Obesity Pillars最新文献

{"title":"Obesity management in primary care: Are we adequately preparing the next generation of Canadian family physicians?","authors":"Helena Piccinini-Vallis ,&nbsp;Vlad Evdaev ,&nbsp;Joseph Asaminew ,&nbsp;Therese McCurdy ,&nbsp;Mark Rogers ,&nbsp;Michael Vallis","doi":"10.1016/j.obpill.2024.100151","DOIUrl":"10.1016/j.obpill.2024.100151","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a chronic disease that affects a large proportion of the population. We examined the preparation of Canadian medical learners for obesity management through three cross-sectional studies exploring the: 1) knowledge of evidence-based obesity management among medical students; 2) perspectives of family medicine residents on the adequacy of obesity management training in their residency programs; and 3) intentions of family medicine residents regarding obesity management when they enter practice.</div></div><div><h3>Methods</h3><div>An online survey instrument was developed for each study. For Study 1, the survey was developed by HP, VE and JA; the questions mapped onto the ten domains outlined in the 2020 Canadian Clinical Practice Guidelines on the Management of Obesity in Adults. For Study 2, the survey was developed by HP and TMcC; the questions aligned with competencies in the management of other chronic diseases. For Study 3, the survey was developed by MR, HP and MV; the Capability, Opportunity, and Motivation (COM-B) model was used as a framework for the questions. All three surveys met the criterion for face validity and the survey for Study 3 met criteria for content and criterion validity.</div></div><div><h3>Results</h3><div>Study 1 enrolled 26 first-year and 22 fourth-year students. Total correct scores were below 50 % for both groups, and patient-centeredness scores differed significantly between the groups. Study 2 enrolled 494 family medicine residents; less than 25 % thought there was sufficient time devoted to training in obesity management during residency and approximately 75 % experienced inconsistent messaging about obesity management from their preceptors. Study 3 enrolled 150 family medicine residents. Few participants believed that they had been well trained or had a clear plan for managing obesity, but most believed that obesity management will form part of their practice and that they will have the time and resources for obesity management.</div></div><div><h3>Conclusion</h3><div>Current medical education does not reflect the requisite knowledge for contemporary obesity management. Further, family medicine residents identified gaps in mentorship of contemporary principles of obesity management. These findings support the revision of the medical curriculum in Canada to better reflect the science of obesity and its management.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100151"},"PeriodicalIF":0.0,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring parental and professional perceptions of weight management services among under-fives in England: A qualitative study","authors":"Maines Msiska ,&nbsp;Lawrence Achilles Nnyanzi ,&nbsp;Misheck Julian Nkhata ,&nbsp;Scott Lloyd ,&nbsp;David B. Olawade","doi":"10.1016/j.obpill.2024.100149","DOIUrl":"10.1016/j.obpill.2024.100149","url":null,"abstract":"<div><h3>Background</h3><div>Childhood obesity is a significant public health challenge, particularly among children under five. In England, weight management programs aim to address this issue; however, engagement and uptake of these services remain low. Understanding the perceptions of parents and professionals involved in these programs is crucial to enhancing participation and improving health outcomes. This study explores these perceptions to identify barriers and facilitators to effective engagement with weight management services.</div></div><div><h3>Method</h3><div>This qualitative study used purposive sampling to recruit parents and professionals involved in weight management programs across England. Semi-structured interviews were conducted with 15 participants (8 parents and 7 professionals). Data were transcribed, coded, and thematically analyzed using Braun and Clarke's six-phase framework to identify key themes related to engagement, cultural influences, and program effectiveness.</div></div><div><h3>Results</h3><div>The study identified several key themes: parental engagement, the impact of virtual versus face-to-face sessions, motivations for participation, barriers to involvement, and the role of cultural beliefs. Parental involvement was critical for the success of weight management programs, but barriers such as time constraints, cultural beliefs, and socioeconomic factors hindered participation. Professionals highlighted the need for more training and resources to effectively address these challenges. Cultural sensitivities and systemic support were found to be crucial for improving engagement and outcomes.