Archives of Bone and Joint Surgery-ABJS最新文献

{"title":"Are We Training Surgeons or Supervisors? Artificial Intelligence, Automation, and the Future of Surgical Expertise in Orthopedics.","authors":"Ali Parsa, Mohammad H Ebrahimzadeh","doi":"10.22038/ABJS.2025.93815.4236","DOIUrl":"10.22038/ABJS.2025.93815.4236","url":null,"abstract":"","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 1","pages":"1-2"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724439","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":"Comparative Effectiveness of Isometric and Isotonic Exercises on Hyperkyphosis, Forward Head Posture, and Rounded Shoulders in Computer Users with Upper Crossed Syndrome: A Randomized Controlled Trial.","authors":"Arash Khaledi, Hooman Minoonejad","doi":"10.22038/abjs.2026.86402.3928","DOIUrl":"10.22038/abjs.2026.86402.3928","url":null,"abstract":"<p><strong>Objectives: </strong>While strengthening exercises have demonstrated efficacy in improving symptoms associated with Upper Crossed Syndrome (UCS), it remains unclear whether isometric or isotonic modalities offer greater benefits. This study compared their effects on forward head posture (FHP), rounded shoulders (RSH), and thoracic kyphosis in individuals with UCS.</p><p><strong>Methods: </strong>In this randomized controlled trial, 43 sedentary computer users diagnosed with UCS (aged 30-45 years) were randomly assigned to isometric (n = 15), isotonic (n = 14), or control (n = 14) groups. The eight-week intervention comprised three weekly supervised sessions for both exercise groups, each lasting 40 to 60 minutes. Postural variables were assessed using photogrammetry (FHP, RSH) and a flexible ruler (thoracic kyphosis). Statistical analyses included analysis of covariance (ANCOVA) and Bonferroni-adjusted post hoc tests, with statistical significance set at α = 0.05.</p><p><strong>Results: </strong>Both the isometric and isotonic groups showed statistically significant improvements in FHP (P < .001; mean difference [MD] = -6.79° and -7.97°, respectively), RSH (P < .001; MD = -6.44° and -8.09°, respectively), and thoracic kyphosis (P < .001; MD = -7.21° and -7.39°, respectively), compared to the control group. No statistically significant differences were observed between the two exercises groups, although the isotonic group exhibited marginally greater improvements.</p><p><strong>Conclusion: </strong>Both isometric and isotonic exercises effectively improved posture-related outcomes associated with UCS among sedentary adults. However, no definitive advantage was observed between the two exercise types. Future studies with longer intervention durations and larger sample sizes may elucidate any clinically meaningful differences.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 3","pages":"185-192"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13179535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965209","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":"Simultaneous Double Dislocation of the Interphalangeal Joints in One Finger: A Case Report and Literature Review.","authors":"Brandon Lim, Ahmed Elhagar, Mohamed Shaalan","doi":"10.22038/ABJS.2025.85462.3897","DOIUrl":"10.22038/ABJS.2025.85462.3897","url":null,"abstract":"<p><p>The simultaneous double dislocation of the distal interphalangeal joint (DIPJ) and proximal interphalangeal joint (PIPJ) in one finger is a rare injury. We present the case of a right-hand dominant male in his late teens who sustained a hyperextension injury to the tip of his left ring finger while playing football. A physical examination followed by anteroposterior and lateral radiographs confirmed dorsal dislocations at both the PIPJ and DIPJ in a \"stepladder\" deformity. His finger was subsequently splinted for 1 week after which hand physiotherapy was initiated. At 6 weeks follow-up, the patient demonstrated full functional recovery with a full range of motion in both DIPJ and PIPJ with no pain or stiffness. We also provide an up-to-date review of PubMed-indexed case reports regarding simultaneous double dislocations of the DIPJ and PIPJ.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 6","pages":"417-422"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654567","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":"Decade-Long Progress of a Patient with Early Onset Scoliosis Treated with Serial Casting, Traditional Growth Rods and Posterior Spinal Instrumentation with Fusion - a Case Report.","authors":"Kashfullah Khalid, Mohd Hisam Muhamad Ariffin, Azmi Baharuddin","doi":"10.22038/ABJS.2025.87025.3954","DOIUrl":"10.22038/ABJS.2025.87025.3954","url":null,"abstract":"<p><p>Early-onset scoliosis poses unique challenges for spinal and pediatric surgeons, as well as clinicians. Without intervention in pediatric patients, the spinal curvature may worsen, leading to abnormal thoracic cage growth, leading to abnormal lung development and poor respiratory tolerance. Treatment aims to correct the deformity while preserving the spinal mobility during growth. This is important because the growing spine will allow the child to achieve optimal height, a healthy thoracic cage, and cardiopulmonary system development. We can divide treatment modalities into observation, serial casting, bracing, and surgery. We are presenting a decade long progress report of a patient who initially underwent treatment with serial casting, growing rods, and definitive fixation for early-onset scoliosis. We strive to illustrate the complexities of early-onset scoliosis treatment by progressing from bracing to the application of a growth-friendly rod system, and finally to definitive posterior instrumentation.