Current Reviews in Musculoskeletal Medicine最新文献

{"title":"Virtual Reality Simulation in Orthopedic Surgery Education Improves Immediate Procedural Skill and Knowledge Acquisition, But Evidence on Cost-Effectiveness and Skill Retention Remains Lacking.","authors":"Francesca R Coxe, Taylor P Stauffer, Michael P Ast","doi":"10.1007/s12178-025-09973-8","DOIUrl":"10.1007/s12178-025-09973-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>Virtual reality (VR) simulation in orthopedic education has gained recent interest in the literature. VR simulation provides a virtual space to practice surgical steps accurately, creating a user-controlled environment for novice surgical trainee skill development. Despite the reported benefits, VR is not routinely incorporated into orthopedic residency core curriculum. This study reviews and synthesizes contemporary data assessing the efficacy of VR simulation in orthopedic surgical training.</p><p><strong>Recent findings: </strong>Twenty-three studies across six subspecialty areas were included. Seven hundred and forty-eight participants trained on over nine different VR simulators. Control groups included no additional training, surgical technique guides, surgical videos, and benchtop simulators. Outcome measurements included procedure-specific checklists, objective grading scales, time-to-task completion, and accuracy of implant placement, among others. No outcomes directly focused on patient safety or involved live patients. Across disciplines, VR simulation training improved outcomes when compared to controls, conferring quicker procedure times, higher correct step completion, and more accurate implant placement, although not always statistically significant. Virtual reality is a tool employed by various industries that offers immersive, interactive, and realistic learning experiences. In orthopedics, VR has the potential to enhance skills, improve safety, and increase trainee confidence. In most of the included studies, trainees performed better in the VR simulation groups when compared to control education modalities, and participants readily embraced VR. However, there is mixed evidence on its use, and future studies are needed involving longitudinal VR education to better assess the actual impact on trainee skills, as well as performance in the operating room and its impact on patient outcomes.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"363-378"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12325134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986004","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":"Management of Posterior Shoulder Instability Among Football Players.","authors":"Kira L Smith, Luc Fortier, Andrew Moyal, John M Apostolakos, Jacob G Calcei, James E Voos","doi":"10.1007/s12178-025-09976-5","DOIUrl":"10.1007/s12178-025-09976-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Football players are at an increased risk for posterior shoulder instability compared to other sports due to certain sport-specific motions that involve posteriorly directed force on the shoulder in a vulnerable position. Management of posterior instability, both nonoperative and operative, is aimed at preventing recurrent instability. Regardless of treatment, timing of return to play revolves around avoiding reinjury and prioritizing player safety. This article provides a review of the current treatment modalities of posterior shoulder instability and the return to play criteria that must be met prior to releasing the player to competition.</p><p><strong>Recent findings: </strong>Posterior shoulder instability was traditionally thought to occur predominately in offensive linemen. However, recent literature suggests it can also commonly be found in other players, including defensive linemen and quarterbacks. Current research reports high return to play rates for athletes that undergo arthroscopic posterior capsulolabral repair. Whereas, there is limited literature regarding return to play rates after posterior bony augmentation and management of reverse Hill-Sachs lesions. Rehabilitation and return to play protocols have been recommended but are nonspecific to American football. Posterior shoulder instability has the potential to sideline young athletes for an extended time and presents a complex challenge to both the athlete and the treating physician. Although the ultimate goal is to facilitate return to play, the physician must balance this with minimizing the risk of re-injury.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"460-468"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12325834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076460","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":"Artificial Intelligence in Spine Surgery: Imaging-Based Applications for Diagnosis and Surgical Techniques.","authors":"James S MacLeod, Tyler Compton, Yianni Bakaes, Avani Chopra, Frances Akwuole, Cole Christenson, Wellington Hsu","doi":"10.1007/s12178-025-09972-9","DOIUrl":"10.1007/s12178-025-09972-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>Artificial intelligence (AI) has rapidly proliferated though medicine with many novel applications to improve patient care and optimize healthcare delivery. This review investigates recent literature surrounding the influence of AI imaging technologies on spine surgical practice and diagnosis.