence, cultural inclusiveness, and methodological rigor.</div></div><div><h3>Objectives</h3><div>To systematically synthesize and interpret qualitative evidence on nursing students' experiences of moral distress during clinical practice.</div></div><div><h3>Methods</h3><div>A qualitative systematic review and meta-synthesis was conducted following Joanna Briggs Institute methodology and reported in accordance with PRISMA and ENTREQ guidelines. Ten databases—PubMed, Embase, CINAHL, PsycINFO, Scopus, Web of Science, Cochrane Library, CNKI, CBM, and WanFang—plus Google Scholar were searched from inception to November 2024 (updated October 3, 2025). Studies were appraised using the JBI Critical Appraisal Checklist, and data were analyzed thematically using NVivo 14. Confidence in the synthesized findings was assessed via the JBI ConQual process.</div></div><div><h3>Results</h3><div>Nine studies from eight countries were included. Six overarching themes and 17 subthemes were identified, highlighting moral distress triggered by unethical conduct, limited autonomy, and inadequate supervision. Students often responded with silence or avoidance, whereas access to peer or faculty support promoted moral resilience. ConQual assessment rated two themes as high confidence, one as moderate, and three as low.</div></div><div><h3>Conclusions</h3><div>Moral distress among nursing students is a culturally embedded, multifactorial experience shaped by systemic, relational, and personal influences. Integrating reflective mentorship and ethics-focused education may transform moral adversity into resilience and support the ethical development of future nurses.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"157 ","pages":"Article 106923"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shaping competence through identity: The mediating role of professional identity in the relationship between clinical learning environment and nursing competence among nursing students","authors":"Shaimaa Mohamed Amin ,&nbsp;Ayman Mohamed El-Ashry ,&nbsp;Nashwa Ahmed Hussein Abdel Karim ,&nbsp;Mohamed Hussien Ramadan Atta ,&nbsp;Nada Alqarawi ,&nbsp;Mahmoud Abdelwahab Khedr ,&nbsp;Hend Wageh Abozed ,&nbsp;Eman Abdeen Ali ,&nbsp;Ahmed Zaher Mohamed ,&nbsp;Ahmed Hashem El-Monshed ,&nbsp;Ibrahim Alasqah ,&nbsp;Mona Metwally El-Sayed","doi":"10.1016/j.nedt.2025.106905","DOIUrl":"10.1016/j.nedt.2025.106905","url":null,"abstract":"<div><h3>Background</h3><div>The clinical learning environment (CLE) is a fundamental component of nursing education, crucial for translating theoretical knowledge into practical competence. While a supportive CLE is known to enhance nursing competence, the precise mechanisms underlying this relationship are not fully understood. Professional identity formation, the process by which students internalize the values, behaviors, and roles of the nursing profession, is theorized to be a key mediating factor in this dynamic.</div></div><div><h3>Objective</h3><div>This study aimed to investigate the mediating role of professional identity in the relationship between the perceived clinical learning environment and self-assessed nursing competence among undergraduate nursing students in Egypt.</div></div><div><h3>Methods</h3><div>A cross-sectional, descriptive-correlational study was conducted at the Faculty of Nursing, Zagazig University, Egypt. A stratified random sample of 520 undergraduate nursing students who had completed at least one clinical practicum was recruited. Data were collected using three validated, Arabic-translated instruments: the Clinical Learning Environment Scale (CLES), the Professional Identity Scale for Nursing Students (PISNS), and the Nursing Competence Assessment Tool (NCAT). Data analysis employed descriptive statistics, Spearman's rank-order correlations, and mediation analysis using the SPSS PROCESS macro (Model 4) with 2000 bootstrap samples to test the significance of the indirect effect.</div></div><div><h3>Results</h3><div>Participants reported a moderate-to-high level of nursing competence (Mean = 116.21 ± 14.54; 77.48 % of total score), with the highest scores in basic nursing skills and communication, and the lowest in medical-related knowledge. Professional identity (Mean = 67.15 ± 10.37) and perceptions of the CLE (Mean = 71.83 ± 10.99) were also rated positively. Spearman correlations revealed significant positive relationships between CLE and competence (rs = 0.67, <em>p</em> &lt; .01), CLE and professional identity (rs = 0.66, p &lt; .01), and professional identity and competence (rs = 0.56, p &lt; .01). Mediation analysis confirmed that professional identity partially mediated the relationship between CLE and nursing competence. The indirect effect was significant (β = 0.544, <em>p</em> &lt; .001), accounting for 26.6 % of the total effect (β = 0.788, p &lt; .001).