Journal of diabetes and its complications最新文献

{"title":"The role of circRNA in insulin resistance and its progression induced by adipose inflammation","authors":"Yifei Liu ,&nbsp;Jie Yue ,&nbsp;Yuxia Jiang ,&nbsp;Xu Tian ,&nbsp;Aihua Shu","doi":"10.1016/j.jdiacomp.2025.109042","DOIUrl":"10.1016/j.jdiacomp.2025.109042","url":null,"abstract":"<div><div>CircRNAs refer to a type of closed circular non-coding RNA without a 5′ cap or a 3′ poly (A) structure. They are largely distributed in the cytoplasm or localized in exosomes and cannot be easily degraded by RNA exonuclease activity. Their stable expression is broadly observed across eukaryotic species. Insulin resistance (IR) refers to the inability of insulin to exert its normal biological function, as manifested by the impairment of glucose utilization in peripheral tissues (e.g., muscle and fat tissues). IR is a key factor in the pathogenesis of Type 2 diabetes (T2D) and is closely associated with obesity. Recent studies have shown that certain circRNAs play critical roles in obesity-induced diabetes by regulating IR and participating in inflammatory processes. CircRNAs, with their multiple microRNA (miRNA) binding sites, act as miRNA sponges to eliminate the inhibitory actions of miRNAs and up-regulate the expression of target genes. CircRNAs play a significant role in regulating obesity-induced diabetes through their interactions with disease-related miRNAs. In the present study, we explored the biological characteristics of circRNAs and extensively discussed the role of circRNAs in the development of inflammation and IR in adipocytes, highlighting their potential as therapeutic targets for obesity-induced diabetes. Specific circRNAs (e.g., circARF3 and circ-ZNF609) have been identified as key players in modulating IR and inflammatory responses in adipose tissue. CircRNAs are emerging as important regulators of IR and inflammation in adipocytes, with significant potential for therapeutic intervention in obesity-induced diabetes. Further research is needed to elucidate the mechanisms underlying their actions and to explore strategies for targeting circRNAs in clinical applications.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 7","pages":"Article 109042"},"PeriodicalIF":2.9,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870502","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":"Body-weight functional exercise promotes greater and safer blood glucose reduction compared to aerobic and strength exercises in type 1 diabetics: a randomised crossover study","authors":"Pooya Soltani ,&nbsp;Fernanda Mendes Almeida ,&nbsp;Hildene Carneiro de Castro Melo ,&nbsp;Guilherme Bruno Santiago Ferreira ,&nbsp;Leiticiany Melo dos Santos ,&nbsp;Jorge Luiz de Brito Gomes","doi":"10.1016/j.jdiacomp.2025.109043","DOIUrl":"10.1016/j.jdiacomp.2025.109043","url":null,"abstract":"<div><h3>Aims</h3><div>Aerobic and strength exercises are commonly recommended for patients with type-1 diabetes (T1DM) but may not suit everyone. Body-weight functional exercise (BWFE) could offer an alternative for diabetes management. We aimed to compare blood glucose (BG), cardiovascular responses and enjoyment levels following a 30-min session of BWFE versus interval aerobic exercise (IAE) and strength exercise (STE) in patients with T1DM.</div></div><div><h3>Methods</h3><div>Ten T1DM participants (seven female) completed three randomised exercise sessions. BG, heart rate (HR), blood pressure (BP) and double product (DP) were measured before (PRE), immediately after (POST-0) and 20 min post-exercise (POST-20). Maximum and average HR were recorded, and enjoyment levels (EL) were assessed post-exercise. Statistical analysis used generalised estimated equations, with minimal detectable difference for assessing clinical significance.</div></div><div><h3>Results</h3><div>We observed clinically meaningful reductions in BG after all sessions, but only BWFE showed a statistically significant drop at POST-0 (−2.2 mmol/L) without hypoglycaemia. HR, BP and DP responses were similar across sessions. BWFE showed the highest EL and maximal HR.</div></div><div><h3>Conclusions</h3><div>BWFE effectively lowered BG safely and provided comparable cardiovascular effects to IAE and STE while being more enjoyable. These findings support incorporating functional exercises into T1DM management to encourage sustained physical activity.