Reviews in Endocrine & Metabolic Disorders最新文献

{"title":"Exploring the relationship between glycemic variability and muscle dysfunction in adults with diabetes: A systematic review.","authors":"Shanshan Lin, Sof Andrikopoulos, Yan-Chuan Shi, David Sibbritt, Wenbo Peng","doi":"10.1007/s11154-025-09942-z","DOIUrl":"10.1007/s11154-025-09942-z","url":null,"abstract":"<p><p>This review is to systematically explore the relationship between muscle dysfunction and diabetes in adults, and to examine the impact of glycemic variability on muscle health and the development of diabetes-related complications. The review was conducted using three databases: MEDLINE, Scopus, and EMBASE, targeting peer-reviewed journal articles written in English and published from January 2014 to September 2024. The methodological quality assessment of the eligible studies was conducted using Joanna Briggs Institute Critical Appraisal Checklists. A total of 17 studies were included. Most studies were undertaken in Asian countries (n = 11) and focused on adults with type 2 diabetes (n = 12). There were 8,392 adults with diabetes, and their mean age ranged from 52 to 75 years old. The measurements for muscle function and glycemic variability varied across studies. The research findings regarding the relationship between muscle dysfunction and glycemic variability metrics among adults with diabetes, both with and without complications were inconsistent. For adults with diabetes and sarcopenic obesity, poor glycemic control was identified as an independent risk factor for sarcopenic obesity. Additionally, all included studies were rated as moderate or high quality in relation to their methodology. In conclusion, this review underscores the complex and inconsistent relationship between glycemic variability and muscle dysfunction in older adults with diabetes. Poor glycemic management is a significant risk factor for sarcopenic obesity, highlighting the need for tailored interventions to improve glycemic control and muscle health in this population.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":"837-855"},"PeriodicalIF":8.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New drugs for the treatment of obesity: do we need approaches to preserve muscle mass?","authors":"Donna H Ryan","doi":"10.1007/s11154-025-09967-4","DOIUrl":"10.1007/s11154-025-09967-4","url":null,"abstract":"<p><p>The development of drugs targeting Nutrient Stimulated Hormone receptors has ushered in a dramatic change in our approach to weight management because of their ability to achieve weight losses of 10%, 20%, even 30% in significant numbers of patients. Additionally, disease modifying properties of these medications are compelling. Indications now include cardiovascular risk reduction, obstructive sleep apnea and diabetes management, and emerging evidence supports efficacy for heart failure and chronic kidney disease. These medications would need to be taken long term and the population being treated will be older than the traditional weight management patient. Emerging evidence cautions that the loss of excessive lean mass with some of the newer medications may be problematic. This is not a concern for most patients who will need the medications, but it is a concern in an older population, since loss of muscle and bone accelerates and progresses past age 60. Of weight lost with semaglutide, approximately 45% is from lean mass, while with tirzepatide, it is 25%. Going forward, combining another NuSH such as glucagon or amylin with the GLP-1 receptor agonists may lessen loss of lean mass. Another approach under study is the use of MAPi - myostatin-activin pathway inhibitors. Promising results with bimagrumab are spurring investigaton in this area. For the full potential of disease modification to be achieved, it's a given that we must demonstrate safe, long term body composition improvement when the new medications are deployed, especially in the older population. This narrative review discusses the justification for focus on lean mass preservation and reviews the status of relevant drugs in development.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":"805-813"},"PeriodicalIF":8.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skeletal muscle atrophy and dysfunction in obesity and type-2 diabetes mellitus: Myocellular mechanisms involved.","authors":"Íñigo M Pérez Castillo, Josep M Argilés, Ricardo Rueda, María Ramírez, José M López Pedrosa","doi":"10.1007/s11154-025-09954-9","DOIUrl":"10.1007/s11154-025-09954-9","url":null,"abstract":"<p><p>Obesity and type-2 diabetes mellitus (T2DM) are interrelated metabolic disorders primarily driven by overnutrition and physical inactivity, which oftentimes entails a transition from obesity to T2DM. Compromised musculoskeletal health consistently emerges as a common hallmark in the progression of these metabolic disorders. Skeletal muscle atrophy and dysfunction can further impair whole-body metabolism and reduce physical exercise capacity, thus instigating a vicious cycle that further deteriorates the underlying