</div></div><div><h3>Conclusion</h3><div>The findings demonstrate that a positive clinical learning environment directly enhances nursing competence and indirectly fosters it through the development of a strong professional identity. This highlights the dual importance of optimizing both the structural/pedagogical aspects of clinical placements and intentionally integrating identity-forming activities into nursing education curricula to cultivate competent, confident future nurses.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"157 ","pages":"Article 106905"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LLM-based pedagogical agent for ICU simulation instructor training: A quasi-experimental study","authors":"Jingbang Liu ,&nbsp;Ting Chen ,&nbsp;Shan Li ,&nbsp;Yeru Xia ,&nbsp;Hong Zhu ,&nbsp;Ruijuan Wu ,&nbsp;Qinli Cao ,&nbsp;Xiaoyan Gong ,&nbsp;Lili Wu","doi":"10.1016/j.nedt.2025.106901","DOIUrl":"10.1016/j.nedt.2025.106901","url":null,"abstract":"<div><h3>Background</h3><div>Intensive Care Unit (ICU) nursing is demanding, requiring advanced clinical decision-making and emergency management skills. Simulation-based instruction is central to ICU nursing education but remains constrained by the cost and time required for scenario authoring, limited faculty capacity for feedback, and slow content updates. Large language models (LLMs)-based pedagogical agents may augment instructor training by supporting rapid scenario generation, formative guidance, and on-demand assistance. However, evidence from real-world ICU instructor training is limited, and the balance between perceived benefits, usability, and objective educational outcomes is unclear.</div></div><div><h3>Objective</h3><div>To evaluate the feasibility and learner-perceived impact of integrating an LLM-based pedagogical agent into ICU simulation instructor training.</div></div><div><h3>Methods</h3><div>An exploratory quasi-experimental study was conducted with 40 ICU nurses from a tertiary hospital in February 2025. Participants were randomly assigned to an experimental group (n = 20) using the LLM-based AI teaching agent for simulation training, and a comparison group (n = 20) using traditional blended learning. The training effectiveness was assessed using the Chinese version of the Jeffries Simulation Design Scale (SDS), the System Usability Scale (SUS), the Adult Online Learning Self-Efficacy Scale, and a teaching satisfaction questionnaire. Data were analyzed using Wilcoxon rank-sum tests and <em>t</em>-tests.</div></div><div><h3>Results</h3><div>The experimental group outperformed the comparison group in multiple areas. Specifically, in the SDS, the experimental group scored higher in case authenticity (5.00 vs. 4.00, <em>p</em> &lt; 0.001), scenario complexity (5.00 vs. 4.00, <em>p</em> &lt; 0.001), feedback mechanisms (5.00 vs. 4.00, <em>p</em> &lt; 0.001), interactivity (5.00 vs. 4.00, <em>p</em> &lt; 0.001), and teaching objectives (5.00 vs. 4.25, <em>p</em> &lt; 0.001). The experimental group also showed higher self-efficacy in learning ability (16.0 vs. 13.0, <em>p</em> &lt; 0.001) and learning technology (18.0 vs. 16.0, <em>p</em> = 0.045). Satisfaction was high in both groups and demonstrated a pronounced ceiling effect.</div></div><div><h3>Conclusion</h3><div>Embedding an LLM-based pedagogical agent into ICU simulation instructor training was feasible and associated with more favorable learner-perceived simulation design quality and online learning self-efficacy, while usability did not differ from traditional blended learning. Findings are preliminary and hypothesis-generating; future multi-centre, adequately powered randomized controlled trials are warranted to determine efficacy and isolate the LLM component's independent contribution.