{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:27:02Z","timestamp":1787009222025,"version":"build-2736575974"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"7-8","funder":[{"DOI":"10.13039\/100007188","name":"Uniformed Services University of the Health Sciences","doi-asserted-by":"publisher","award":["Award # 11052-N21-10 (TriService Nursing Research Program)"],"award-info":[{"award-number":["Award # 11052-N21-10 (TriService Nursing Research Program)"]}],"id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007188","name":"Uniformed Services University of the Health Sciences","doi-asserted-by":"publisher","award":["Award # 11052-N21-10 (TriService Nursing Research Program)"],"award-info":[{"award-number":["Award # 11052-N21-10 (TriService Nursing Research Program)"]}],"id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,30]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Musculoskeletal (MSK) injury can negatively affect service members by compromising job performance and readiness. These injuries can impact the service member\u2019s physical health, functional abilities, and quality of life (QoL). Rehabilitation therapies for MSK injuries can reduce these impacts. One approach is home use rehabilitative therapy, usable during deployment and at home stations. The purpose of this updated systematic review with meta-analysis was to broaden our scope of pain\/symptoms, disability, and QoL as outcome measures for nonpharmaceutical MSK therapies in a military population versus controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>An updated systematic literature search was conducted from inception to September 2022 using electronic databases. From 2790 retrievals, 22 reports were identified from 21 randomized or nonrandomized control trials. Interventions included exercise, electrotherapy, bracing, and other devices compared to a standard control treatment. Outcomes for MSK pain\/symptoms, disability, and QoL were summarized as (1) standardized change from baseline for both intervention and control by time and (2) standardized mean differences (SMDs) in the time change between the intervention and control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Relative to baseline, pain improved during treatment and follow-up (P\u2009&amp;lt;\u2009.0001) with differences between intervention and control groups (P\u2009&amp;lt;\u2009.0001) but no significant interactions between group and time (P\u2009=\u2009.11). Overall, interventions showed modest (0.33 SMD, 95% CI, 0.11 to 0.54) improvement relative to controls across body regions and time. On average, disability exhibited an SMD of 0.12 (95% CI, \u22120.20 to 0.44) across all measures with substantial heterogeneity (I2\u2009=\u20090.93). Time (P\u2009=\u2009.02) but not intervention (P\u2009=\u2009.87) was a significant moderator with no clear pattern of change over time and no time by group interaction (P\u2009=\u2009.84). Quality of life had an overall modest effect with an SMD of 0.10 (95% CI, \u22120.04 to 0.24) with no evidence supporting a difference between the intervention and control groups (P\u2009=\u2009.10) and no significant interaction between time and group (P\u2009=\u2009.41). The QoL measures were primarily derived using the Short Form Health Survey (SF12\/36), which provide a mental and physical component summary score. For the mental component, there was either no change or a small decline during the study (P(time)\u2009=\u2009.80), with a difference between the intervention and control (P\u2009=\u2009.04) but no interaction between groups over time (P\u2009=\u2009.40). For the physical component scale, there was improvement during the study (P\u2009=\u2009.01), with the intervention showing better improvement than the control (P\u2009=\u2009.005), with no interaction between the time and treatment\/control group (P\u2009=\u2009.80). The report considers responses by region and individual treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This analysis demonstrated modest improvement in pain and physical well-being with therapy, with low certainty across diverse military cohorts. The impact on overall health-related disability and QoL was limited, with little change in mental well-being. The substantial heterogeneity and low certainty across diverse military cohorts limit generalizability, suggesting that further research in homogeneous environments is important for guiding clinical decisions. The study\u2019s findings suggest that nonpharmacological home use interventions may offer modest improvements in pain relief, particularly early in treatment, and in strength and function, according to our previous report. These interventions could complement standard care, providing options that may benefit service members during deployment and at home.