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 7","pages":"Article 109043"},"PeriodicalIF":2.9,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874735","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 effects of SGLT2 inhibitors and GLP-1 receptor agonists on the triglyceride to HDL cholesterol ratio and the triglyceride-glucose index in patients with type 2 diabetes","authors":"Dimitra Voziki ,&nbsp;Georgios Dimakopoulos ,&nbsp;Ioannis Stergiou ,&nbsp;Ioanna Zografou ,&nbsp;Manfredi Rizzo ,&nbsp;Evangelos N. Liberopoulos ,&nbsp;Kalliopi Kotsa ,&nbsp;Theocharis Koufakis","doi":"10.1016/j.jdiacomp.2025.109044","DOIUrl":"10.1016/j.jdiacomp.2025.109044","url":null,"abstract":"<div><div>We analyzed the medical records of 100 patients with type 2 diabetes to evaluate the effects of new antidiabetic drugs on the TG/HDL-C ratio and the TG-glucose index. We found that GLP-1 RA treatment significantly improved both markers, while SGLT2 inhibitors led to significant reductions only in the latter.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 6","pages":"Article 109044"},"PeriodicalIF":2.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848128","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":"Semaglutide, central retinal thickness and continuous glucose monitoring in persons with type 2 diabetes: A post-hoc analysis from a randomised trial","authors":"Søren Gullaksen ,&nbsp;Liv Vernstrøm ,&nbsp;Steffen Skovgaard Sørensen ,&nbsp;Kristian Løkke Funck ,&nbsp;Line Petersen ,&nbsp;Toke Bek ,&nbsp;Per Løgstrup Poulsen ,&nbsp;Esben Laugesen","doi":"10.1016/j.jdiacomp.2025.109039","DOIUrl":"10.1016/j.jdiacomp.2025.109039","url":null,"abstract":"<div><h3>Aims</h3><div>Glycemic control is important for preventing diabetic retinopathy (DR), but rapid improvements could deteriorate the disease. In some, but not all studies, semaglutide is speculated to worsen DR, but the mechanism is unknown. Central retinal thickness (CRT) is an early marker of DR. Therefore, the objective was to investigate whether increased Time in Range (TIR (3.9–10.0 mmol/L)), was associated with reduced CRT in persons treated with semaglutide.</div></div><div><h3>Methods</h3><div>Forty participants with type 2 diabetes were included in this post-hoc analysis of a 32-week randomised, placebo-controlled, partly open-label trial investigating the separate and combined effects of semaglutide and empagliflozin on target organ damage in 120 participants with type 2 diabetes. Individuals were randomised into four groups: i) semaglutide, ii) empagliflozin, iii) the combination or iv) placebo, <em>n</em> = 30 for each group). In the present study, 10 participants from each of the 4 arms participated. TIR was assessed using Continuous Glucose Measurement for 7–8 days and CRT was assessed using ocular coherence tomography.</div></div><div><h3>Results</h3><div>In the 10 individuals treated with semaglutide, CRT increased ~1 % (3.76 μm, 95%CI [−0.32; 7.85], <em>p</em> = 0.065) compared to placebo. This was attenuated with adjustment for TIR (<em>p</em> = 0.21).</div><div>Independently of the four interventions, increased TIR remained associated with increased CRT (0.07 μm, 95%CI[0.03; 0.12]μm, <em>p</em> = 0.002).</div></div><div><h3>Conclusion</h3><div>Semaglutide treatment did not impact CRT beyond what could be explained by changes in glycaemia. Across all interventions, increased TIR was associated with increases in CRT, thus supporting the link between rapid improved glycemia and DR.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 6","pages":"Article 109039"},"PeriodicalIF":2.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829425","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":"Contents/Barcode","authors":"","doi":"10.1016/S1056-8727(25)00080-7","DOIUrl":"10.1016/S1056-8727(25)00080-7","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 5","pages":"Article 109027"},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective study to investigate the risk factors for gestational diabetes mellitus and its impact on maternal and neonatal outcomes","authors":"Xiujuan Zhang ,&nbsp;Yonghui Wang ,&nbsp;Huirong Zhao ,&nbsp;Shenglin Chen ,&nbsp;Xia Gao","doi":"10.1016/j.jdiacomp.2025.109035","DOIUrl":"10.1016/j.jdiacomp.2025.109035","url":null,"abstract":"<div><h3>Background</h3><div>Currently, risk factors for gestational diabetes mellitus (GDM) and its impact on maternal and neonatal outcomes have not been fully elucidated. Therefore, we performed a retrospective epidemiologic study to explore the above research objectives.