Diabetes epidemiology and management最新文献

{"title":"Decision-support for functional insulin therapy on multiple daily injections: An integrated qualitative study of patients and healthcare professionals","authors":"Arnaud Bubeck ,&nbsp;Coline Hehn ,&nbsp;Marie Barroyer ,&nbsp;Nicolas Naïditch","doi":"10.1016/j.deman.2026.100306","DOIUrl":"10.1016/j.deman.2026.100306","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes technology innovation increasingly focuses on pumps and hybrid closed-loop systems, yet many people living with type 1 diabetes remain on basal–bolus multiple daily injections. Digital decision-support tools may extend algorithmic assistance to pen regimens, but evidence on their adoption and role in routine care remains limited.</div></div><div><h3>Methods</h3><div>Integrated qualitative analysis of 25 semi-structured interviews collected in France (patients <em>n</em> = 15; healthcare professionals <em>n</em> = 10). Data were analysed using reflexive thematic analysis with cross-dataset comparison.</div></div><div><h3>Results</h3><div>Participants situated EkiYou, a mobile decision-support application for pen-treated regimens, within a hierarchised \"innovation landscape\" where pumps are seen as the most legitimate option. The application was valued—primarily by people with type 1 diabetes—for extending algorithmic support to pen users and reducing feelings of being \"left behind\". Its clearest contribution concerned functional insulin therapy: meal-entry and food-search routines, insulin-on-board, and personalised parameters scaffolded dose decisions, reducing dose-related uncertainty and meal-time anxiety for some, while adding time and attentional demands that most participants described as acceptable. Clinicians also used EkiYou as a bridge during pump–pen alternation and as a step toward calibrated trust in algorithmic recommendations. However, discontinuation occurred when the tool conflicted with embodied self-management routines, and food-database frictions were socially patterned. Time constraints in routine care and the need for nursing delegation appear as critical implementation determinants.</div></div><div><h3>Conclusions</h3><div>EkiYou may act as a socio-technical scaffold for functional insulin therapy on pens and as a transition-support tool in an increasingly automated care environment. Scaling will require organisational support and attention to unequal capacities for sustained use.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"21 ","pages":"Article 100306"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147612130","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":"Poor glycemic control and kidney function decline in older adults: Evidence from the health and retirement study","authors":"Fan Zhang,&nbsp;Yifei Zhong","doi":"10.1016/j.deman.2026.100313","DOIUrl":"10.1016/j.deman.2026.100313","url":null,"abstract":"<div><div>Chronic kidney disease is common in older adults, and diabetes is a major contributor to kidney function decline. However, the relationship between glycemic control and long-term kidney function trajectories in older populations remains incompletely understood. We examined the association between diabetes, glycemic control, and longitudinal changes in kidney function using data from 9,281 participants in the Health and Retirement Study. Estimated glomerular filtration rate based on cystatin C (eGFR_cys) was analyzed using linear mixed-effects models. Participants were categorized as having no diabetes, diabetes with good glycemic control (HbA1c &lt;7%), or diabetes with poor glycemic control (HbA1c ≥7%). Over 8 years, eGFR_cys declined by -6.50 mL/min/1.73 m² per 4-year interval among participants without diabetes. Individuals with diabetes experienced a faster decline compared with those without diabetes. When stratified by glycemic control, the rate of eGFR_cys decline did not differ significantly between participants with good glycemic control and those without diabetes, whereas those with poor glycemic control showed a substantially steeper decline (additional -3.98 mL/min/1.73 m² per 4-year interval). These findings suggest that poor glycemic control is associated with accelerated kidney function decline in older adults, whereas well-controlled diabetes shows trajectories similar to those without diabetes.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"21 ","pages":"Article 100313"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147709407","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":"Diabetes screening practices of japanese dental hygienists: The role of attitudes and training","authors":"Rie Kudoh,&nbsp;Taiga Shibayama","doi":"10.1016/j.deman.2025.100296","DOIUrl":"10.1016/j.deman.2025.100296","url":null,"abstract":"<div><h3>Background</h3><div>Despite the bidirectional relationship between diabetes and periodontal disease, dental hygienists' (DHs') engagement in diabetes screening remains underexplored in Japan. This study examined associations between attitudes and diabetes screening practices among Japanese DHs.