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usae541","type":"journal-article","created":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T15:24:11Z","timestamp":1731511451000},"page":"e1420-e1431","source":"Crossref","is-referenced-by-count":2,"title":["Home Use Therapies for Pain, Disability, and Quality of Life in Military Service Members with a Musculoskeletal Injury: An Updated Systematic Review Meta-Analysis"],"prefix":"10.1093","volume":"190","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0381-4486","authenticated-orcid":false,"given":"Laura A","family":"Talbot","sequence":"first","affiliation":[{"name":"Department of Neurology, University of Tennessee Health Science Center, College of Medicine , Memphis, TN 38163,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Tennessee Health Science Center, College of Medicine , Memphis, TN 38163,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa J","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Military Performance Division, U.S. Army Research Institute of Environmental Medicine , Natick, MA 01760,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"David F","family":"Bradley","sequence":"additional","affiliation":[{"name":"Graduate School of Nursing, Uniformed Services University of the Health Sciences , Bethesda, MD 20814,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Scallan","sequence":"additional","affiliation":[{"name":"Center for Nursing Science and Clinical Inquiry, Landstuhl Regional Medical Center, Dr. Hitzelberger Strasse , Landstuhl\/Kirchberg, Rheinland-Pfalz 66849,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Zuber","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, University of North Carolina at Charlotte, College of Health and Human Services , Charlotte, NC 28223,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher H","family":"Morrell","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Statistics, Loyola University Maryland , Baltimore, MD 21210,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayla","family":"Enochs","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Tennessee Health Science Center, College of Medicine , Memphis, TN 38163,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Fagan","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Tennessee Health Science Center, College of Medicine , Memphis, TN 38163,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse","family":"Hillner","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Tennessee Health Science Center, College of Medicine , Memphis, TN 38163,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Jeffrey","family":"Metter","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Tennessee Health Science Center, College of Medicine , Memphis, TN 38163,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,12,11]]},"reference":[{"issue":"12","key":"2025070106322357500_R1","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.4085\/1062-6050-52.12.22","article-title":"Physical and performance characteristics related to unintentional musculoskeletal injury in special forces operators: a prospective analysis","volume":"52","author":"Heebner","year":"2017","journal-title":"J Athl Train"},{"key":"2025070106322357500_R2","doi-asserted-by":"crossref","first-page":"S101","DOI":"10.1519\/JSC.0b013e31822e7721","article-title":"Prevention and rehabilitation of musculoskeletal injuries during military operations and training","volume":"26","author":"Zambraski","year":"2012","journal-title":"J Strength Cond Res"},{"issue":"4","key":"2025070106322357500_R3","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1016\/j.pain.2013.12.025","article-title":"Pain-related musculoskeletal disorders, psychological comorbidity, and the relationship with physical and mental well-being in Gulf War veterans","volume":"155","author":"Kelsall","year":"2014","journal-title":"Pain"},{"issue":"5","key":"2025070106322357500_R4","doi-asserted-by":"publisher","first-page":"S53","DOI":"10.1016\/j.outlook.2017.07.010","article-title":"Health-related quality of life in active duty military: a secondary data analysis of two randomized controlled trials","volume":"65","author":"Talbot","year":"2017","journal-title":"Nurs Outlook"},{"issue":"9\u201310","key":"2025070106322357500_R5","doi-asserted-by":"publisher","first-page":"e1461","DOI":"10.1093\/milmed\/usaa027","article-title":"Musculoskeletal injuries and United States army readiness part I: overview of injuries and their strategic impact","volume":"185","author":"Molloy","year":"2020","journal-title":"Mil Med"},{"key":"2025070106322357500_R6","article-title":"A taxonomy of injuries for Public Health Monitoring and Reporting\u2014Public Health Information paper (PHIP)","volume-title":"Army Public Health Center","author":"Hauschild"},{"issue":"7","key":"2025070106322357500_R7","doi-asserted-by":"publisher","DOI":"10.3390\/s21072438","article-title":"Overuse-related injuries of the musculoskeletal system: systematic review and quantitative synthesis of injuries, locations, risk factors and assessment techniques","volume":"21","author":"Orejel Bustos","year":"2021","journal-title":"Sensors"},{"issue":"10","key":"2025070106322357500_R8","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1016\/j.jsams.2021.03.016","article-title":"Musculoskeletal injuries in military personnel\u2014descriptive epidemiology, risk factor identification, and prevention","volume":"24","author":"Lovalekar","year":"2021","journal-title":"J Sci Med Sport"},{"issue":"3\u20134","key":"2025070106322357500_R9","doi-asserted-by":"publisher","first-page":"e196","DOI":"10.1093\/milmed\/usx055","article-title":"Overuse injuries in the IDF\u2019s combat training units: rates, types, and mechanisms of injury","volume":"183","author":"Schwartz","year":"2018","journal-title":"Mil