</div></div><div><h3>Conclusions</h3><div>The findings emphasize the need for culturally tailored, accessible, and sustainable weight management interventions. Enhanced professional training, increased community outreach, and policy-level support are essential to improve engagement and ensure long-term success in addressing childhood obesity.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100149"},"PeriodicalIF":0.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood obesity in South Asian population","authors":"Vimal Pahuja,&nbsp;Sushma Sanghvi","doi":"10.1016/j.obpill.2024.100148","DOIUrl":"10.1016/j.obpill.2024.100148","url":null,"abstract":"<div><h3>Introduction</h3><div>Obesity is worldwide health concern, with its prevalence rising steeply specially in low and middle-income countries in the past decade. World Obesity Federation estimates that one in five women and one in seven men - will be obese by 2030.Obesity numbers are expected to double during same year in South and South Asian countries, with obesity in children over age of five estimated to be at forty-five million.</div></div><div><h3>Methods</h3><div>Relevant articles, full text and abstract pertaining to childhood obesity, pediatric obesity, technology in childhood obesity and specifically articles on obesity in children in South Asian countries were obtained from search engines like PUBMED, Google Scholar and Cochrane data base. The full text relevant articles and abstracts and the cross references after verification suitable to the topic were used to draft this review.</div></div><div><h3>Results</h3><div>The double burden of undernutrition and obesity poses a unique public health challenge in Southeast Asia. In recent decades, South and Southeast Asia have experienced a period of rapid nutrition and lifestyle transition, leading to a proportional rise in the burden of obesity and Type 2 diabetes. The traditional diets of whole grains and vegetables in this region are being replaced by highly processed fast food due to rapid urbanization and westernisation in this region.There is growing and unrelenting burden of health risks in adulthood like diabetes, heart disease, hypertension, dyslipidaemia and mental health issues due to childhood obesity. Therapy mainly focuses on lifestyle changes underpinned by underlying behaviour changes, addressing emotional stress and sleep issues, pharmacotherapy and metabolic surgery in certain situations. Personalisation of therapy remains corner stone of therapeutics in childhood obesity.</div></div><div><h3>Conclusion</h3><div>This comprehensive review aims at addressing the risk factors, complications, treatment and highlights effective preventive strategies for childhood obesity in South Asia.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100148"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duties, tasks, knowledge and skills of an obesity medicine physician: A practice analysis","authors":"Kimberly A. Gudzune ,&nbsp;Dana R. Brittan ,&nbsp;Adrienne W. Cadle ,&nbsp;Tirissa J. Reid ,&nbsp;Edmond P. Wickham III ,&nbsp;Judith Korner","doi":"10.1016/j.obpill.2024.100147","DOIUrl":"10.1016/j.obpill.2024.100147","url":null,"abstract":"<div><h3>Background</h3><div>Given the evolving nature of obesity medicine, periodic evaluation of its clinical practice is needed to ensure that certification requirements address real-world experience. Practice analysis is a systematic approach to define a field's body of knowledge, and its results can inform the content outline and examination blueprint for a certification examination. This study describes the 2023 practice analysis conducted by the American Board of Obesity Medicine (ABOM).</div></div><div><h3>Methods</h3><div>Initially, 14 obesity medicine physicians participated in a practice analysis panel, resulting in 3 duties and 30 tasks required for competent practice of obesity medicine physicians. Each task included steps, knowledge, skills, and abilities needed to perform the task. ABOM then recruited 645 certified obesity medicine physicians from its database to participate in a validation survey to rate the frequency [scale: never (0) to very frequently (5)] and importance [scale: not important (0) to very important (3)] of each task. Survey participants could also provide open-ended comments.</div></div><div><h3>Results</h3><div>Among validation survey participants (n = 645), the most common primary medical specialties reported were internal medicine (46.0 %), family medicine (33.8 %), and pediatrics (11.2 %). Years practicing obesity medicine varied with 45.3 % reporting 1–4 years, 26.0 % 5–9 years, and 28.7 % ≥ 10 years in practice. Most tasks were performed frequently (mean score ≥4.0) and rated as important (mean score ≥2.0). All tasks were retained based on the frequency and importance ratings. Survey results informed the weighting in the examination blueprint.