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 2","pages":"159-164"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869958","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":"Clinical Outcome of Proximal Femoral Osteoid Osteoma: Radiofrequency (RF) and Ablation Surgical Resection.","authors":"Ramin Zargarbashi, Mazaher Ebrahimian, Behnam Panjavi, Salar Baghbani, Mohammad Soleimani, Rasoul Shirmohammadi","doi":"10.22038/ABJS.2025.83833.3813","DOIUrl":"10.22038/ABJS.2025.83833.3813","url":null,"abstract":"<p><strong>Objectives: </strong>Osteoid osteoma (OO) is one of the most common benign bone tumors and can occur in various skeletal structures. It often presents with symptoms, such as nocturnal pain, which may mimic constitutional conditions, and it is characterized by a distinct radiological appearance that allows for easy differentiation from other lesions. Over the past decade, numerous studies have evaluated the efficacy of both surgical and radiological interventions for treating OO. While several treatment methods are available, each carries distinct advantages and disadvantages. This study aims to report the outcomes of surgical resection for ocular (OO) lesions.</p><p><strong>Methods: </strong>A total of 29 patients were enrolled in this study. Of these, 14 patients chose surgical resection as their primary treatment, while 15 patients opted for radiofrequency (RF) ablation. Three patients who exhibited a lack of response to RF ablation subsequently underwent surgical resection, bringing the total number of patients in the surgery group to 17. This study specifically focused on lesions located in the peritrochanteric region. For lesions that recurred at the same site, whether due to recurrence or lack of response to initial treatment, the same treatment modality used in the first instance was applied.</p><p><strong>Results: </strong>Among the 17 individuals who initially underwent surgical resection, 11 had extracapsular lesions, and 6 had intracapsular lesions. All patients who underwent surgical resection became symptom-free, and no complications were observed during the procedure. Furthermore, all cases that received surgical resection were confirmed through pathological assessment. Additionally, three patients with extracapsular lesions had previously been treated with RF thermoablation but had not fully recovered from their symptoms, necessitating surgical resection.</p><p><strong>Conclusion: </strong>Based on the results, although RF is the first choice of treatment for OO, surgical resection could be a vital and safe option for peritrochanteric OO.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 7","pages":"471-477"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664657","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":"Combination of Arthroscopic Arthrolysis and Minimal Invasive Quadricepsplasty for Management of Stiff Knee: Our Experience.","authors":"Bushu Harna, Shivali Arya, Dinesh Sandal","doi":"10.22038/abjs.2025.91373.4138","DOIUrl":"10.22038/abjs.2025.91373.4138","url":null,"abstract":"<p><strong>Objectives: </strong>Knee stiffness following surgeries around the knee significantly limits functional mobility and quality of life. This study aimed to evaluate the clinical outcomes of arthroscopic arthrolysis combined with minimally invasive quadricepsplasty in the management of post-surgical knee stiffness.</p><p><strong>Methods: </strong>This retrospective study included 14 patients with knee stiffness persisting for at least one year despite implant removal. All patients underwent arthroscopic arthrolysis with modified quadricepsplasty through a small midline incision over the superior pole of the patella. The procedure involved isolation of the rectus femoris, release of medial and lateral adhesions, and elevation of the quadriceps from the underlying femur. A standardized aggressive postoperative rehabilitation protocol was followed. Patients were evaluated for demographic details, knee range of motion (ROM), Visual Analog Scale (VAS), and Knee Society Score (KSS) at a minimum follow-up of 12 months.