Indian Journal of Endocrinology and Metabolism最新文献

{"title":"A Young Man with a Limp-Hypothyroidism Presenting with Slipped Capital Femoral Epiphysis.","authors":"Dharaneswari Hari Narayanan, Asha Ranjan, Adlyne R Asirvatham, Shriraam Mahadevan","doi":"10.4103/ijem.ijem_406_23","DOIUrl":"10.4103/ijem.ijem_406_23","url":null,"abstract":"","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 2","pages":"227-228"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11189289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442564","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":"Generation of South Indian Data for Normal Clitoral Dimensions and Anogenital Ratio in Term Neonates.","authors":"K Priyadarshini, Swathi Padankatti, Shriraam Mahadevan","doi":"10.4103/ijem.ijem_145_23","DOIUrl":"10.4103/ijem.ijem_145_23","url":null,"abstract":"<p><strong>Introduction: </strong>Assessment of genitalia is an important part of the neonatal examination. Regional, racial, and ethnic variations in phallic length have been documented. Clitoral dimensions may also show similar variations. Normal values for neonatal clitoral measurements may help the pediatrician/neonatologist to accurately diagnose clitoromegaly and underlying etiology to guide appropriate investigations. Data on clitoral measurements is limited with only one study from India (Kolkata). Hence we aimed in this study to generate south Indian data on neonatal clitoral dimensions, anogenital distance, and anogenital ratio. Two hundred and fifty two hemodynamically stable term female neonates without ambiguous genitalia/vulval masses born in a community hospital. Hospital-based cross-sectional study. 1. To measure clitoral dimensions, anogenital distance, and anogenital ratio in female neonates. 2. To correlate clitoral dimensions, anogenital distance, and ratio with anthropometric measurements, gestational age, and maternal comorbidities.</p><p><strong>Methods: </strong>Measurements were recorded using a digital vernier caliper, under strict aseptic precautions with labia majora gently separated and the baby held in a frog-leg position. Clitoral length, width, and anogenital distance were measured and anogenital ratio and clitoral index were calculated.</p><p><strong>Results: </strong>In term neonates, the mean ± SD of clitoral length (CL), clitoral width (CW), anogenital ratio (AGR) were 6.34 ± 1.75 mm, 6.39 ± 1.27 mm and 0.39 ± 0.05, respectively. The 3^rd and 97^th centiles for mean clitoral length were 3.55 and 9.93 mm, for mean clitoral width were 3.37 and 8.35 mm, and for AGR were 0.28 and 0.48, respectively. These clitoral dimensions in south Indian neonates were higher than those from East India (Kolkata), lower than Nigerian babies, and similar to Israeli neonates. Mean CL and CW had no statistical correlation with birth weight, gestational age, head circumference, or length in term neonates. A significant correlation was noted between pregnancy-induced hypertension and mean clitoral width, and between gestational diabetes and AGR.</p><p><strong>Conclusion: </strong>Normative values for clitoral dimensions (length and width) and AGR for south Indian term female neonates have been established. 97^th centiles of 9.93 mm (CL) and 8.35 mm (CW) and 0.48 mm (AGR) may be used as practical cut-offs to diagnose clitoromegaly and virilization. Clitoral measurements had no statistical correlation with birth weight, gestational age, or anthropometry. Clitoral measurements exhibit ethnic and racial differences, thus emphasizing the importance of regional cut-offs and need for more studies from different parts of India on CL.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 2","pages":"208-212"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11189291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442535","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":"Comparison of WHO 2006 Growth Standards and Synthetic Indian References in Assessing Growth in Normal Children and Children with Growth-Related Disorders.","authors":"Nimisha Shankar Dange, Vaman Khadilkar, Vrushali Kore, Shruti Mondkar, Sushil Yewale, Ketan Gondhalekar, Anuradha V Khadilkar","doi":"10.4103/ijem.ijem_380_23","DOIUrl":"10.4103/ijem.ijem_380_23","url":null,"abstract":"<p><strong>Introduction: </strong>A good screening tool, such as a growth chart, should distinguish between children with normal growth and those with perturbed growth. Suitability of synthetic Indian growth references for diagnosing growth-related disorders for under-five children has not been evaluated. To assess the validity of World Health Organization (WHO) 2006 standards vs synthetic Indian references (2019) (by comparing weight, height, body mass index (BMI), standard deviation scores (SDS) and the composite index of anthropometric failure (CIAF)) in differentiating normal children and children with growth-related disorders.