</div></div><div><h3>Conclusion</h3><div>There was consensus among practicing ABOM-certified physicians who participated in the validation survey in the tasks required for competent obesity medicine practice. Our practice analysis approach was a structured process that engaged obesity medicine physicians and captured the breadth and depth of knowledge required for obesity medicine. The new content outline and examination blueprint developed will be implemented with the 2025 ABOM certification exam administration.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100147"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity medicine provider-directed health coaching in a commercial weight loss program: Proof of concept","authors":"Michelle Alencar ,&nbsp;Angela Fitch ,&nbsp;Rachel M. Sauls ,&nbsp;Kelly Johnson ,&nbsp;Mayur Patel","doi":"10.1016/j.obpill.2024.100146","DOIUrl":"10.1016/j.obpill.2024.100146","url":null,"abstract":"<div><h3>Background</h3><div>Obesity remains a leading serious chronic disease and cause of death in the U.S. Despite previous research in diets (i.e., caloric restriction), physical activity levels, and biochemical markers, no studies to date have investigated the combination of an obesity medicine physician with a health coach alongside a commercial program for reducing body weight. As a result, this pilot study aims to assess the relationship between a commercial diet program and health and wellness coaching (HWC) for weight reduction outcomes when delivered in conjunction with an obesity medicine physician chronic disease care model, as a proof-of-concept study.</div></div><div><h3>Methods</h3><div>This 24-week proof-of-concept study was pragmatic, being an unblinded, unrandomized, uncontrolled, longitudinal, observational study. Its purpose was to assess participant weight reduction from a commercial weight reduction program using a pre-packaged portion-controlled reduced-calorie diet while meeting with a health coach and obesity medicine physician for counseling and support. Participants in the sample underwent a commercial weight reduction program through dietary control while meeting with an HWC. A repeated measures ANOVA was conducted to determine the weight reduction trends across a 24-week program.</div></div><div><h3>Results</h3><div>This study included n = 53 participants; a majority were white females (n = 45; 85 %), with an average (SD) age of 50.3 (12.2) years. There was a significant improvement in weight reduction (21.8 ± 9.4 lbs. WL) seen throughout the 24-week program (F (7, 364) = 33.129, p &lt; 0.001), with a large effect (η² = 0.922).</div></div><div><h3>Conclusion</h3><div>This proof-of-concept project found that Obesity Medicine Physician-directed, portion-controlled meals and HWC can improve weight reduction across a 24-week program using portioned-controlled meals. Confirmation of these findings and their clinical significance requires a follow-up randomized, controlled clinical trial using validated assessment tools.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100146"},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to \"Differentiating monogenic and syndromic obesities from polygenic obesity: Assessment, diagnosis, and management\" [Obesity Pillars 11C (2024) 100110].","authors":"Angela K Fitch, Sonali Malhotra, Rushika Conroy","doi":"10.1016/j.obpill.2024.100135","DOIUrl":"https://doi.org/10.1016/j.obpill.2024.100135","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1016/j.obpill.2024.100110.].</p>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"100135"},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Metabolic surgery in Asian patients with type 2 diabetes mellitus and body mass index less than 30kg/m2: A systematic review”","authors":"Angel Alois Osorio Manyari ,&nbsp;Azucena Lirio Armas Alvarez ,&nbsp;Joel Davis Osorio Manyari ,&nbsp;Francisco Gonzalez Caballero ,&nbsp;Sjaak Pouwels","doi":"10.1016/j.obpill.2024.100145","DOIUrl":"10.1016/j.obpill.2024.100145","url":null,"abstract":"<div><h3>Background</h3><div>The effect of metabolic surgery on long-term diabetes remission in Asian patients with a body mass index (BMI) &lt; 30 kg/m² has not been widely reported.</div></div><div><h3>Methods</h3><div>We conducted a systematic review of the PubMed and Cochrane Library databases from inception to June 2024. All clinical trials and observational studies involving the effect of metabolic surgery in Asian patients with type 2 diabetes mellitus and BMI &lt;30 kg/m² were considered. The quality of the studies was assessed using the Newcastle-Ottawa scale.</div></div><div><h3>Results</h3><div>Of the 1175 studies screened, 21 studies (11 prospective and 10 retrospective), including 1005 patients, were selected. Only one study had a control group. The longest follow-up was 60 months. The results showed significant improvement in glycated hemoglobin (HbA1c), fasting blood glucose (FBG), 2-h plasma glucose (2hPG), homeostasis model assessment for insulin resistance index (HOMA-IR), fasting C-peptide, triglycerides, total cholesterol, and a reduction in the use of oral hypoglycemic agents/insulin at 12, 24, 36, and 60 months after metabolic surgery. The most common surgical complications observed were anemia (2.1 %–33 %), marginal ulcer (4.2 %–17.3 %), gastrointestinal bleeding (1.9 %–12 %), anastomotic leak (2.1 %–3.5 %), anastomotic stenosis (2.1 %–3.5 %), reoperation (1.18 %), and a mortality rate of zero.