</div></div><div><h3>Methods</h3><div>We collected extensive clinical data from January 2020 to June 2023 for 855 maternity cases at the Department of Obstetrics and Gynecology, Chaoyang Hospital, Capital Medical University. Vitamin D deficiency, undergoing assisted reproductive techniques, advanced maternal age (≥35), multiparas, abortion history, pre-pregnancy body mass index (≥25.0), twin pregnancy, polycystic ovary syndrome (PCOS), family history of diabetes, history of delivering a low-birth-weight infant, and weight gain during gestation of &gt;2 kg per month (mean) as variables that may affect GDM to investigate the risk factors for GDM. In addition, a total of 15 adverse postpartum outcomes (including maternal complications and neonatal complications) were used to explore the adverse effects of maternal comorbidity with GDM. Variables that were significant in the univariate logistic regression model were included in the multivariate logistic regression model. Receiver operating characteristic (ROC) curves were conducted for the ability to predict the risk of the GDM and its impact on maternal and neonatal outcomes, using variables derived from the multivariate logistic regression models.</div></div><div><h3>Results</h3><div>The results of multivariate logistic regression analyses shown that only multipara was not a risk factor for the development of GDM. Postpartum hemorrhage (blood loss ≥500 ml) and the neonatal Apgar score (≤9) (all <em>P</em> &gt; 0.05) was excluded in the multivariate logistic regression model. According to the results of multivariate logistic regression analyses, the incidence of hypothyroid complications, hyperlipidemic complications, postpartum anemia, gestational hypertension, racket placenta, premature rupture of membranes, fetal malposition, macrosomia (≥4000 g), low-birth-weight infants (&lt;2500 g), prematurity, neonatal infections, neonatal jaundice, and fetal distress was higher in pregnancies with combined GDM (all <em>P</em> &lt; 0.05). The model demonstrated excellent diagnostic performance, with an area under the ROC curve of 0.91, indicating its efficacy in predicting adverse prognostic outcomes associated with maternal GDM.</div></div><div><h3>Conclusions</h3><div>It is essential for women of childbearing age to correct vitamin D deficiency as well as to maintain their body mass index within the normal range before preparing for pregnancy. Maternal weight gain needs to be managed appropriately throughout pregnancy, which may reduce the risk of GDM to some extent. Therefore, our results suggest that effective measures to reduce the risk of GDM are essential for both the mother and the newborn.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 6","pages":"Article 109035"},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816651","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":"Postpartum diabetes mellitus among patients with early gestational diabetes: A systematic review and meta-analysis","authors":"Sarah J. Weingarten ,&nbsp;Ariel T. Levy ,&nbsp;Huda B. Al-Kouatly ,&nbsp;Rodney A. McLaren Jr.","doi":"10.1016/j.jdiacomp.2025.109038","DOIUrl":"10.1016/j.jdiacomp.2025.109038","url":null,"abstract":"<div><h3>Aims</h3><div>It is unclear whether patients diagnosed with early gestational diabetes mellitus (GDM) (&lt;24 weeks) are at higher risk of diabetes mellitus (DM) in the postpartum period compared to those with standard GDM (diagnosed ≥24 weeks). This study assessed if rate of DM diagnosed postpartum differs among patients with early versus standard GDM.</div></div><div><h3>Methods</h3><div>PubMed, EMBASE, WHO ICTRP, Clinicaltrials.gov and Cochrane Central Register of Controlled Trials were searched from inception to March 2023. Randomized controlled trials or observational studies that assessed rate of postpartum DM among patients with early GDM were included. Primary outcome was rate of DM diagnosed postpartum. Secondary outcomes were postpartum visit attendance, completion and results of postpartum oral glucose tolerance testing, and glycated hemoglobin (HbA1c) levels.</div></div><div><h3>Results</h3><div>Of 5682 studies screened, 11 met inclusion criteria (N = 1573 early GDM vs. N = 3340 standard GDM). Patients with early GDM had mean age of 30.2–37.0 years and mean body mass index (BMI) of 24.4–35.6 kg/m², while the standard group had a mean age of 28.9–32.8 years and mean BMI of 23.6–36.0 kg/m². Most studies evaluated postpartum glucose tolerance at 5–12 weeks, though one followed patients up to six years postpartum. Overall, patients with early GDM were more likely to be diagnosed with DM postpartum than those with standard GDM (12.8 % vs. 6.1 %, RR 1.89, 95 % CI 1.10–3.24). Impaired glucose tolerance was also higher in patients with early GDM (24.7 % vs. 13.0 %, RR 1.84, 95 % CI 1.32–2.57).</div></div><div><h3>Conclusions</h3><div>Rate of DM diagnosed postpartum was higher in patients with early GDM compared to standard GDM.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 6","pages":"Article 109038"},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829424","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":"Comments on the article “the association between age at diagnosis of diabetes and development of diabetic retinopathy and assessment of healthcare access as an effect modifier “","authors":"Víctor Manuel Asensio-Sánchez","doi":"10.1016/j.jdiacomp.2025.108948","DOIUrl":"10.1016/j.jdiacomp.2025.108948","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 6","pages":"Article 108948"},"PeriodicalIF":2.