{"title":"The increasing prevalence of cancer in the elderly: An investigation of epidemiological trends","authors":"Ramya Prathap, Sherlin Kirubha, Aravindhan Thiyaga Rajan, Santhosh Manoharan, Karthikeyan Elumalai","doi":"10.1002/agm2.12347","DOIUrl":"10.1002/agm2.12347","url":null,"abstract":"<p>Cancer poses a significant health threat to the elderly, accounting for a substantial proportion of cancer patients aged 65 and above. As life expectancy continues to rise and the population ages, the incidence of cancer in the elderly is expected to increase further. Age is a major risk factor for the majority of common cancers, with the incidence and prevalence rising as individuals grow older. Factors such as chemoprevention and environmental carcinogen elimination may influence the process of carcinogenesis. Studies reveal that the incidence and mortality rates of various cancers in the elderly and extremely old individuals are on the rise worldwide, with most types peaking around the age of 75 to 90, followed by a sharp decline. Birth cohort and period effects also play a complex role in the connection between aging and cancer risk. Clinical trials often exclude older individuals, limiting our understanding of cancer treatments' effects on this particular age group. More research is needed to focus on the unique requirements of older adults with cancer.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 4","pages":"516-527"},"PeriodicalIF":2.2,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134032","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":"Vitamin B12 status and skeletal muscle function among elderly: A literature review and pilot study on the effect of oral vitamin B12 supplementation in improving muscle function","authors":"Sowmya Sharma, Rohini Bhadra, Sumithra Selvam, Sucharita Sambashivaiah","doi":"10.1002/agm2.12346","DOIUrl":"10.1002/agm2.12346","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study is to understand the role of vitamin B12 supplementation in improving skeletal muscle function among the elderly.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A literature review in the Medline database was conducted to understand the association between vitamin B12 and muscle function in Section A. In Section B, 28 healthy elderly participants aged ≥60 years were recruited in a cross-sectional design for estimation of plasma vitamin B12 status and assessment of upper limb muscle strength Maximal voluntary contraction (MVC) and muscle quality (expressed as MVC/total muscle mass). Participants were grouped based on vitamin B12 status into vitamin B12-depleted (<148 pmol/L) and replete (≥148 pmol/L) groups. In a quasi-experimental study design, the vitamin B12-depleted group (<i>n</i> = 14) received daily oral vitamin B12 supplementation of 100 μg for 3 months. All the study measures were repeated post-supplementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Vitamin B12 deficiency was identified to contribute adversely to muscle strength, quality, and physical performance among older people in the extensive literature review. The pilot intervention study showed significant improvement in MVC and muscle quality (<i>p</i> < 0.050) post-vitamin B12 supplementation, comparable to the vitamin B12-replete group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Vitamin B12 may have a crucial role in the maintenance of muscle function. 3-month oral vitamin B12 supplementation among subclinical vitamin B12 deficient elderly improved muscle strength and quality and reached levels similar to the vitamin B12 replete group.</p>\u0000 </section>\u0000 </div>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 4","pages":"480-489"},"PeriodicalIF":2.2,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134034","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}
Aging MedicinePub Date : 2024-08-17DOI: 10.1002/agm2.12344
Alwin Ru Kiet Wong, Li Ting Eileen Ng, Ming Hao Lee, James Lai Hock Yeow, Yong Jia Lim, Kah Hui Yap
{"title":"The effectiveness of group music reminiscence therapy for people thriving with dementia: A systematic review of randomized controlled trials","authors":"Alwin Ru Kiet Wong, Li Ting Eileen Ng, Ming Hao Lee, James Lai Hock Yeow, Yong Jia Lim, Kah Hui Yap","doi":"10.1002/agm2.12344","DOIUrl":"https://doi.org/10.1002/agm2.12344","url":null,"abstract":"<p>Dementia is characterized by a progressive decline in cognition, behavioral and psychological symptoms (BPSD), and quality of life (QoL). The lack of curative therapies has led to a psychosocial discourse prioritizing QoL of people thriving with dementia (PTD). Group reminiscence therapy (RT) is a relatively inexpensive intervention, with music prompts being a preferred choice, owing to robust musical memory in the early disease stage. However, a synthesis of current evidence is needed to inform research and clinical use of group music RT in dementia care. Therefore, we conducted a systematic review on PubMed, Scopus, CINAHL, APA