conditions. However, the myocellular repercussions of these metabolic disturbances remain to be completely clarified. Insulin signaling not only facilitates skeletal muscle glucose uptake but also plays a central role in skeletal muscle anabolism mainly due to suppression of catabolic pathways and facilitating an anabolic response to nutrient feeding. Chronic overnutrition may trigger different myocellular mechanisms proposed to contribute to insulin resistance and aggravate skeletal muscle atrophy and dysfunction. These mechanisms mainly include the inactivation of insulin signaling components through sustained activation of stress-related pathways, mitochondrial dysfunction, a shift to glycolytic skeletal muscle fibers, and hyperglycemia. In the present review, we aim to delve on these mechanisms, providing an overview of the myocellular processes involved in skeletal muscle atrophy and dysfunction under chronic overnutrition, and their contribution to the progression to T2DM.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":"815-836"},"PeriodicalIF":8.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Looking beyond fat in obesity: the frequently overlooked importance of muscle mass.","authors":"Refaat Hegazi, Bruno Halpern","doi":"10.1007/s11154-025-09986-1","DOIUrl":"10.1007/s11154-025-09986-1","url":null,"abstract":"<p><p>Obesity is traditionally defined as \"abnormal or excessive fat accumulation that presents a health risk,\" yet this definition lacks precision and fails to account for individual variability in body composition. The continued reliance on body mass index (BMI) as a diagnostic tool further complicates accurate assessment, as BMI does not differentiate between fat mass and lean mass. Emerging evidence highlights that health risks associated with obesity are not solely determined by fat accumulation, but also by the relative deficiency in fat-free mass, particularly muscle. Despite this, the role of muscle health in obesity management remains underappreciated in clinical practice. With the advent of potent pharmacotherapies for obesity, such as a new class of GLP-1 receptor agonists, there is growing concern about their impact on muscle mass during weight loss. This underscores the need for a more holistic understanding of body composition changes and their implications for long-term health. This special issue of Reviews in Endocrine and Metabolic Disorders addresses these critical gaps, offering diverse perspectives on integrating muscle health into the continuum of obesity care.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":"719-721"},"PeriodicalIF":8.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging evidence and potential avenues to achieve durable outcomes in patients with obesity: the confluence of nutrition, and Microbiome on body composition.","authors":"Dra M Isabel T D Correia, Nitin Kapoor, Emma Chávez-Manzanera, Luís Henrique Wolff Gowdak, Amira Al Kharusi, Felipe F Casanueva, Bruno Halpern, Gary Frost, Raed Aldahash","doi":"10.1007/s11154-025-09977-2","DOIUrl":"10.1007/s11154-025-09977-2","url":null,"abstract":"<p><p>Obesity is a global health concern that impacts health, quality of life, and longevity in affected individuals. Comorbid cardiovascular disease, type 2 diabetes, cancer, and other conditions often accompany obesity, and researchers are actively investigating therapeutic strategies to treat obesity and mitigate the health risks associated with excess adiposity. Restrictive nutritional intake and body weight reduction through lifestyle behavioral interventions, bariatric procedures, and highly effective anti-obesity medications are all recommended treatments for obesity. Meanwhile, the caloric restriction that comes with very low-calorie diets can result in changes in body composition, most notably a progressive loss of muscle mass and/or functionality, a process that can be accelerated by aging, underlying metabolic disease, or inadequate protein intake seen with many dietary patterns. While muscle loss was previously understood as a condition only affecting older individuals, this outcome is common in patients with obesity. The term sarcopenic obesity has been used to refer to this condition, and it is now recognized as an important potential complication in all patients with obesity. Dietary challenges that influence overall body composition also have drawn attention to the gut microbiome, a topic of growing interest as there is an increasingly recognized interplay between diet, the metabolic actions of microorganisms in the gut that impact macronutrient and micronutrient production and absorption, and human health. This article will review the current understanding of obesity as a chronic disease, the impact of diet and nutritional therapy on body composition, and the potential relevance of the gut microbiome in this setting.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":"745-758"},"PeriodicalIF":8.