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816650","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":"Growth differentiation factor-15: A marker for diabetic kidney disease in patients with metabolic-associated fatty liver disease","authors":"Hassan A. Shora ,&nbsp;Ibrahim M. EL-Deen ,&nbsp;Naglaa M. El-Lithy ,&nbsp;Dina M. Abo-Elmatty ,&nbsp;Salma M. Khirallah","doi":"10.1016/j.jdiacomp.2025.109037","DOIUrl":"10.1016/j.jdiacomp.2025.109037","url":null,"abstract":"<div><h3>Background</h3><div>Growth/differentiation factor-15 (GDF-15) plays a crucial role in modulating inflammation and fibrosis and is emerging as a potential biomarker in metabolic diseases. This study investigated the association between circulating GDF-15 levels and the development of diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM), with or without metabolic dysfunction-associated fatty liver disease (MAFLD).</div></div><div><h3>Methods</h3><div>In this prospective observational study, participants were stratified into three groups: those with T2DM and MAFLD (Group A) and those with T2DM and no MAFLD (Group B), alongside a healthy control group (Group C). Comprehensive clinical evaluations and laboratory assessments, including measurements of GDF-15, metabolic profiles, liver enzymes, and renal function, were performed.</div></div><div><h3>Results</h3><div>GDF-15 levels demonstrated a stepwise elevation from controls to T2DM patients, with the highest levels observed in patients with MAFLD (1929 ± 412 pg/mL in Group A, 1655 ± 368 pg/mL in Group B, and 1246 ± 245 pg/mL in Group C; p &lt; 0.001). DKD was diagnosed in 51.4 % of patients in Group A compared to 37.1 % in Group B (p &lt; 0.001). Multivariate analysis identified GDF-15 as the sole independent predictor of DKD (p = 0.01). ROC curve analysis revealed that a GDF-15 cutoff value of ≥1890.51 pg/mL provided an AUC of 0.951, with a sensitivity of 94.2 % and specificity of 87.1 %.</div></div><div><h3>Conclusion</h3><div>Elevated GDF-15 levels are independently associated with an increased risk of DKD in T2DM patients, particularly in those with MAFLD. These findings highlight the potential of GDF-15 as an early biomarker for DKD.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 6","pages":"Article 109037"},"PeriodicalIF":2.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826463","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":"Inflammation levels in type 2 diabetes mellitus patients with mild cognitive impairment: Assessment followed by amelioration via dapagliflozin therapy","authors":"Wei Zhang ,&nbsp;Chunping Sun ,&nbsp;Yating Huang ,&nbsp;Meng Zhang ,&nbsp;Ao Xu ,&nbsp;Chen Wang ,&nbsp;Fang Lv ,&nbsp;Tianrong Pan","doi":"10.1016/j.jdiacomp.2025.109017","DOIUrl":"10.1016/j.jdiacomp.2025.109017","url":null,"abstract":"<div><h3>Aims</h3><div>To investigate systemic inflammation and the effect of dapagliflozin treatment in (type 2 diabetes mellitus) T2DM patients with mild cognitive impairment (MCI).</div></div><div><h3>Methods</h3><div>Between January and December 2023, 200 participants were recruited from the Department of Endocrinology of Hefei First People's Hospital. Baseline data collected included medical history, fasting blood glucose, HbA1c, liver and kidney function, lipid profiles, IL-1β, TNF-α, sVCAM-1 level, and the urinary albumin-creatinine ratio (uACR). Based on their Montreal Cognitive Assessment Scale (MoCA) scores, these participants were categorized into two groups: 127 in the MCI group and 73 in the non-MCI group. MCI group received dapagliflozin (10 mg daily) alongside standard treatment.</div></div><div><h3>Results</h3><div>The MCI group showed higher age, height, weight, BMI, HbA1c, FBG, disease duration, carotid plaques, stenosis rates, and elevated IL-1β, TNF-α, and sVCAM-1. MoCA scores were significantly lower in the MCI group. Correlation analysis showed a negative correlation of MoCA scores with IL-1β, TNF-α, sVCAM-1, plaques, stenosis, FBG, and HbA1c, and a positive correlation with height. Binary logistic regression identified age, BMI, IL-1β, sVCAM-1, and FBG as predictors of cognitive impairment in T2DM. Dapagliflozin treatment reduced BMI, HbA1c, inflammatory markers, and FBG, improving MoCA scores.</div></div><div><h3>Conclusion</h3><div>Dapagliflozin treatment may improve cognitive function by reducing inflammation.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 6","pages":"Article 109017"},"PeriodicalIF":2.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824090","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}