</p><p><strong>Recent findings: </strong>Robotic-assisted pedicle screw placement has been shown to increase the rate of clinically acceptable screw placement while increasing operative time. AI technologies have also shown promise in creating 3D spine imaging while reducing patient radiation exposure. Several models using various imaging modalities have been shown to reliably identify vertebral osteoporotic fractures, stenosis and spine cancers. Complex spinal anatomy and pathology as well as integration of robotics make spine surgery a promising field for the deployment of AI-based imaging technologies. Imaging-based AI projects show potential to enhance diagnostic and surgical efficiency, facilitate trainee learning and improve operative outcomes.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"398-405"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12325831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985339","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":"The Effects of GLP-1 Agonists on Musculoskeletal Health and Orthopedic Care.","authors":"Andrew Gatto, Kevin Liu, Nesa Milan, Stephanie Wong","doi":"10.1007/s12178-025-09978-3","DOIUrl":"10.1007/s12178-025-09978-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>The global rise in obesity and type 2 diabetes mellitus (T2DM) presents significant challenges in musculoskeletal care, contributing to increased perioperative complications, impaired bone health, and compromised muscle function. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), initially developed for glycemic control in T2DM, have demonstrated substantial benefits in weight reduction and metabolic regulation. The purpose of this review is to understand the musculoskeletal biologic and clinical implications of GLP-1RAs.</p><p><strong>Recent findings: </strong>Evidence suggests that GLP-1RAs may impact musculoskeletal health through anti-inflammatory effects, bone metabolism modulation, and alterations in muscle composition. GLP-1RAs may promote osteoblastogenesis while dampening osteoclast activity to maintain bone mineral density. The result on fracture risk is unclear. Additionally, while GLP-1RAs cause lean mass loss, GLP-1RAs appear to preserve skeletal muscle, reduce fatty infiltration, and enhance fiber formation and function. Further, GLP-1Rs are present in synovial tissue and cartilage, demonstrating downregulation of inflammatory molecules and chondrocyte apoptotic pathways, though clinical studies show variable effects in the setting of osteoarthritis. Overall, the heterogeneity in findings underscores the need for further research to delineate the long-term musculoskeletal effects of GLP-1RAs. Understanding the musculoskeletal impact of GLP-1RAs is critical for optimizing their integration into orthopedic practice. This review explores the orthopedic implications of GLP-1RAs, highlighting their biologic mechanisms and clinical effects on obesity-related joint inflammation and arthropathy, bone mineral density and fracture risk, and skeletal muscle preservation.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"469-480"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12325148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076463","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":"Sports Injuries in Female and Non-Binary Athletes: A Systematic Review.","authors":"Leah N Nairn, Amar Aziz, Lana Moayad, Lauren A Gyemi, Nicole Simunovic, Kim Madden, Marko Simunovic, Olufemi R Ayeni","doi":"10.1007/s12178-025-09974-7","DOIUrl":"10.1007/s12178-025-09974-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>The main purpose of this review was to summarize the current evidence on treatment and outcomes of sports injuries requiring surgical intervention in female and non-binary athletes and identify key gaps in the related literature concerning sports injuries requiring surgical intervention to guide future research.</p><p><strong>Recent findings: </strong>Of the 59 included studies, all focused on biological sex or sex-based differences, while none of the studies discussed gender or the inclusion of non-binary and transgender individuals. Most of the studies (47/59, 80%) focused on ACL reconstruction (37%), hip arthroscopy (27%) or rotator cuff repair (15%). Important sex-based differences were seen with these injuries including differences in fears regarding recovery after ACL injury and pre- and post-operative pain scores following rotator cuff injury. Despite increasing recognition of the role of biologic sex in the treatment and outcomes of sports injuries, very little is known about the impact of gender in sports injuries. Previous sociological literature suggests that gender may play an important role in one's athletic experience, and thus their injury experience. With most of the included studies focused on only three injury types, the experiences of female and non-binary athletes with all other sports injuries are poorly characterized. The lack of gender-inclusive sports injuries research means that the complete experiences of female, non-binary and transgender athletes are not comprehensively captured in the current literature. Future research should aim to characterize the effect of gender on the treatment and outcomes on all sport-related injuries, with the goal of providing inclusive surgical care for all athletes.