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144542026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond satiety: unraveling the complex roles of POMC neurons in behavior and metabolism.","authors":"Victor Jouque, Cristina Miralpeix, Antonio J López-Gambero, Jean Charles Nicolas, Carmelo Quarta, Daniela Cota","doi":"10.1007/s11154-025-09993-2","DOIUrl":"https://doi.org/10.1007/s11154-025-09993-2","url":null,"abstract":"<p><p>Hypothalamic pro-opiomelanocortin (POMC) neurons are classically viewed as mediators of satiety, acting in response to metabolic and hormonal cues and in opposition to Agouti-related protein (AgRP) neurons to maintain energy balance. This model, centered on the appetite-suppressant effects of the POMC-derived neuropeptide α-melanocyte-stimulating hormone (α-MSH) through its activation of melanocortin-4 receptors (MC4R), has shaped our understanding of feeding and body weight regulation for decades. However, recent discoveries have challenged and expanded this traditional view, revealing that POMC neurons are not a uniform population dedicated solely to satiety control. Single-cell transcriptomic analyses have revealed striking molecular heterogeneity, reflected in distinct anatomical distributions, receptor expression profiles, electrophysiological properties, and projection patterns - all supporting the idea of functional specialization within this neuronal population. In this review, we propose a conceptual framework that integrates POMC neuronal heterogeneity with the regulation of appetite, metabolic physiology, and behavior beyond feeding. We highlight emerging evidence showing that discrete POMC neuronal subpopulations respond to specific combinations of interoceptive and environmental cues to orchestrate diverse adaptive responses. This perspective underscores the developmental plasticity and functional versatility of POMC neurons, offering new insights into the mechanisms of obesity and potentially paving the way for novel targeted therapeutic strategies.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging role of AgRP neurons as integrators of metabolic, sensory and environmental cues in the control of energy homeostasis.","authors":"Maya Faour, Nour Mesto, Claire Martin, Serge Luquet","doi":"10.1007/s11154-025-09990-5","DOIUrl":"https://doi.org/10.1007/s11154-025-09990-5","url":null,"abstract":"<p><p>The regulation of energy homeostasis is an essential function of every living organism. In mammals a complex interplay of neural networks has evolved to ensure proper adaptation to energy demands, availability, consumption, storage and utilization. While a large set of parallel and redundant brain networks are functionally intertwined in these processes, a specific subset of hypothalamic neurons producing the agonist and antagonist of the anorectic signaling pathway controlled by the melanocortin receptor have been extensively studied. The anorectic/catabolic pro-opiomelanocortin (POMC) producing neurons and the orexigenic/anabolic Agouti-related peptide (AgRP) producing neurons exert opposing functions of various aspects of foraging, ingestive and post-ingestive processes. Located close to circumventricular these two populations integrate circulating reflecting energy status but are dynamically controlled by food-predicting cues. This review will be focusing on recent advances in understanding the role of the hypothalamic AgRP neurons, as critical metabolic sensors and regulators. We explore the intricate mechanisms by which these neurons integrate diverse nutritional signals and coordinate autonomic and behavioral responses to maintain metabolic equilibrium.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood obesity: The threatening apprentice of the adiposity empire.","authors":"J Karina Zapata, Javier Gómez-Ambrosi, Gema Frühbeck","doi":"10.1007/s11154-025-09959-4","DOIUrl":"10.1007/s11154-025-09959-4","url":null,"abstract":"<p><p>Childhood obesity is a global health problem, with its prevalence having tripled since 1975. The increase in its prevalence has been predominantly in developing countries, but also in those with high economic status. Nowadays, there are multiple obesity definitions, however, one of the most accurate is the one which defines obesity as the accumulation of excessive body adiposity and not as an body weight excess. Nevertheless, the body mass index (BMI) is the most frequently used tool for its classification, according to the cut-off points established by the Center for Disease Control and World Health Organization tables. In children and adolescents an adiposity excess is related to the appearance of cardiovascular disease in adulthood and with many comorbidities such as metabolic syndrome, insulin resistance, type 2 diabetes, hypertension and metabolic dysfunction-associated steatotic liver disease, among others. Currently, there is still controversy about which is the ideal indicator for measuring overweight and obesity. BMI is still used as a standardized measure but may miss cases in which body composition is pathological despite a BMI within the normal-weight category. An adequate knowledge of the impact on health of dysfunctional adiposity as well as its accurate diagnosis will allow health professionals to address this condition in a more precise and comprehensive manner, and substantially improve the associated cardiometabolic risk and prognosis.