</p><p><strong>Results: </strong>The mean patient age was 34.7 ± 5.2 years, with a mean duration of knee stiffness of 1.4 ± 0.6 years from the index injury. Mean preoperative extension lag was 15° and flexion was 50°, which improved significantly to 3° and 115°, respectively, at final follow-up. Significant postoperative improvements were observed in both KSS and VAS scores. According to Judet's criteria, most patients achieved excellent outcomes. One patient developed minor wound complications, which resolved with conservative management.</p><p><strong>Conclusion: </strong>Arthroscopic arthrolysis combined with minimally invasive quadricepsplasty is an effective and safe treatment for post-surgical knee stiffness, providing significant improvements in knee ROM, pain relief, and functional outcomes with minimal complications.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 5","pages":"356-362"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200454","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":"Defining the Era of Shoulder Arthroscopy 2.0: A Perspective on Integrating Precision, Biology, and Smart Technology.","authors":"Kang Qin, Can Liu, Geng Peng, Yucheng Song, Liang Zhao, Yijun Wang","doi":"10.22038/ABJS.2025.90032.4084","DOIUrl":"10.22038/ABJS.2025.90032.4084","url":null,"abstract":"<p><p>Over the past four decades, shoulder arthroscopy has advanced from diagnostic exploration to sophisticated therapeutic procedures. However, current techniques remain limited in addressing complex pathologies. We propose the concept of the Era of Shoulder Arthroscopy 2.0 (ESA2.0)-defined by surgical precision, biological integration, and digital innovation. Technologies such as three-dimensional (3D) imaging, augmented reality, and robotics are being explored to enhance accuracy and reproducibility. Concurrently, biological strategies, including platelet-rich plasma, stem cells, and scaffold-based techniques, may improve healing. Smart systems, including AI-assisted diagnosis and wearable rehabilitation tools, support more personalized treatment and optimize outcomes. This paradigm may define a future standard in arthroscopic care, offering solutions to challenges previously deemed intractable.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 4","pages":"329-331"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13231256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148165115","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":"Evaluating Knee Osteoarthritis Induction Methods in Small Translational Animal Models from 1970-2025: A Comprehensive Systematic Review.","authors":"Armin Arabzadeh, Shervin Mossavarali, Gita Manzari Tavakoli, Kasra Mirzaei, Ayda Manzari Tavakoli, Brian T Feeley, Mohammad Hossein Nabian","doi":"10.22038/ABJS.2025.89905.4077","DOIUrl":"10.22038/ABJS.2025.89905.4077","url":null,"abstract":"<p><strong>Objectives: </strong>This approaches, for inducing knee osteoarthritis (KOA) in rabbit and rodent models. It also summarizes data study evaluates surgical, mechanical, chemical, genetic, and diet-induced methods, as well as combination-based on post-intervention time points for KOA development, the duration required for osteophyte formation, KOA scoring systems, and relevant histopathological findings.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, and Web of Science (from 1970 to February 2025) was conducted using the PICO framework, focusing on animal models (rabbits and rodents), osteoarthritis induction methods, comparative efficacy, and relevant outcomes. Extracted variables included model characteristics, interventions, and KOA-related findings. The risk of bias was assessed using the Cochrane risk-of-bias tool and the ROBINS-I tool.</p><p><strong>Results: </strong>After screening 5,702 records, 98 studies met the inclusion criteria. Surgical (n = 34), chemical (n = 15), genetic (n = 13), mechanical (n = 19), and high-fat diet-induced (n = 6) models, as well as combination approaches, were reviewed. Among surgical techniques, anterior cruciate ligament transection (ACLT) and medial meniscus destabilization (DMM) were the most frequently used, whereas monosodium iodoacetate (MIA) was the predominant chemical inducer. Genetic models primarily involved gene deletions or mutations in C57BL/6 mice. Mechanical induction methods included joint loading, treadmill running, and immobilization. Histological evaluation-most commonly using the Mankin and Osteoarthritis Research Society International (OARSI) scoring systems-was the predominant approach for KOA assessment, while micro-computed tomography (micro-CT) was employed in selected studies. Osteophyte formation was prominent in surgical and specific chemical models and was typically observed within 8 weeks post-intervention. Additionally, each induction method exhibited a distinct time course for osteophyte development and the establishment of KOA.</p><p><strong>Conclusion: </strong>Each approach offers distinct advantages for replicating KOA pathology and for facilitating research into disease mechanisms and therapeutic interventions.