</p><p><strong>Methods: </strong>Records of 2188 children (0-60 months) attending a tertiary centre paediatric outpatient department (OPD) were retrospectively studied; 1854 children were healthy and 334 were diagnosed with growth-related disorders as per the European Society for Paediatric Endocrinology (ESPE) classification. The anthropometric parameters converted to Z-scores for weight-for-age (WAZ), height-for-age (HAZ), BMI-for-age (BAZ) and a CIAF were computed using WHO and synthetic charts; Student's <i>t</i>-test was used for assessing differences and Youden's index for validity.</p><p><strong>Results: </strong>Disease status of children and anthropometric failure on WAZ, HAZ, BAZ and CIAF on both WHO and synthetic charts had a significant association (<i>P</i>-value <0.05). WAZ, HAZ on both charts and CIAF on synthetic chart had a fair to moderate agreement (Kappa statistics) with disease status as per diagnosis (<i>P</i>-value <0.05). The sensitivity and negative predictive value for all anthropometric parameters were higher for synthetic charts.</p><p><strong>Conclusion: </strong>Indian charts were more sensitive for diagnosing growth-related disorders from birth to 60 months of age when compared to WHO growth standards.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 2","pages":"220-226"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11189285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442566","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":"Role of Dietary Macronutrient Composition and Fibre Intake in Development of Double Diabetes in Indian Youth.","authors":"Chirantap Oza, Rubina Mandlik, Anuradha V Khadilkar, Ketan M Gondhalekar, Vaman V Khadilkar","doi":"10.4103/ijem.ijem_90_23","DOIUrl":"10.4103/ijem.ijem_90_23","url":null,"abstract":"<p><strong>Introduction: </strong>Insulin resistance (IR) and obesity are common presentations of double diabetes (DD) in subjects with type-1 diabetes (T1D). There is evidence that dietary composition has an impact on developing IR. Objectives were to assess the impact of macronutrient and fibre intake on glycaemic control and the role of macronutrient composition of diet in the development of DD in subjects with T1D.</p><p><strong>Methods: </strong>This cross-sectional study included 77 young adults (10-25 years) with T1D. Data related to demography, anthropometry, biochemistry and body composition were collected. Dietary data was collected by fourteen-day food diary. IR was calculated using eGDR, SEARCH and CACTI equations, and metabolic syndrome (MS) was diagnosed using the International Diabetes Federation Consensus Definition.</p><p><strong>Results: </strong>Subjects at risk of DD had higher age, leptin levels, percentage carbohydrate consumption in diet and IR. A positive association of insulin sensitivity with fibre intake and %protein intake was noted. Poor glycaemic control, adiponectin/leptin ratio, fibre intake and insulin/carbohydrate ratio were significant negative predictors of IR. Addition of dietary factors to the regression model improved the R square and percentage of subjects identified correctly. Inclusion of dietary parameters significantly improves the prediction of the risk of development of DD in subjects with T1D.</p><p><strong>Conclusion: </strong>Good glycaemic control and increased intake of dietary fibre may prevent the development of IR in subjects with T1D and reduce the burden of DD.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 2","pages":"213-219"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11189281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442567","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":"Tackling the Rising Tide: Understanding the Prevalence of Childhood Obesity in India.","authors":"Jubbin Jagan Jacob","doi":"10.4103/IJEM.IJEM_144_24","DOIUrl":"10.4103/IJEM.IJEM_144_24","url":null,"abstract":"","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 2","pages":"101-103"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11189283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442570","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":"Type 1 Diabetes in Singapore: Self-Care Challenges, Diabetes Technology Awareness, Current Use, and Satisfaction, an Online Survey.","authors":"Suresh Rama Chandran, Cindy Ho, Ester Yeoh, Daphne Gardner","doi":"10.4103/ijem.ijem_369_22","DOIUrl":"10.4103/ijem.ijem_369_22","url":null,"abstract":"<p><strong>Introduction: </strong>To describe the self-care challenges, diabetes technology awareness, current use, and satisfaction among adults with type 1 diabetes and parents of children with type 1 diabetes in Singapore.</p><p><strong>Methods: </strong>An anonymous online survey was administered between November 2020 and October 2021. Data are presented as mean (standard deviation) or count (percentages). Comparisons between groups were done using the independent samples T-test.