European Journal of Clinical Nutrition最新文献

{"title":"Early childhood growth and nutritional status in India: trends in five National Family Health Surveys spanning 1992 and 2021.","authors":"Ramendra Nath Kundu, Grażyna Liczbińska, Rajesh K Gautam, Susmita Bharati, Manoranjan Pal, Premananda Bharati, Robert M Malina","doi":"10.1038/s41430-025-01568-3","DOIUrl":"https://doi.org/10.1038/s41430-025-01568-3","url":null,"abstract":"<p><strong>Background/objective: </strong>To evaluate the weight and height status of under-five children between 1992 and 2021 in relation to nutritional context.</p><p><strong>Subjects/methods: </strong>The study is based on the lengths/heights and weights of children <5 years in five national surveys (n = 505,026). After evaluating normality of the distributions, heights, and weights were expressed as z-scores relative to the WHO reference. Nonparametric tests were used as the heights and weights did not have normal distributions.</p><p><strong>Results: </strong>Heights and weights of boys and girls increased systematically, on average, across the five national surveys, indicating improvement in nutritional status over time. Nevertheless, median z-scores for height and weight relative to the WHO reference indicated the persistence of relatively poor nutritional status across the surveys.</p><p><strong>Conclusions: </strong>The growth status of Indian children <5 years improved over three decades, indicating that national initiatives promoting child health had a positive impact. Unfortunately, the nutritional status of significant numbers of children has not sufficiently improved and merits further attention.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective association between breakfast consumption frequency and BMI z-score among European school-aged children. The Feel4Diabetes Study.","authors":"Panayiota Kostarellou, Costas A Anastasiou, Eva Karaglani, Violeta Iotova, Natalya Usheva, Tsvetalina Tankova, Imre Rurik, Stavros Liatis, Natalia Giménez Legarre, Luis A Moreno, Jaana Lindstrom, Katja Wikström, Greet Cardon, Konstantinos Makrilakis, Yannis Manios","doi":"10.1038/s41430-025-01570-9","DOIUrl":"https://doi.org/10.1038/s41430-025-01570-9","url":null,"abstract":"<p><strong>Background: </strong>The long-term effects of breakfast on childhood z-BMI remain inconclusive.</p><p><strong>Objective: </strong>To prospectively assess the impact of stable and altered breakfast consumption habits on z-BMI change over two years, in school-aged children across six European countries.</p><p><strong>Methods: </strong>Data of 6,528 children (8.2 ± 1.0 years, 48.9% male) from the Feel4Diabetes study were used. Children's lifestyle behaviors, including breakfast frequency, were assessed through parent-reported questionnaires. Weight and height were objectively measured and converted to z-BMI. Participants were categorized into trajectories combining breakfast consumption habit (i.e., regular consumption, irregular consumption or omission) at baseline and follow up. Logistic regression analyzed the prospective association between breakfast trajectories and z-BMI increase, with adjustment for demographic and lifestyle variables.</p><p><strong>Results: </strong>A statistically significant effect of breakfast trajectories was observed in z-BMI, both at baseline and follow up. Stable skippers was the only trajectory that showed a significant increase in BMI z-score from baseline to follow up (0.891 ± 1.058 vs. 1.034 ± 1.072 respectively, p < 0.05). BMI z-score at follow up of regular eaters (0.615 ± 0.967) was significantly lower, compared to both irregular eaters (1.229 ± 0.890) and stable skippers (both p < 0.05). Stable regular consumption and transition from omission to regular consumption were independently associated with significantly lower risk of z-BMI gain, compared to stable omission [OR, 95% CI: 0.55 (0.31, 0.97), p = 0.039 and 0.43 (0.21, 0.88), p = 0.021 respectively].</p><p><strong>Conclusion: </strong>Stable regular breakfast consumption or transition from omission to regular consumption seem to contribute to superior weight regulation in children and to independently protect against z-BMI gain, compared to stable omission. Further studies are warranted to extend the evidence on the breakfast habit-BMI association among children.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences between the normal and perceived appropriate portion sizes of discretionary foods.","authors":"Qingzhou Liu, Margaret Allman-Farinelli, Anna Rangan","doi":"10.1038/s41430-025-01569-2","DOIUrl":"https://doi.org/10.1038/s41430-025-01569-2","url":null,"abstract":"<p><strong>Background: </strong>There are limited data on the amount of discretionary foods that people normally consume and consider as appropriate at one eating occasion. This study aimed to provide an overview of the range and assess differences of the 'normal portion size' and 'perceived appropriate portion size' of energy-dense nutrient-poor discretionary foods among consumers aged 18-65 years.