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"406-416"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12325152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958731","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":"A Review of Revision Meniscal Repair: Clinical Considerations and Outcomes.","authors":"Emily Berzolla, Vishal Sundaram, Eric Strauss","doi":"10.1007/s12178-025-09968-5","DOIUrl":"10.1007/s12178-025-09968-5","url":null,"abstract":"<p><strong>Purpose: </strong>Meniscus repair is preferred over meniscectomy when possible due to its ability to preserve meniscal tissue and reduce long-term joint degeneration. However, meniscus repair has a risk of failure, resulting in an increasing number of patients presenting with symptoms following a failed repair. Revision meniscus repair remains an option for symptomatic patients, yet guidance on indications, surgical techniques, and expected outcomes is limited. The purpose of this review is to summarize indications, surgical approaches, and outcomes associated with revision meniscus repair.</p><p><strong>Recent findings: </strong>Patient-specific factors such as age, activity level, and modifiable risk factors influence revision repair success. Younger, highly active individuals may be at higher risk of retear due to increased mechanical stress. Tissue quality and vascularity are critical, as degenerative changes and poor perfusion increase failure rates. The gold-standard inside-out technique is often favored for revision repairs due to its superior biomechanical stability. However, all-inside and outside-in techniques remain viable options in specific cases. Biological augmentation, including platelet-rich plasma (PRP) and marrow venting, may enhance healing potential but requires further investigation. Revision meniscus repair demonstrates comparable failure rates and functional outcomes to primary repair, with reported failure rates ranging from 21-33% at mid-term follow-up. Many patients successfully return to high levels of activity following revision repair. Although younger age and high activity levels may predispose to failure, revision meniscus repair remains a viable option for preserving meniscal integrity and optimizing long-term joint health.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"344-352"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981886","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":"Redefining Failure: Criteria for Unsuccessful Outcomes in Meniscus Repair.","authors":"Saygin Kamaci, James Lee Pace","doi":"10.1007/s12178-025-09971-w","DOIUrl":"10.1007/s12178-025-09971-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>Meniscus repair plays a critical role in preserving knee function and delaying degenerative changes after a meniscus tear. Despite advancements in surgical techniques, there remains significant variability in how outcomes are defined and reported. This review examines the evolving interplay between traditional metrics of success such as reoperation rates, radiographic healing, etc., and the more subjective patient reported outcome measures (PROMs).</p><p><strong>Recent findings: </strong>Recent findings highlight the discrepancies between radiographic healing, symptomatic relief, and functional improvement. While reoperation rates remain a widely used failure criterion, they do not account for patients who avoid revision surgery despite persistent symptoms. MRI assessments can detect incomplete healing, but imaging abnormalities do not always correlate with clinical dysfunction. PROMs and return-to-sport (RTS) rates offer valuable insight into functional recovery, yet they vary across studies and may not always reflect anatomical failure. Emerging consensus supports a dual model: anatomical failure, which reflects structural compromise seen on imaging or second-look arthroscopy, and clinical failure, which includes persistent symptoms, limited function, or poor patient-reported outcomes regardless of imaging results. Meniscus repair failure should be assessed using a multidimensional approach, incorporating structural integrity, symptom persistence, functional performance, and patient satisfaction. Standardizing failure definitions will improve data comparability, enhance treatment strategies, and guide patient expectations. Future research should refine composite failure models and integrate meniscus-specific PROMs to optimize long-term outcomes. By redefining failure, clinicians can improve surgical success rates and provide more personalized, evidence-based care.</p><p><strong>Takeaway: </strong>Not all healed menisci function well, and not all unhealed ones fail. By redefining failure, we can reframe success-and better serve patients.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"353-360"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969176","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":"Evaluation and Management of Rotator Cuff Tears Following Shoulder Dislocation.","authors":"Natalie K Kucirek, Jamie E Confino, Brian Feeley, Michael R Davies","doi":"10.1007/s12178-025-09970-x","DOIUrl":"10.1007/s12178-025-09970-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to summarize the epidemiology, associated pathology, and treatment options for rotator cuff tears following shoulder dislocations and to provide a treatment algorithm for these complex injuries.