PsycInfo, and APA PsycArticles to critically appraise published randomized controlled trials examining group music RT to improve cognition, BPSD, and QoL in PTD. Of 14,725 articles, two RCTs involving 102 PTD were included. All studies used prerecorded music for group music RT. All studies were deemed of good quality, adhering to intention-to-treat analysis and assessor blinding. Based on the American Academy of Neurology guidelines, we assigned a Level C recommendation for group music RT for cognition and Level B recommendations for BPSD and QoL (ineffective). In conclusion, group music RT may be useful for symptomatic management in PTD. However, heterogeneous study designs, disease severity, dementia subtype, and outcome measures are likely barriers to meaningful clinical translation. Therefore, the rating of recommendations only serves as a point of reference. Future avenues include live performances as prompts for group music RT.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 4","pages":"528-534"},"PeriodicalIF":2.2,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12344","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142130374","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}
Aging MedicinePub Date : 2024-08-17DOI: 10.1002/agm2.12345
Ren Junhong, He Wen
{"title":"Standardized evaluation methodology for renal cortical blood perfusion in elderly patients using contrast-enhanced ultrasound: A Chinese expert consensus (2024 edition)","authors":"Ren Junhong, He Wen","doi":"10.1002/agm2.12345","DOIUrl":"10.1002/agm2.12345","url":null,"abstract":"<p>As a sensitive and non-invasive method for assessing changes in renal cortical blood perfusion in the elderly, contrast-enhanced ultrasound (CEUS) can indirectly reflect changes in kidney filtration and reabsorption function, thus providing feasibility for early evaluation of renal function changes. However, significant differences exist among researchers in terms of operational methods, contrast agent selection, post-data analysis, and many other aspects, leading to substantial heterogeneity in results. This hinders horizontal comparisons and greatly limits the clinical application of contrast-enhanced ultrasound for evaluating renal cortical blood flow perfusion. Based on the latest domestic and overseas literature and discussions with clinical experts, this consensus provides recommended guidelines for the evaluation of renal cortical blood flow perfusion using contrast-enhanced ultrasound. It is hoped that this consensus will promote a better understanding of CEUS among medical practitioners at all levels and standardize the examination of renal cortical blood flow perfusion with CEUS.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 4","pages":"429-437"},"PeriodicalIF":2.2,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134031","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}
Aging MedicinePub Date : 2024-08-14DOI: 10.1002/agm2.12355
Guo Yaming, Chen Zuoguan, Li Yongjun, Zhang Wayne W
{"title":"Renal cortex blood perfusion contrast-enhanced ultrasound: Assisting diagnosis and treatment of renal artery disease","authors":"Guo Yaming, Chen Zuoguan, Li Yongjun, Zhang Wayne W","doi":"10.1002/agm2.12355","DOIUrl":"https://doi.org/10.1002/agm2.12355","url":null,"abstract":"<p>Renal cortical blood perfusion CEUS can evaluate the structure and microcirculation of renal cortex, which is expected to provide a safer and more convenient evaluation system for clinicians in the diagnosis and treatment of early renal artery disease.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 4","pages":"438-442"},"PeriodicalIF":2.2,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12355","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142130412","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}
Aging MedicinePub Date : 2024-08-12DOI: 10.1002/agm2.12351
Minglei Zhu, Lin Kang, Xiaohong Liu
{"title":"Promote the integrated care in China","authors":"Minglei Zhu, Lin Kang, Xiaohong Liu","doi":"10.1002/agm2.12351","DOIUrl":"https://doi.org/10.1002/agm2.12351","url":null,"abstract":"<p>This article presents a brief overview of the researches on ICOPE in China, the barriers influencing the implementation of ICOPE are identified, and the recommendations are proposed to advance the ICOPE practice in China.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 4","pages":"449-452"},"PeriodicalIF":2.2,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12351","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142130330","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}
Aging MedicinePub Date : 2024-08-12DOI: 10.1002/agm2.12342
Anteneh Mehari Tizazu