</p><p><strong>Methods: </strong>To measure normal and perceived appropriate portion sizes, a validated online image-series questionnaire consisting of eight successive portion size options for 15 discretionary foods was completed at two timepoints. Quantile regression models were used to estimate the ranges (lower boundary at 17^th percentile, upper boundary at 83^rd percentile) of normal and perceived appropriate portion sizes selected by two thirds of the study population. Models were adjusted for the effects of potential influencing factors including biological sex, age, usual physical activity level, cooking confidence, socio-economic status, body mass index, and baseline hunger levels.</p><p><strong>Results: </strong>A final sample of 295 participants were included in the analysis (51% females, mean age 39.5 ± 14.1 years). The normal portion sizes were significantly higher than the perceived appropriate portion sizes across all test foods, with the effects of sex, age, and BMI being significant for some foods.</p><p><strong>Conclusion: </strong>The finding suggests that consumers would normally consume a portion size that was larger than what they perceive to be appropriate for discretionary foods. The estimated lower and upper boundaries would be valuable for the development of pragmatic public health messages to empower consumers towards better portion control.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of frailty and bedside body composition tools with total body potassium and body cell mass: a pilot study in adults with cirrhosis.","authors":"Ana Teresa Limon-Miro, Karolina Sekulic, Serena Isley, Carla M Prado, Puneeta Tandon","doi":"10.1038/s41430-024-01562-1","DOIUrl":"https://doi.org/10.1038/s41430-024-01562-1","url":null,"abstract":"<p><p>The accurate assessment of body composition in cirrhosis is challenging as fluid accumulation affects most techniques. The whole-body counter is a state-of-the-art method that measures total body potassium (TBK) unbiased by fluid, from which body cell mass (BCM) is derived. This pilot study in 20 patients with cirrhosis evaluated bedside tools including the liver frailty index (LFI), bioimpedance analysis-based phase angle, calf circumference (CC), and BMI (body mass index)/edema-adjusted CC, and explored their association with TBK and BCM. Stepwise multiple linear regression analysis and Pearson's correlation tests were conducted. Adjusted for sex, BCM and TBK were inversely associated with frailty (p < 0.0001). LFI r = -0.568 (p = 0.009), CC r = 0.484 (p = 0.031), and edema-adjusted CC r = 0.467 (p = 0.038), demonstrated moderate correlations with BCM. Further research involving a larger sample of participants is needed to confirm these findings associating these bedside tools and gold-standard body composition measures.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The dynamic effects of nutritional status on chemotherapy-related toxicity in patients with non-Hodgkin's lymphoma.","authors":"Qian Zhou, HeXiang Yang, Xinyue Wang, LiHong Wang, XueQian Yan, BeiRong Zhang, XueHong Ma, GuoHua Li, JingLin Li, JiaHui Zhang, ZhiHong Yan, Ni Bao, Chao Li, Peng Ge, Jia Liu, Xiaoqin Luo","doi":"10.1038/s41430-025-01565-6","DOIUrl":"https://doi.org/10.1038/s41430-025-01565-6","url":null,"abstract":"<p><strong>Background/objectives: </strong>Understanding the dynamic changes in nutritional status of patients with non-Hodgkin's lymphoma (NHL) during chemotherapy is crucial, as it significantly impacts chemotherapy-related toxicity and survival outcomes.</p><p><strong>Subjects/methods: </strong>This multi-center study included newly diagnosed NHL patients. Nutritional status and chemotherapy-related toxic effects were assessed over the first five chemotherapy sessions, with follow-ups conducted every 3 months. Patients were categorized into three groups based on pre-chemotherapy Patient-Generated Subjective Global Assessment (PG-SGA) scores: Group A (0-1), Group B (2-8), and Group C (>9). Repeated-measures ANOVA and Generalized Estimating Equations (GEE) models were used for analysis, with survival outcomes evaluated via Kaplan-Meier and Cox regression.