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"157 ","pages":"Article 106901"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction to Exploring the nexus between nursing/midwifery education, planetary health, climate change and sustainable healthcare","authors":"Gemma Stacey","doi":"10.1016/j.nedt.2025.106922","DOIUrl":"10.1016/j.nedt.2025.106922","url":null,"abstract":"","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"157 ","pages":"Article 106922"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing and midwifery education for a planet beyond 1.5 °C","authors":"Zerina Lokmic-Tomkins ,&nbsp;Catelyn Richards ,&nbsp;Deb Massey","doi":"10.1016/j.nedt.2025.106912","DOIUrl":"10.1016/j.nedt.2025.106912","url":null,"abstract":"","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"157 ","pages":"Article 106912"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practice assessment documentation for midwifery programmes: A scoping review","authors":"Rachael Crocker ,&nbsp;Lindsay Gillman ,&nbsp;Ann Ooms ,&nbsp;Jacqui Williams","doi":"10.1016/j.nedt.2025.106911","DOIUrl":"10.1016/j.nedt.2025.106911","url":null,"abstract":"<div><h3>Background</h3><div>Practice assessment documentation is a critical component of midwifery education globally, to ensure students meet regulatory standards for clinical proficiency. However, variations in documentation, grading criteria, and assessor interpretation have led to inconsistencies in student assessment. This scoping review maps existing literature evaluating midwifery practice assessment documentation, synthesises the evidence, and identifies gaps.</div></div><div><h3>Methods</h3><div>A scoping review was conducted following the JBI methodology, including searches in CINAHL, MEDLINE, Embase, MIDIRS, Web of Science, Scopus, APA PsycInfo, and Education Research Complete. Gray literature sources, reference lists, and systematic review databases were also screened. Studies evaluating midwifery practice assessment documentation in clinical education across Australia, New Zealand, Canada, the UK, and EU member states were included. Data extraction followed a narrative synthesis approach.</div></div><div><h3>Results</h3><div>Nine articles met the inclusion criteria, including seven primary research articles, one national report, and one conference presentation. Key themes identified included validity and reliability of documentation and assessment tools, training, time, language and consistency. Several articles highlighted the need for nationalised assessment tools, with some evidence suggesting that standardisation can improve reliability and feedback quality.</div></div><div><h3>Conclusion</h3><div>The review highlights ongoing challenges in midwifery assessment, emphasising the need for standardised, user-friendly documentation that ensures consistency and reliability. Ensuring that midwifery assessment effectively captures both clinical competencies and professional attitudes is essential to fostering well-rounded, competent practitioners ready to meet the demands of contemporary midwifery practice. While nationalised tools show promise, further research is required to assess their impact on student learning and assessor’ confidence.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"157 ","pages":"Article 106911"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Panoptic pedagogy: A Foucauldian debate on micromanagement in nursing education","authors":"Trae Stewart","doi":"10.1016/j.nedt.2025.106910","DOIUrl":"10.1016/j.nedt.2025.106910","url":null,"abstract":"<div><div>Nursing education is increasingly caught between demands for standardized accountability and the need for pedagogical autonomy. Drawing on Michel Foucault's concepts of disciplinary power, panopticism, governmentality, and docile bodies, this article critiques the rise of micromanagement practices (e.g., templated syllabi, incessant data audits, and test-driven curricula) that cast faculty as permanent objects of surveillance. Proponents argue that such oversight guarantees quality, reduces liability, and protects accreditation. In contrast, evidence shows it also erodes professional identity, fuels burnout, and suppresses the creative teaching essential to safe, adaptive practice. International comparisons reinforce this paradox. The article balances these findings with a Foucauldian-inspired roadmap for reform. Key recommendations include cultivating care of the self through peer-mentoring and reflective practice; embedding participatory governance to democratize policy-making; training leaders in servant- and transformational‑leadership models; and enacting workload, wellness, and transparency policies that replace fear-based compliance with mutual accountability. By shifting from a panoptic to a collaborative architecture of power, nursing programs can meet regulatory standards while restoring the intellectual vitality and ethical agency of their educators.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"157 ","pages":"Article 106910"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145428752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}