{"title":"Fasting and calorie restriction modulate age-associated immunosenescence and inflammaging","authors":"Anteneh Mehari Tizazu","doi":"10.1002/agm2.12342","DOIUrl":"10.1002/agm2.12342","url":null,"abstract":"<p>Aging is a multifaceted process impacting cells, tissues, organs, and organ systems of the body. Like other systems, aging affects both the adaptive and the innate components of the immune system, a phenomenon known as immunosenescence. The deregulation of the immune system puts elderly individuals at higher risk of infection, lower response to vaccines, and increased incidence of cancer. In the Western world, overnutrition has increased the incidence of obesity (linked with chronic inflammation) which increases the risk of metabolic syndrome, cardiovascular disease, and cancer. Aging is also associated with inflammaging a sterile chronic inflammation that predisposes individuals to age-associated disease. Genetic manipulation of the nutrient-sensing pathway, fasting, and calorie restriction (CR) has been shown to increase the lifespan of model organisms. As well in humans, fasting and CR have also been shown to improve different health parameters. Yet the direct effect of fasting and CR on the aging immune system needs to be further explored. Identifying the effect of fasting and CR on the immune system and how it modulates different parameters of immunosenescence could be important in designing pharmacological or nutritional interventions that slow or revert immunosenescence and strengthen the immune system of elderly individuals. Furthermore, clinical intervention can also be planned, by incorporating fasting or CR with medication, chemotherapy, and vaccination regimes. This review discusses age-associated changes in the immune system and how these changes are modified by fasting and CR which add information on interventions that promote healthy aging and longevity in the growing aging population.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 4","pages":"499-509"},"PeriodicalIF":2.2,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134029","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":"Frailty and chronic diseases: A bi-directional relationship","authors":"Urza Bhattarai, Bijaya Bashyal, Anu Shrestha, Binu Koirala, Sanjib Kumar Sharma","doi":"10.1002/agm2.12349","DOIUrl":"https://doi.org/10.1002/agm2.12349","url":null,"abstract":"<p>Frailty is a multidimensional syndrome associated with a decline in reserve capacity across multiple organ systems involving physical, psychological, and social aspects. Weakness is the earliest indicator of the frailty process. Multi-morbidity is the state of presence of two or more chronic diseases. Frailty and chronic diseases are interlinked as frail individuals are more prone to develop chronic diseases and multi-morbid individuals may present with frailty. They share common risk factors, pathogenesis, progression, and outcomes. Significant risk factors include obesity, smoking, aging, sedentary, and stressful lifestyle. Pathophysiological mechanisms involve high levels of circulating inflammatory cytokines as seen in individuals with frailty and chronic diseases such as hypertension, cardiovascular diseases, type 2 diabetes mellitus, chronic kidney disease, and anemia. Hence, frailty and chronic diseases go hand in hand and it is of utmost importance to identify them and intervene during early stages. Screening frailty and treating multi-morbidity incorporate both pharmacological and majorly non- pharmacological measures, such as physical activities, nutrition, pro-active care, minimizing polypharmacy and addressing reversible medical conditions. The purpose of this mini-review is to highlight the interrelation of frailty and chronic diseases through the discussion of their predictors and outcomes and how timely interventions are essential to prevent the progression of one to the other.</p>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 4","pages":"510-515"},"PeriodicalIF":2.2,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12349","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142130329","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}
Aging MedicinePub Date : 2024-08-12DOI: 10.1002/agm2.12353
Gevesh Chand Dewangan, Sunny Singhal, Dinu S. Chandran, Maroof Ahmad Khan, Aparajit Ballav Dey, Avinash Chakrawarty
{"title":"Short-term heart rate variability: A potential approach to frailty assessment in older adults","authors":"Gevesh Chand Dewangan, Sunny Singhal, Dinu S. Chandran, Maroof Ahmad Khan, Aparajit Ballav Dey, Avinash Chakrawarty","doi":"10.1002/agm2.12353","DOIUrl":"https://doi.org/10.1002/agm2.12353","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to evaluate cardiac autonomic modulation using short-term heart rate variability (HRV) and compare it among frailty statuses in older Indian adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 210 subjects aged 60 years and above were recruited into three groups: frail (<i>n</i> = 70), pre-frail (<i>n</i> = 70), and non-frail (<i>n</i> = 70) from the outpatient department of Geriatric Medicine at a tertiary care hospital in India. Frailty status was assessed using the Rockwood frailty index (FI) criteria. HRV was derived from a 5-min ECG