</p><p><strong>Results: </strong>A total of 143 patients (mean age 50.26 ± 15.02 years) completed the study, over a median follow-up of 18.8 months. PG-SGA scores were highest in Group C during chemotherapy (P < 0.001), with significant time-group interaction effects (P < 0.001). Liver and kidney impairments worsened across all groups (P < 0.05), while gastrointestinal toxicity and bone marrow suppression initially decreased before increasing. GEE analysis showed that nutritional status positively influenced gastrointestinal toxicity (β = 0.05, P = 0.001) and bone marrow suppression (β = 0.04, P = 0.014). Malnourished patients exhibited worse pulmonary infection-free survival and overall survival (P < 0.05).</p><p><strong>Conclusions: </strong>NHL patients are highly susceptible to malnutrition during chemotherapy, which exacerbates chemotherapy-related toxicities, particularly gastrointestinal effects and myelosuppression. Maintaining good initial nutrition is vital for reducing toxicities and improving survival outcomes.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutoff points for handgrip strength in patients with liver cirrhosis: a multicenter study.","authors":"Bárbara Chaves Santos, Bruna Cherubini Alves, Ana Luisa Ferreira Fonseca, Samanta Catherine Ferreira, Yani Gláucia Gomide Mizubuti, Camila Saueressig, Ramona Souza da Silva Baqueiro Boulhosa, Lívia Alves Amaral Santos, Carla de Magalhães Cunha, Andre Castro Lyra, Lucivalda Pereira Magalhães Oliveira, Rosângela Passos de Jesus, Fernando Gomes Romeiro, Valesca Dall'Alba, Vivian Cristine Luft, Maria Isabel Toulson Davisson Correia, Lívia Garcia Ferreira, Lucilene Rezende Anastácio","doi":"10.1038/s41430-024-01563-0","DOIUrl":"https://doi.org/10.1038/s41430-024-01563-0","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to define handgrip strength (HGS) cutoff points to predict 1-year mortality in adult patients with liver cirrhosis.</p><p><strong>Methods: </strong>This is an analysis of cohort databases from four reference centers in Brazil. Inpatients or outpatients with cirrhosis and aged ≥18 years were included. The best cutoff values of HGS (highest value from three attempts with the non-dominant hand) for predicting 1-year mortality, stratified by sex and age, were established based on the sensitivity and specificity analyses. Adjusted Cox regression models were used to test the predictive value of low HGS.</p><p><strong>Results: </strong>The study included 724 patients with cirrhosis, with a median age of 57.0 years (IQR: 50.0-63.0), 66.4% (n = 481) male. Most patients had alcoholic cirrhosis (n = 281; 38.8%), 400 (55.3%) were classified as Child-Pugh B or C, and 134 (18.5%) patients died after 1-year. The HGS cutoffs were ≤33 kgf and ≤12 kgf for men and women aged <60 years, respectively, and ≤22 kgf and ≤10 kgf for older men and women, respectively (sensitivity: 70.9%; specificity: 61.2%). Low HGS was associated with a 2.5-fold increase in the risk of 1-year mortality.</p><p><strong>Conclusion: </strong>These cutoff points could be used to identify patients with a higher mortality risk.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaemia and iron deficiency in India: a venous blood-based survey of adolescents, adults, and the elderly in eight states.","authors":"S Ghosh, A Laxmaiah, G R Chandak, I I Meshram, R Raman, S Sengupta, C S Yajnik, A V Kurpad, H S Sachdev","doi":"10.1038/s41430-024-01559-w","DOIUrl":"https://doi.org/10.1038/s41430-024-01559-w","url":null,"abstract":"<p><strong>Background: </strong>Surveys based on capillary blood show that anaemia is rampant in India, but capillary blood haemoglobin (Hb) may not accurately reflect venous blood Hb concentrations. Further, iron deficiency (ID) is thought to be the main cause of anaemia, there are no venous blood-based surveys to confirm this.</p><p><strong>Methods: </strong>A community-based (urban, slum and rural) cross-sectional, venous blood survey was conducted in eight Indian states to estimate anaemia and ID prevalences from Hb and inflammation-corrected plasma ferritin concentrations in adolescents, adults, and elderly.</p><p><strong>Results: </strong>The prevalence of anaemia was 44%, 41% and 45% in adolescent girls, adult and elderly women respectively, compared to 24%, 21% and 37% in adolescent boys, adult, and elderly men. The overall prevalence varied widely, ranging from 12% in Meghalaya to 70% in Assam. Mild anaemia prevalence was predominant at about half of overall anaemia prevalence. ID-associated anaemia (IDA) prevalence was less than a third of the overall anaemia prevalence, and varied among age and sex groups, approaching 45% only in adolescent girls. IDA prevalence was even lower in the mild anaemia group. Thus, the major proportion of anaemia in all groups was associated with 'other' causes.</p><p><strong>Conclusions: </strong>Anaemia prevalence, when measured by venous blood Hb, was substantially lower than earlier capillary blood-based estimates and was predominantly of the mild variety. The prevalence of IDA was also much lower than anticipated; therefore, the aetiological role of ID appears not to be predominant. These results have policy implications for anaemia prevention and correction at the population level.