</p><p><strong>Recent findings: </strong>Rotator cuff tears after shoulder dislocations most often occur in patients older than 40 and may be more prevalent in women. Up to 50% of these patients may have concomitant Bankart lesions. Patients treated nonoperatively generally have worse functional outcomes and higher pain scores than those who undergo rotator cuff repair. However, further studies are needed to elucidate when the rotator cuff can be repaired in isolation versus in combination with capsulolabral stabilization. Reverse total shoulder arthroplasty is a viable treatment option for elderly patients with irreparable cuff tears after dislocation or post-instability arthropathy. Patients who sustain a shoulder dislocation should be evaluated for a rotator cuff tear, particularly if older than 40. Those with post-instability full-thickness rotator cuff tears benefit from surgical treatment. Further research is needed to clarify when additional stabilization procedures should be performed alongside rotator cuff repair.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"323-330"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984760","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":"Current Rehabilitation Principles Following Meniscus Repairs.","authors":"Jill K Monson, Luke V Tollefson, Christopher M LaPrade, Robert F LaPrade","doi":"10.1007/s12178-025-09967-6","DOIUrl":"10.1007/s12178-025-09967-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to synthesize current science on meniscus anatomy and biomechanics and repair techniques to create an empirical foundation for postoperative rehabilitation precautions and guidelines, including timelines, clinical and performance-based criteria for return to activity, to maximize both meniscal healing potential and patient recovery.</p><p><strong>Recent findings: </strong>Recent literature has focused on meniscus repair rather than debridement, and rehabilitation protocols should be designed to optimize healing. Complex, unstable tears, like root and radial tears, disrupt hoop stress and warrant a more conservative protocol including 6 weeks of non-weightbearing; however, more stable tears, like ramp and vertical tears, can often weight bear immediately after surgery. All protocols should emphasize early protected joint motion. Return to activity guidelines remain ill-defined but this review explores evidence-based recommendations for timelines, strength and performance testing. Patients typically should wait ≥ 4 months for a return to activity and the presence of joint line tenderness or effusion could be a sign of delayed/failed healing. It is essential for therapists to know the size, type, and location of a meniscus repair to optimize patient outcomes. Guidelines for weight bearing, range of motion, strength training, and return to activity should vary per tear type and repair technique and recovery should be both time- and criteria-based. Return to activity should align with healing time, objective clinical and performance testing, and clinical and imaging exam findings. Future research should aim to optimize repair techniques and rehabilitation protocols, specifically further study on the timing to initiate weightbearing, early motion, and return to activity.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"331-343"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988971","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":"Biomechanics of Meniscus Tears and Repair Techniques.","authors":"Jason Ina, Grant Nelson, John T Strony, Adam Tagliero, Jacob Calcei, Aaron J Krych, James Voos","doi":"10.1007/s12178-025-09958-7","DOIUrl":"10.1007/s12178-025-09958-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>Treatment of meniscus injuries can have a substantial effect on the intra-articular biomechanics and long-term function of the knee. Meniscus repair has become a more favorable treatment option as prior studies have demonstrated a strong correlation between meniscal preservation and restoration of intra-articular contact pressure and decreased progression of arthritis. The goal of meniscus repair is to provide a stable load bearing construct to allow for meniscal healing. Repair constructs vary by tear pattern, tear location, and repair technique. The purpose of this review is to highlight the biomechanical strength of meniscus repair techniques for frequently encountered meniscus tears.</p><p><strong>Recent findings: </strong>Recent literature reports that meniscus tear type and location influence which repair technique would provide the most stable construct. Prior studies report that inside-out meniscus repair is the gold standard for longitudinal tears, but more recent literature on modern all-inside repair devices suggest improvements with all-inside devices. Radial tears repaired with vertical mattress rip stop sutures added to horizontal mattress repair sutures have less suture cut-out and improved stability. Root tears repaired with a locking suture configuration result in biomechanical strength similar to a native meniscus and addition of a centralization suture may further improve this construct. No single repair technique is superior to others across meniscus repair types. Surgeons need to thoroughly understand various tear patterns and be familiar with a variety of repair techniques in order to provide the most stable construct for meniscus repair.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":"311-322"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555394","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}