</div></div><div><h3>Conclusions</h3><div>Long-term diabetes remission, along with improvements in HbA1c, 2hPG, FBG, and HOMA-IR, with an acceptable rate of complications, was observed in Asian patients with BMI &lt;30 kg/m² after metabolic surgery. Future research with controlled studies should focus on preoperative patient selection criteria beyond just the BMI cutoff.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100145"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Retrospective review of seven patients with obesity simultaneously treated with a combination of a glucagon-like peptide-1 receptor agonist and a meal replacement product\" [Obesity Pillars 12C (2024) 100138].","authors":"Catherine Bacus, Terri-Lynne South, Sonia Raudszus, Odd Erik Johansen","doi":"10.1016/j.obpill.2024.100144","DOIUrl":"https://doi.org/10.1016/j.obpill.2024.100144","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1016/j.obpill.2024.100138.].</p>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"100144"},"PeriodicalIF":0.0,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of in-person versus digital enhanced lifestyle interventions in adults with overweight and obesity","authors":"Diego Anazco ,&nbsp;Maria A. Espinosa ,&nbsp;Lizeth Cifuentes ,&nbsp;Blake Kassmeyer ,&nbsp;Tara M. Schmidt ,&nbsp;Sima Fansa ,&nbsp;Alejandro Campos ,&nbsp;Elif Tama ,&nbsp;William S. Harmsen ,&nbsp;Maria D. Hurtado ,&nbsp;Donald D. Hensrud ,&nbsp;Andres Acosta","doi":"10.1016/j.obpill.2024.100133","DOIUrl":"10.1016/j.obpill.2024.100133","url":null,"abstract":"<div><h3>Background</h3><div>Lifestyle interventions (LIs) are the cornerstone for obesity management. The Mayo Clinic Diet (MCD) offers two approaches for LIs: the In-Person LI (IPLI) and the Digital Enhanced LI (DELI). The IPLI includes a 2-day in-person program with monthly follow-ups, whereas the DELI provides on-demand digital tools. The comparative efficacy of these approaches is currently unknown.</div></div><div><h3>Methods</h3><div>This retrospective study included two cohorts of adults with a body mass index (BMI) of ≥25 kg/m² and weight metrics at least 3 months after starting either the IPLI or DELI program. The primary endpoint was the total body weight loss percentage (TBWL%) at 6 months.</div></div><div><h3>Results</h3><div>The study included 133 participants in the IPLI cohort (mean age 46.3 years, 65.4 % female, BMI 36.4) and 9603 in the DELI cohort (mean age 60.1 years, 85.0 % female, BMI 33.1). The DELI group achieved superior TBWL% at 1, 3, and 6 months compared to the IPLI group (3.4 % vs. 1.5 %, 4.7 % vs. 2.4 %, 5.3 % vs. 2.9 %, respectively; p &lt; 0.001). After adjusting for age, gender, and starting weight, the DELI group maintained a higher TBWL% (difference 2.0 %; 95 % CI [1.0, 3.0], p &lt; 0.001) and a greater proportion of participants achieved &gt;5 % TBWL at 6 months (OR 1.66; 95 % CI [1.08, 2.55], p &lt; 0.023).</div></div><div><h3>Conclusion</h3><div>The DELI approach resulted in superior weight loss outcomes compared to the IPLI. Further research is needed to explore how digital tools can improve weight loss effectiveness.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100133"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing nutrition, diet, and lifestyle communication in GLP-1 medication therapy for weight management: A qualitative research study with registered dietitians","authors":"David Despain,&nbsp;Brenda L. Hoffman","doi":"10.1016/j.obpill.2024.100143","DOIUrl":"10.1016/j.obpill.2024.100143","url":null,"abstract":"<div><h3>Background</h3><div>This qualitative study used semi-structured interviews to examine registered dietitians’ perspectives on diet, nutrition, and lifestyle communication for patients on GLP-1 medications for obesity management.</div></div><div><h3>Methods</h3><div>Through in-depth interviews with registered dietitians, this research identifies elements that could improve both the efficacy of GLP-1 medication therapies and patient adherence.</div></div><div><h3>Results</h3><div>indicate that a comprehensive approach, integrating patient communication with proactive management of side effects and ongoing lifestyle counseling, is essential for optimizing treatment outcomes.</div></div><div><h3>Conclusion</h3><div>Key findings include the importance of using visual and metaphorical aids to improve understanding, the necessity for structured lifestyle programs, and the pivotal role of personalized diet plans. These insights offer valuable directions for enhancing patient care and formulating clinical practices around the use of GLP-1 receptor agonist medications.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"12 ","pages":"Article 100143"},"PeriodicalIF":0.0,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}