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":"539-557"},"PeriodicalIF":8.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incretins and SGLT-2 inhibitors in diabetic patients with neuroendocrine tumors: current updates and future directions.","authors":"Rosaria M Ruggeri, Erika Maria Grossrubatscher, Eleonora Ciocca, Iderina Hasballa, Simona Jaafar, Monica Oldani, Manila Rubino, Flaminia Russo, Andrea M Isidori, Annamaria Colao, Antongiulio Faggiano","doi":"10.1007/s11154-025-09958-5","DOIUrl":"10.1007/s11154-025-09958-5","url":null,"abstract":"<p><p>Neuroendocrine tumors (NET) are frequently associated with glycemic disorders, such as prediabetes or diabetes, which may result from either surgical or medical treatments or hormonal hypersecretion by the tumor itself. Moreover, pre-existing diabetes is a known risk factor for NET development, with metabolic control and antidiabetic therapies potentially influencing tumor progression. The complex interplay between diabetes and NET, which share several molecular pathways, has spurred interest in the anti-cancer effects of antidiabetic medications. This is particularly relevant as new antidiabetic drugs continue to emerge, including sodium-glucose cotransporter-2 (SGLT2) inhibitors and incretin-based therapies, such as dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor (GLP-1R) agonists and dual GIP/GLP- 1 R agonists. This review explores the impact of these novel pharmacological options on NET development and progression through a comprehensive analysis of pre-clinical and clinical studies, with the purpose to evaluate safety and feasibility of introducing these drugs in the treatment of NETs patients. We conducted a comprehensive search of online databases, including PubMed, ISI Web of Science, and Scopus, for studies assessing the therapeutic effects and potential mechanisms of action of incretins and SGLT2 inhibitors in patients with NET. These novel antidiabetic drugs exhibit promising anticancer properties, potentially inhibiting tumor cell proliferation and inducing apoptosis, though concerns about certain cancer risks remain. Based on current evidence, the benefits of incretin-based therapies outweigh any potential cancer risks, leading to the proposal of tailored management algorithms for diabetes in NET patients, factoring in the diabetes aetiology, comorbidities, and life expectancy.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":"575-592"},"PeriodicalIF":8.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical outcomes of partial adrenalectomy for pheochromocytoma: A systematic review and meta-analysis.","authors":"Marta Araujo-Castro, César Mínguez Ojeda, Victoria Gómez Dos Santos, Alfonso Sanjuanbenito, Joaquín Gómez Ramírez, Enrique Mercander, Felicia Hanzu, Leire Zarain, Óscar Vidal, Alfonso Muriel García, Alberto Artiles Medina","doi":"10.1007/s11154-025-09962-9","DOIUrl":"10.1007/s11154-025-09962-9","url":null,"abstract":"<p><p>The purpose of our study was to evaluate the efficacy and safety of partial adrenalectomy (PA) in the management of pheochromocytomas. A systematic review and metanalyses of all randomized controlled trials and observational studies (comparative and non-comparative studies), including case series with at least 5 cases, reporting efficacy and safety outcomes of PA in the treatment of bilateral and/or inherited pheochromocytomas was performed. A total of 33 articles were included in this systematic review, including 22 observational comparative and 11 single-arm studies. The pooled rates of biochemical and clinical cure after PA were 99.7% (95%CI: 98.7-100) and 99.8% (95%CI: 98.8-100), respectively. The pooled complication rate was 5.9% (95%CI: 0.8-10.9). Tumor recurrence and metastatic rates were 4% (95%CI: 0-1.6) and 0% (95%CI: 0.00-0.6), respectively. Steroid supplementation was required in 7.6% (95%CI: 2.8-12.5) of patients. No significant difference was detected in acute adrenal crisis (odds ratio [OR] 0.44, 95%CI: 0.16-1.22), biochemical (OR 0.42, 95%CI: 0.05-3.85) and clinical cure (OR 0.42, 95%CI: 0.05-3.85), complication (OR 1.59, 95%CI: 0.28-9.13) and metastatic rate (OR 1.56, 95%CI: 0.59-4.15) between the group of partial and total adrenalectomy. Nevertheless, recurrence rate (OR 2.55, 95%CI: 1.24-5.23) was higher with PA, while the need for supplementation rate (OR 0.01, 95%CI: 0.00-0.01) was significantly lower than in the total adrenalectomy group. The conclusion of the study is that the probability of biochemical cure and the rate of complications is similar between the group of patients who underwent total and partial adrenalectomy, but PA is associated with a lower rate of adrenal insufficiency and a higher recurrence rate than total adrenalectomy.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":" ","pages":"625-640"},"PeriodicalIF":8.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}