</p><p><strong>Results: </strong>251 people (176 adults, 75 parents) participated. The most challenging self-care burdens were carbohydrate counting (24.4%) among adults and insulin dose calculations (28%) among parents. Nocturnal awakenings for diabetes care of their child were a common event (25.3%). Despite high awareness about continuous glucose monitoring devices (77.8% adults, 78.7% parents) the use (24.9% adults, 55% children) remained low. Both adults and parents of children with type 1 diabetes found continuous glucose monitoring to be liberating and less restrictive. Despite overall low insulin pump use (23.9% adults, 29.3% children); satisfaction scores were higher among insulin pump users than insulin pen users (<i>P</i> = 0.02).</p><p><strong>Conclusion: </strong>Carbohydrate counting and insulin dose calculations were the most challenging self-care tasks among people with type 1 diabetes in Singapore. Diabetes technology use was relatively low in Singapore. Continuous glucose monitoring and Insulin pump users found them to be beneficial.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 2","pages":"167-176"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11189278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442572","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":"The Effects of Prolonged Use of Caffeine on Thyroid and Adrenal Glands: A Retrospective Cohort Study","authors":"Vasishtha A. Upadrasta","doi":"10.4103/ijem.ijem_313_23","DOIUrl":"https://doi.org/10.4103/ijem.ijem_313_23","url":null,"abstract":"\u0000 \u0000 \u0000 Caffeine consumption has skyrocketed in recent decades as we try to match the pace with the machines. Studies have been conducted on animals and a few on humans, mainly on the acute effects of high-dose caffeine intake. Almost none have been conducted on the chronic effects of caffeine consumption. This study involved medical professionals as case subjects, who consumed caffeine daily.\u0000 \u0000 \u0000 \u0000 This study, for 3 months, involved 96 volunteers (chosen randomly w.r.t. gender and field in the medical fraternity), including people who drank >500 mg of caffeine a day and people who consumed none. People with any comorbidities at all were excluded straight away. Two sets of blood samples were drawn and assessed. Three groups were created: group 1 (>200 mg caffeine/day), group 2 (15–200 mg caffeine/day) and group 3 (<200 mg caffeine/day).\u0000 \u0000 \u0000 \u0000 The result of the study found that exposure to caffeine at doses >200 mg/day for more than 6 months leads to a significant difference in circulating free T3 ((-0.96 pmol/L ± 0.07) = (-18.5%), 95% confidence interval (CI), P = .000024) and cortisol ((-123 nmol/L ± 9.8) = (-46.8%), 95% CI, P = .00029) hormones but shows an insignificant effect on circulating thyroid-stimulating hormone (TSH) (0.4 mIU/L, 95% CI, P = .37) and adrenocorticotrophic hormone (ACTH) ((-3.2 pg/ml ± 0.3), 95% CI, P = .53) hormones, which stay within normal physiological ranges, irrespective of the daily dose of consumption. Results also highlight that women are more susceptible to a decrement in fT3 than men (relative risk = 1.58, analysis of variance (ANOVA) F-static = 7.15, P = 0.0105).\u0000 \u0000 \u0000 \u0000 Caffeine consumption in excess of 200 mg/day, for more than or equal to 6 months, causes significant derangement in basal fT3 and cortisol hormone levels, without affecting the TSH and ACTH (regulatory) hormone levels, indicating disturbance of action at the peripheral and/or cellular levels, possibly via the paraventricular nucleus (PVN)–leptin–CAR–adenosine interactions. Women are more susceptible to a decrement in fT3 levels than men (at the same dose of caffeine).\u0000","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"21 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139783462","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":"The Effects of Prolonged Use of Caffeine on Thyroid and Adrenal Glands: A Retrospective Cohort Study","authors":"Vasishtha A. Upadrasta","doi":"10.4103/ijem.ijem_313_23","DOIUrl":"https://doi.org/10.4103/ijem.ijem_313_23","url":null,"abstract":"\u0000 \u0000 \u0000 Caffeine consumption has skyrocketed in recent decades as we try to match the pace with the machines. Studies have been conducted on animals and a few on humans, mainly on the acute effects of high-dose caffeine intake. Almost none have been conducted on the chronic effects of caffeine consumption. This study involved medical professionals as case subjects, who consumed caffeine daily.\u0000 \u0000 \u0000 \u0000 This study, for 3 months, involved 96 volunteers (chosen randomly w.r.t. gender and field in the medical fraternity), including people who drank >500 mg of caffeine a day and people who consumed none. People with any comorbidities at all were excluded straight away. Two sets of blood samples were drawn and assessed. Three groups were created: group 1 (>200 mg caffeine/day), group 2 (15–200 mg caffeine/day) and group 3 (<200 mg caffeine/day).