recording of standard limb leads and assessed using time domain, frequency domain, and nonlinear analysis of cardiac interval variability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The HRV parameters indicative of parasympathetic modulation such as SDNN, SDSD, rMSSD, NN50, pNN50, absolute HF power, and SD1 were significantly lower in frail subjects compared with both pre-frail and non-frail subjects (<i>P</i> < 0.05). Absolute LF power and SD2 were also lower in frail subjects compared with pre-frail and non-frail subjects (<i>P</i> < 0.05). Measures of sympatho-vagal balance (LF/HF and SD1/SD2 ratios) did not show statistical significance. The FI demonstrated negative correlations with all HRV parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Frail individuals exhibit decreased sympathetic and parasympathetic modulation compared with pre-frail and non-frail individuals, although maintaining a balanced sympatho-vagal state. Furthermore, autonomic modulation declines progressively with increasing frailty.</p>\u0000 </section>\u0000 </div>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 4","pages":"456-462"},"PeriodicalIF":2.2,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12353","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142130352","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}
Aging MedicinePub Date : 2024-08-12DOI: 10.1002/agm2.12343
Ivan David Lozada-Martinez, Juan-Manuel Anaya
{"title":"What are blue zones? An argument in favor of its definition based on the most successful model of biological aging","authors":"Ivan David Lozada-Martinez, Juan-Manuel Anaya","doi":"10.1002/agm2.12343","DOIUrl":"https://doi.org/10.1002/agm2.12343","url":null,"abstract":"<p>The exhaustive and rigorous study of aging, especially healthy aging, constitutes a highly interesting area of research today, due to the demographic transition the world is undergoing with a dramatic increase in the proportion of older persons. Due to the imprecise capacity of health systems to be able to respond to this scenario,<span><sup>1</sup></span> a transformation and restructuring of priorities in public health and global health have been considered. In recent years, the United Nations declared the period between 2021 and 2030 as the decade of healthy aging, defining four principles that have the potential to impact the human rights of healthy longevity,<span><sup>2</sup></span> and the health outcomes of older persons.<span><sup>3</sup></span> These principles, accompanied by some objectives of the World Health Organization on aging and health, propose strengthening research on healthy longevity to impact, more than life expectancy, on healthy lifespan.<span><sup>4</sup></span></p><p>The term “blue zone” was coined by Poulain et al.<span><sup>5</sup></span> who arbitrarily defined it as a geographical area with a higher proportion of male centenarians compared to female centenarians (which is commonly the opposite case) in Sardinia. Despite this, the term has been used heterogeneously in some studies on extreme longevity, referring to areas or populations with high rate of centenarians, high life expectancy/healthy lifespan, high proportion of octogenarians and nonagenarians (but not centenarians), or very low prevalence of age-related chronic diseases in aged over 80 years old.</p><p>Dan Buettner, an American explorer, and journalist, is known for disseminating information about some “well-documented” blue zones,<span><sup>6</sup></span> which can be explored through documentary films on National Geographic and the Netflix series called “Live to 100: Secrets of the Blue Zones.” These zones include Okinawa in Japan, Sardinia in Italy, Nicoya in Costa Rica, Ikaria in Greece, and Loma Linda in California.<span><sup>6</sup></span> In these documentary films, anecdotes and experiences related to lifestyles, customs, and social behaviors typical of areas, where octogenarians, nonagenarians, and centenarians with favorable health phenotypes can be found, are shared. However, just as there are similarities, there are also significant differences in the demographic and clinical characteristics of these populations, which must be examined and discussed considering the evidence.</p><p>In a nonsystematic search in PubMed, there are no more than 12 documents published to January 2024 that include the term “blue zones” in their titles. What is even more intriguing, most of the available documents are reviews or correspondences where claims are made about lessons, outcomes, and special considerations regarding extreme longevity. These analyses often include people starting from the age of 65 (who are not extreme longevity candidates).<span><sup>7","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"7 4","pages":"446-448"},"PeriodicalIF":2.2,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.12343","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142130353","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}