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among 234 DHs in the Kanto region between December 2023 and February 2024. After excluding invalid responses, 75 (response rate: 32.1 %) were analyzed. Attitudes and practices were assessed using a self-administered questionnaire. Exploratory factor analysis identified underlying constructs, and multiple regression analyses examined associations between attitudes and screening practices.</div></div><div><h3>Results</h3><div>Only 36 % had received diabetes management training. Factor analysis identified two attitude factors—willingness to manage diabetes and lack of knowledge and confidence—and two practice factors—checking diabetes management status and checking diabetes therapeutic management status. Willingness to manage diabetes was positively associated with all screening practices: checking diabetes management status (β = 0.34, 95 % CI 0.28–1.41), checking diabetes therapeutic management status (β = 0.39, 95 % CI 0.22–0.84), and symptom checking (β = 0.30, 95 % CI 0.12–0.72), indicating substantial effects. Lack of knowledge and confidence was negatively associated with checking diabetes management status (β = -0.33, 95 % CI -0.94 to -0.17), reflecting a moderate effect. Clinical experience and diabetes education experience also predicted symptom checking, highlighting the importance of structured training.</div></div><div><h3>Conclusions</h3><div>Educational interventions targeting knowledge, confidence, and willingness are essential to promote diabetes screening practices among DHs. These findings provide evidence for developing targeted training programs to enhance medical-dental collaboration in diabetes care.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"21 ","pages":"Article 100296"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145797419","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":"Diet quality as assessed by the healthy eating Index-2020 among individuals diagnosed with and without type 2 diabetes","authors":"Minghao Zhou ,&nbsp;Hairui Yu ,&nbsp;Renee Underwood ,&nbsp;Hongning Cai ,&nbsp;Tung-Sung Tseng ,&nbsp;Susu Luo","doi":"10.1016/j.deman.2025.100299","DOIUrl":"10.1016/j.deman.2025.100299","url":null,"abstract":"<div><h3>Background</h3><div>Dietary management is key to preventing and controlling type 2 diabetes mellitus (T2DM). However, few studies have examined differences in Healthy Eating Index (HEI-2020) scores and components among individuals with and without diagnosed T2DM. This study aimed to assess gender differences in HEI-2020 scores and its 13 components by T2DM status.</div></div><div><h3>Methods</h3><div>Using National Health and Nutrition Examination Survey (NHANES) data from 2011 to 2018, this cross-sectional study analyzed 19,464 adults. Diagnosed T2DM was identified via self-report or diabetes medication use. Diet quality was assessed using the HEI-2020, scored from 0 to 100, with a higher HEI score indicates better dietary quality. HEI-2020 scores were calculated per person using a standard scoring algorithm. Survey-weighted descriptive analyses and regression models were applied.</div></div><div><h3>Results</h3><div>The prevalence of diagnosed T2DM in the US adults (≥20 years) was 9.9%, with an average HEI-2020 score of 53.9. In unadjusted analyses, males with diagnosed T2DM had a significantly higher HEI score than those without (53.3 vs. 51.8, respectively) . Across both sexes, individuals with diagnosed T2DM reported higher HEI component scores for added sugar, indicating lower sugar intake, but lower scores for sodium and refined grains, indicating higher intake of these components, compared to those without diagnoses. Age- and sex-specific patterns were evident in adjusted models: adults aged ≥60 years with T2DM consumed less added sugar but more sodium than their non-diagnosed counterparts, while younger women (20–40 years) with T2DM reported higher added sugar intake.</div></div><div><h3>Conclusions</h3><div>Diet quality among adults with diagnosed T2DM was heterogeneous rather than uniformly improved. Although lower added sugar intake represents a favorable dietary change, persistently high sodium and refined grain consumption remains a concern, particularly among older adults, and poorer sugar intake was observed among younger women. These findings highlight important gaps in dietary management following diabetes diagnosis and underscore the need for targeted, subgroup-specific nutritional guidance in T2DM care.