\u0000 \u0000 \u0000 \u0000 The result of the study found that exposure to caffeine at doses >200 mg/day for more than 6 months leads to a significant difference in circulating free T3 ((-0.96 pmol/L ± 0.07) = (-18.5%), 95% confidence interval (CI), P = .000024) and cortisol ((-123 nmol/L ± 9.8) = (-46.8%), 95% CI, P = .00029) hormones but shows an insignificant effect on circulating thyroid-stimulating hormone (TSH) (0.4 mIU/L, 95% CI, P = .37) and adrenocorticotrophic hormone (ACTH) ((-3.2 pg/ml ± 0.3), 95% CI, P = .53) hormones, which stay within normal physiological ranges, irrespective of the daily dose of consumption. Results also highlight that women are more susceptible to a decrement in fT3 than men (relative risk = 1.58, analysis of variance (ANOVA) F-static = 7.15, P = 0.0105).\u0000 \u0000 \u0000 \u0000 Caffeine consumption in excess of 200 mg/day, for more than or equal to 6 months, causes significant derangement in basal fT3 and cortisol hormone levels, without affecting the TSH and ACTH (regulatory) hormone levels, indicating disturbance of action at the peripheral and/or cellular levels, possibly via the paraventricular nucleus (PVN)–leptin–CAR–adenosine interactions. Women are more susceptible to a decrement in fT3 levels than men (at the same dose of caffeine).\u0000","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"224 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139843321","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":"Starving for a Cure.","authors":"S V Madhu, Nishant Raizada","doi":"10.4103/IJEM.IJEM_63_24","DOIUrl":"10.4103/IJEM.IJEM_63_24","url":null,"abstract":"","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10962772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293451","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":"Accuracy of a Non-Invasive Home Glucose Monitor for Measurement of Blood Glucose.","authors":"Himel Mondal, Sairavi Kiran Biri, Neha Pipil, Shaikat Mondal","doi":"10.4103/ijem.ijem_36_23","DOIUrl":"10.4103/ijem.ijem_36_23","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with diabetes mellitus monitor their blood glucose at home with monitors that require a drop of blood or use a continuous glucose monitoring device that implants a small needle in the body. However, both cause discomfort to the patients which may inhibit them for regular blood glucose checks. Photoplethysmogram (PPG) sensing technology is an approach for non-invasive blood glucose measurement and PPG sensors can be used to predict hypoglycaemic episodes. InChcek is a PPG-based non-invasive glucose monitor. However, its accuracy has not been checked yet. Hence, this study aimed to evaluate the accuracy of InCheck, a non-invasive glucose monitor for the estimation of blood glucose.</p><p><strong>Methods: </strong>In a tertiary care hospital, patients who came for blood glucose estimation were tested for blood glucose non-invasively on the InCheck device and then by the laboratory method (glucose oxidase-peroxidase). These two readings were compared. We used International Organization for Standardization (ISO) 15197:2013 (95% of values should be within ± 15 mg/dL of reference reading if reference glucose <100 mg/dL or within ± 15% of reference reading if reference glucose ≥100 mg/dL and 99% of the values should be within zones A and B in consensus error grid), and Surveillance Error Grid for analyzing the accuracy.</p><p><strong>Results: </strong>A total of 1223 samples were analyzed. There was a significant difference between the reference method glucose level (135 [Q1-Q3: 97 - 179] mg/dL) and monitor-measured glucose level (188.33 [Q1-Q3: 167.33-209.33] mg/dL) (P < 0.0001). A total of 18.5% of readings were following ISO 15197:2013 criteria and 67.25% of coordinates were within zone A and zone B of the consensus error grid. In the surveillance error grid analysis, about 29.4% of values were in the no-risk zone, 51.8% in slight risk, 18.6% in moderate risk, and 0.2% were in the severe risk zone.</p><p><strong>Conclusion: </strong>The accuracy of the InCheck device for the estimation of blood glucose by PPG signal is not following the recommended guidelines. Hence, further research is necessary for programming or redesigning the hardware and software for a better result from this optical sensor-based non-invasive home glucose monitor.</p>","PeriodicalId":13353,"journal":{"name":"Indian Journal of Endocrinology and Metabolism","volume":"28 1","pages":"60-64"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10962770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293438","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}