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on recent narrative review for ageing population focused on dysphagia and geriatric nutritional needs.","authors":"Carlo Pedrolli","doi":"10.1038/s41430-024-01560-3","DOIUrl":"10.1038/s41430-024-01560-3","url":null,"abstract":"","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myosteatosis is associated with adiposity, metabolic derangements and mortality in patients with chronic kidney disease.","authors":"Alice Sabatino, Antonio C Cordeiro, Carla M Prado, Bengt Lindholm, Peter Stenvinkel, Carla Maria Avesani","doi":"10.1038/s41430-024-01551-4","DOIUrl":"https://doi.org/10.1038/s41430-024-01551-4","url":null,"abstract":"<p><strong>Background/objectives: </strong>Myosteatosis has been associated with sarcopenia, and increased mortality risk in patients on hemodialysis. We aimed to explore the associations between myosteatosis, as assessed by computed tomography (CT), with demographic parameters, body composition metrics, muscle strength, metabolic parameters and mortality in patients with chronic kidney disease (CKD).</p><p><strong>Subjects/methods: </strong>We enrolled 216 patients (age 60.3 ± 10.6 years, 63% men) with CKD stages 3-5. Abdominal CT scans at the third lumbar vertebra (L3) were used to assess body composition. Abdominal obesity was determined by abdominal adipose tissue (AT), sarcopenia by low skeletal muscle area (SMA) and low handgrip strength. Myosteatosis was evaluated by two parameters using CT scans at L3: mean muscle attenuation and percentage of intermuscular adipose tissue (%IMAT) within SMA. We evaluated the correlation between parameters of myosteatosis with demographic, clinical and metabolic variables. To determine independent predictors of myosteatosis, a multiple linear regression model was fitted. Mortality risk was evaluated with Cox-regression analysis.</p><p><strong>Results: </strong>Both parameters of myosteatosis were independently associated with age, metabolic syndrome, abdominal AT and SMA in the multiple linear regression analysis (adjusted R² for multiple linear regression: muscle attenuation model 0.535, P < 0.001; %IMAT model 0.462, P < 0.001). Moreover, higher %IMAT and lower attenuation were associated with a higher mortality risk.</p><p><strong>Conclusion: </strong>In patients with CKD, increased myosteatosis, as assessed by abdominal CT, was associated with old age, adiposity, metabolic dysfunction, and higher mortality risk.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Greater adherence to the Dietary Approaches to Stop Hypertension (DASH) diet during pregnancy reduces the likelihood of having a large-for-gestational-age newborn.","authors":"Ana Laura Fogaça, Ana Vitória Lanzoni Chaves, Maria Carolina de Lima, Natalia Posses Carreira, Daniela Saes Sartorelli","doi":"10.1038/s41430-024-01561-2","DOIUrl":"https://doi.org/10.1038/s41430-024-01561-2","url":null,"abstract":"<p><strong>Background/objectives: </strong>Studies suggest that greater maternal adherence to the Dietary Approaches to Stop Hypertension (DASH) diet reduces the risk of both maternal and fetal adverse health outcomes. The study aimed to evaluate the relationship between adherence to the DASH diet during pregnancy and the classification of birth weight according to gestational age.</p><p><strong>Subjects/methods: </strong>Secondary analysis of a prospective cohort of 601 mother and child pairs who attended primary healthcare in a Brazilian municipality. Dietary intake was estimated based on 24 h recall and a Food Frequency Questionnaire. Data on gestational duration, birth weight, and newborn sex were obtained from the Live Birth Information System. The relationship between adherence to the DASH diet and birth weight categories was investigated using logistic regression models adjusted for confounding factors.</p><p><strong>Results: </strong>In total, 10.3% of newborns were classified as small for gestational age (SGA), and 13.3% as large for gestational age (LGA). There was low adherence to the healthy components of the DASH diet. However, it was observed that pregnant women classified in the third tertile of the DASH diet score had a lower chance of having LGA newborns [OR 0.51 (95% CI 0.28; 0.94), p = 0.03]. There was no association between adherence to the DASH diet and SGA newborns [OR 0.87 (95% CI 0.42; 1.84), p = 0.65].</p><p><strong>Conclusion: </strong>Despite the low adherence to the DASH diet between Brazilian pregnant women, higher adherence scores in its components had a lower chance of having LGA newborns.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}