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"21 ","pages":"Article 100299"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925102","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":"Removal notice to <\" DRESS Syndrome with the Use of Dapagliflozin: A Case Report and Review of Literature \">","authors":"Rebecca Badawi ,&nbsp;Layal Akl ,&nbsp;Karima Chafai ,&nbsp;Jean-Louis Nguewa ,&nbsp;Jean-François Gautier","doi":"10.1016/j.deman.2026.100307","DOIUrl":"10.1016/j.deman.2026.100307","url":null,"abstract":"","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"21 ","pages":"Article 100307"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147538068","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":"Diabetes distress is associated with food insecurity in Iranian adults with type 2 diabetes: a cross sectional study adjusted for socioeconomic determinants","authors":"Mehran Alijanzadeh ,&nbsp;Amaneh Behpoor ,&nbsp;Fereshteh Attaran ,&nbsp;Samira Saremi ,&nbsp;Leila Modarresnia ,&nbsp;Zainab Alimoradi","doi":"10.1016/j.deman.2026.100317","DOIUrl":"10.1016/j.deman.2026.100317","url":null,"abstract":"<div><h3>Introduction</h3><div>Diabetes distress represents a significant psychological burden that adversely affects self-management and clinical outcomes. Food insecurity has been proposed as factor associated with this distress. This study aimed to examine the association between food insecurity and diabetes distress in individuals with type 2 diabetes adjusted for socioeconomic factors.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, 207 adult patients with type 2 diabetes attending outpatient endocrinology clinics in Qazvin, Iran, were enrolled during 2025 via convenience sampling. Data on socioeconomic status, food insecurity (using a validated household access scale), and diabetes distress (using the 17-item Diabetes Distress Scale) were collected through interviewer-administered questionnaires. Multivariable linear regression was employed to identify factors independently associated with overall and domain-specific diabetes distress.</div></div><div><h3>Results</h3><div>Participants had a mean age of 55.70 (±15.95) years, diabetes duration of 7.87 (± 5.37) years, and a BMI of 28.92 (± 4.14) kg/m². After adjustment for covariates, significant factors associated with greater overall diabetes distress included: positive screen for depression (β = 0.20, 95% CI [0.11, 0.48], <em>p</em> = 0.002), rural residence (β = 0.17, 95% CI [0.08, 0.47], <em>p</em> = 0.006), and food insecurity (β = 0.16, 95% CI [0.05, 0.45], <em>p</em> = 0.016). Conversely, better self-perceived health status (β = -0.27, 95% CI [-0.64, -0.22], <em>p</em> &lt; 0.001) and use of oral hypoglycemic agents versus insulin (β = -0.13, 95% CI [-0.38, -0.02], <em>p</em> = 0.032) were associated with lower distress.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that integrated care approaches may be warranted including routine screening for depression and food insecurity using validated tools (e.g., PHQ-4 and HFIAS) during diabetes visits, targeted food assistance programs for vulnerable households, and patient education programs designed to improve self-perceived health status, particularly in rural populations.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"21 ","pages":"Article 100317"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147995802","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":"Retraction notice to “The correlation of ABC goal attainment with insulin resistance/sensitivity in Syrian type 2 diabetes patients” [Diabetes Epidemiology and Management (2024) 100221]","authors":"Samer Younes","doi":"10.1016/j.deman.2026.100314","DOIUrl":"10.1016/j.deman.2026.100314","url":null,"abstract":"","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"21 ","pages":"Article 100314"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147746691","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":"Using real-world data derived from electronic health records: the Dutch national diabetes registry DPARD","authors":"Vivienne F. Lit,&nbsp;Jessica C.G. Bak,&nbsp;Arianne C. van Bon,&nbsp;Erik H. Serné,&nbsp;Mechteld A.R. Vermeulen,&nbsp;Paul G. Voorhoeve,&nbsp;Ingo A. Eland,&nbsp;Pauline J.H.M. Stouthart,&nbsp;Thomas van Bemmel,&nbsp;Rolf H.H. Groenwold,&nbsp;Theo C.J. Sas,&nbsp;Carianne L. Verheugt","doi":"10.1016/j.deman.2026.100322","DOIUrl":"10.1016/j.deman.2026.100322","url":null,"abstract":"<div><div>The nationwide Dutch Pediatric and Adult Registry of Diabetes (DPARD) was established to gain insights into the quality of Dutch diabetes outpatient care, in order to improve patient care and health outcomes. The DPARD cohort is a dynamic population of Dutch children and adults treated for diabetes in a hospital outpatient clinic or independent diabetes care centres across the Netherlands. Data are extracted directly from electronic health records of participating healthcare centres since 2017. The dataset comprises 135 variables related to patient characteristics, diagnostic tests, treatments, and clinical outcomes including complications. In total, 113,451 children and adults across the Netherlands were included, of whom 40,514 were diagnosed with type 1 diabetes (T1D) and 41,998 were diagnosed with type 2 diabetes (T2D). Of all Dutch healthcare centres, 88% had registered and 70% were contributing data. The percentage of patients with unknown values varied up to a quarter of the patients for most variables. The Dutch national registry DPARD plays an important role in evaluating diabetes care. While current DPARD data offer valuable insights, further data enrichment will enable even more solid conclusions. This study describes the basis for future research using DPARD.