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 4","pages":"232-266"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13231263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148165190","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":"Predictive Radiographic Factors for Soft Tissue Release and Distal Femoral Cut Angle for Appropriate Biomechanics in Total Knee Arthroplasty.","authors":"Arash Sharafatvaziri, Ehsan Hedayat, Maryam Salimi, Fardis Vosoughi, Ramin Shayan-Moghadam, Ghazaleh Moradkhani, Hamidreza Nematy, Morad Karimpour","doi":"10.22038/abjs.2025.80846.3689","DOIUrl":"10.22038/abjs.2025.80846.3689","url":null,"abstract":"<p><strong>Objectives: </strong>Total knee arthroplasty (TKA) relies on precise soft tissue releases and bone cuts for balanced weight distribution. Challenges include the lack of predictors to guide the extent and timing of soft tissue release. This study examines the relationship between radiographic parameters and the distal femur valgus cut angle (VCA), and their correlation with the medial soft tissue release (MSTR) stage in TKA patients. The goal is to identify predictors that aid in achieving optimal biomechanics and tissue balance.</p><p><strong>Methods: </strong>In this prospective cohort study, we examined preoperative standard lower limb three-joint views of 62 limbs (57 patients) to explore the relationship between radiographic parameters, the stage of MSTR, and VCA. Univariate and multivariate linear regression analyses, along with various statistical tools, were used to identify relationships and determine cut-off values.</p><p><strong>Results: </strong>A notable positive correlation was observed between VCA and medial hip offset (MHO), as well as between VCA and femoral length (FL), with both correlations yielding P < .001. Patients with shorter femurs and an MHO greater than 4.35 cm required a distal femoral cut angle of 6 degrees or more, while those with longer femurs and an MHO less than 4.35 cm needed an angle of less than 6 degrees (sensitivity: 83%, specificity: 80%). Additionally, the joint line congruency angle (JLCA), varus angle (VA), and lateral distal femoral angle (LDFA) showed significant correlations with the stage of MSTR. Among these variables, the VA emerged as the most accurate predictor, with a sensitivity of 91.7% and a specificity of 100%.</p><p><strong>Conclusion: </strong>Increasing the LDFA to above 93.5°, JLCA to above 7.5°, and the VA to above 19° would heighten the probability of requiring extensive MSTR. Additionally, MHO and FL are the most crucial predictive factors for determining the VCA.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 2","pages":"104-112"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869940","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":"Does Unplanned Excision of Soft Tissue Sarcomas Affect the Oncological Outcome: A Retrospective Study.","authors":"Wael Mohamed Safwat Sadek, Ahmed Gamal ELBadawi Ahmed, Wessam Gamal Abou Senna, Walid Atef Ebeid","doi":"10.22038/ABJS.2025.87788.3973","DOIUrl":"10.22038/ABJS.2025.87788.3973","url":null,"abstract":"<p><strong>Objectives: </strong>Soft tissue sarcoma is commonly misdiagnosed as a benign tumor and excised without appropriate precautions mandatory to deal with malignancy. Referrals after inadequate initial excision account for 19-35% of new patients in sarcoma centers. The objective of this study was to assess the oncological outcome of inappropriately treated soft tissue sarcomas in a retrospective, single-center analysis.</p><p><strong>Methods: </strong>This study included 43 patients who had soft tissue sarcomas in the extremities and were inadequately treated. They were referred to Cairo University Hospitals, Egypt and managed from November 1999 to April 2017. The minimum follow-up period was 1 year after adequate resection. The oncological outcome was assessed regarding the incidence of local recurrence, chest metastasis as well as the overall survivorship.</p><p><strong>Results: </strong>This study included 23 males and 20 females. 19 patients developed local recurrence (44.2%). 17 patients developed chest metastasis (39.5%). The incidence of local recurrence and chest metastasis was significantly affected by the type of the margin. Regarding the overall survival, 14 patients (32.6%) died during the follow up, while 29 patients (67.4%) were still alive by the end of the study.</p><p><strong>Conclusion: </strong>In our study, oncological outcome was significantly affected only by the margin status. Chest metastasis affected overall survival dramatically. Although it is challenging to achieve resection with wide margin, it is mandatory to get good oncological outcome.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 2","pages":"135-143"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870015","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}