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"21 ","pages":"Article 100322"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148523753","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":"Causes and clinical presentations of hypoglycemia in patients with type 2 diabetes presenting to the emergency department: A descriptive cross-sectional study","authors":"Seyed Mohammad Hosseininejad,&nbsp;Maryam Nabavi,&nbsp;Seyedeh Masoumeh Pashaei,&nbsp;Zahra Kashi,&nbsp;Amir Hasan Farzaneh","doi":"10.1016/j.deman.2026.100332","DOIUrl":"10.1016/j.deman.2026.100332","url":null,"abstract":"<div><h3>Background</h3><div>Hypoglycemia is a common and serious effect of diabetes treatment, leading to significant morbidity, mortality, and healthcare costs. Identifying its causes and presenting symptoms in emergency settings is crucial for prevention and management strategies.</div></div><div><h3>Objective</h3><div>To determine the causes, clinical presentations and correlates of blood glucose level among patients with type 2 diabetes presenting to the emergency department (ED) with hypoglycemia</div></div><div><h3>Design</h3><div>Prospective descriptive cross-sectional study</div></div><div><h3>Setting</h3><div>Emergency Department of major referral center in Northern Iran</div></div><div><h3>Patients</h3><div>T2DM patients aged ≥30 years with confirmed diagnosis who presented to the ED with symptoms consistent with hypoglycemia and a plasma glucose &lt;70 mg/dL (n = 60).</div></div><div><h3>Measurements</h3><div>Demographics, clinical characteristics, medications, and etiology and symptoms were collected using a checklist. The primary outcome was blood glucose. Factors associated with lower glucose were identified using bivariate tests and multiple linear regression.</div></div><div><h3>Results</h3><div>Mean age was 65.1 ± 14.0 years, 55% female. Most frequent causes: incorrect drug use (63.3%) and inappropriate prescription (16.7%). Neuroglycopenic symptoms were more common (43.3%) with lower mean glucose than neuroadrenergic symptoms (24.7 vs 53.9 mg/dL, p &lt; 0.001). In multivariable analysis, older age (β=-0.714, p = 0.001) and higher BMI (β=-0.492, p = 0.004) were independent correlates of lower presenting glucose.</div></div><div><h3>Conclusions</h3><div>Inappropriate medication use is the leading cause of hypoglycemia-related ED visits. Neuroglycopenic symptoms predominate, particularly in older patients. Patient education and provider vigilance are essential to reduce this preventable complication.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"21 ","pages":"Article 100332"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148951043","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":"Prevalence of comorbidities associated with type 2 diabetes and prediabetes and a case-control analysis of the emergence of new comorbidities in 2007 - 2019","authors":"Merja A Laine ,&nbsp;Hannu Järveläinen ,&nbsp;Markku Vielma ,&nbsp;Helena Ollila ,&nbsp;Päivi Rautava","doi":"10.1016/j.deman.2026.100318","DOIUrl":"10.1016/j.deman.2026.100318","url":null,"abstract":"<div><h3>Aims</h3><div>Diabetes and its comorbidities substantially contribute to morbidity. This study aimed to investigate the prevalence of cardiovascular diseases and diabetic kidney disease (CKD) among patients with type 2 diabetes (T2DM) and prediabetes, and the association of variables related to the treatment of T2DM with the risk of comorbidities.</div></div><div><h3>Methods</h3><div>We collected the data by extracting laboratory test results from real-world data of the catchment area of Turku University Hospital between 2005 and 2019 (fP-Gluk, 2-h glucose stress test, B-HbA1c). Cardiovascular diseases were ascertained using ICD10 codes from 1999 onward. CKD was diagnosed based on the measurement of estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (U-AlbKre). The prevalence of comorbidities was studied in a cohort 1 in 2019 that included 37,209 patients with type 2 diabetes and 42,554 with prediabetes. The risk of comorbidities was studied in a cohort 2 of 41,664 T2DM patients during the years 2007–2019. We analyzed the emergence of type 2 diabetes comorbidities by logistic regression.</div></div><div><h3>Results</h3><div>Patients with T2DM exhibited a higher prevalence of all comorbidities compared with individuals with prediabetes. Hyperglycemia was associated with a higher risk of complications in all disease groups. Highest risk ratio in glycemic burden was in CKD (OR 1.006, 95% CI 1.005–1.006). Use of cholesterol-lowering drugs, GLP-1 receptor agonists and SGLT2 inhibitors was associated with a lower risk in comorbidities (p &lt; 0.0001).</div></div><div><h3>Conclusions</h3><div>Early risk factor modification, optimal glycaemic control, and appropriate drug selection may substantially reduce the development of comorbidities.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"21 ","pages":"Article 100318"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147995801","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}