Med"},{"issue":"9","key":"2025070106322357500_R10","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.7205\/milmed-d-10-00471","article-title":"Orthopedic injuries before combat deployment\u2014will the soldiers be ready for combat when their unit is called upon?","volume":"176","author":"Frank","year":"2011","journal-title":"Mil Med"},{"issue":"2","key":"2025070106322357500_R11","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1097\/BOR.0b013e3283503406","article-title":"Rehabilitation programs for musculoskeletal injuries in military personnel","volume":"24","author":"Yancosek","year":"2012","journal-title":"Curr Opin Rheumatol"},{"issue":"9\u201310","key":"2025070106322357500_R12","doi-asserted-by":"publisher","first-page":"e1890","DOI":"10.1093\/milmed\/usae023","article-title":"Nonpharmacological therapies for musculoskeletal injury in military personnel: a systematic review\/meta-analysis","volume":"189","author":"Talbot","year":"2024","journal-title":"Mil Med"},{"key":"2025070106322357500_R13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n160","article-title":"PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"2025070106322357500_R14","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6947-7-16","article-title":"Utilization of the PICO framework to improve searching PubMed for clinical questions","volume":"7","author":"Schardt","year":"2007","journal-title":"BMC Med Inform Decis Mak"},{"key":"2025070106322357500_R15","article-title":"Veritas Health Innovation","author":"Covidence systematic review software"},{"issue":"3","key":"2025070106322357500_R16","doi-asserted-by":"crossref","first-page":"276","DOI":"10.11613\/BM.2012.031","article-title":"Interrater reliability: the kappa statistic","volume":"22","author":"McHugh","year":"2012","journal-title":"Biochem Med"},{"key":"2025070106322357500_R17","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"2025070106322357500_R18","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.jclinepi.2020.06.015","article-title":"The revised Cochrane risk of bias tool for randomized trials (RoB 2) showed low interrater reliability and challenges in its application","volume":"126","author":"Minozzi","year":"2020","journal-title":"J Clin Epidemiol"},{"key":"2025070106322357500_R19","article-title":"RoB 2 tool: a revised Cochrane risk of bias tool for randomized trials","volume-title":"Risk of bias tools","author":"riskofbias.info","year":"2022"},{"issue":"29","key":"2025070106322357500_R20","doi-asserted-by":"crossref","first-page":"5429","DOI":"10.1002\/sim.8362","article-title":"An extended mixed-effects framework for meta-analysis","volume":"38","author":"Sera","year":"2019","journal-title":"Stat Med"},{"issue":"3","key":"2025070106322357500_R21","doi-asserted-by":"crossref","first-page":"154","DOI":"10.20982\/tqmp.12.3.p154","article-title":"Fitting three-level meta-analytic models in R: A step-by-step tutorial","volume":"12","author":"Assink","year":"2016","journal-title":"Quant Meth Psych"},{"key":"2025070106322357500_R22","volume-title":"Introduction to Meta-analysis","author":"Borenstein","year":"2011"},{"key":"2025070106322357500_R23","first-page":"241","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Deeks","year":"2022"},{"issue":"2","key":"2025070106322357500_R24","first-page":"193","article-title":"Neuromuscular exercises on pain intensity, functional disability, proprioception, and balance of military personnel with chronic low back pain","volume":"65","author":"Alvani","year":"2021","journal-title":"J Can Chiropr Assoc"},{"key":"2025070106322357500_R25","doi-asserted-by":"publisher","DOI":"10.1177\/2164957x221094596","article-title":"Comparing types of yoga for chronic low back and neck pain in military personnel: a feasibility randomized controlled trial","volume":"11","author":"Groessl","year":"2022","journal-title":"Glob Adv Health Med"},{"issue":"6","key":"2025070106322357500_R26","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1123\/jsr.2021-0327","article-title":"Effect of compression therapy in the treatment of tibial stress syndrome in military service members","volume":"31","author":"Peterson","year":"2022","journal-title":"J Sport Rehabil"},{"issue":"5\u20136","key":"2025070106322357500_R27","doi-asserted-by":"publisher","first-page":"e385","DOI":"10.1093\/milmed\/usy294","article-title":"The effectiveness of an upper extremity neuromuscular training program on the shoulder function of military members with a rotator cuff tendinopathy: a pilot randomized controlled trial","volume":"184","author":"Ager","year":"2019","journal-title":"Mil Med"},{"issue":"11","key":"2025070106322357500_R28","doi-asserted-by":"publisher","first-page":"880","DOI":"10.7205\/milmed.169.11.880","article-title":"The use of a pneumatic leg brace in soldiers with tibial stress fractures\u2014a randomized clinical trial","volume":"169","author":"Allen","year":"2004","journal-title":"Mil Med"},{"issue":"10","key":"2025070106322357500_R29","doi-asserted-by":"publisher","first-page":"889","DOI":"10.3357\/amhp.4245.2015","article-title":"A randomized controlled trial of core strengthening exercises in helicopter crewmembers with low back pain","volume":"86","author":"Brandt","year":"2015","journal-title":"Aerosp Med Hum Perform"},{"issue":"Suppl 1","key":"2025070106322357500_R30","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1093\/milmed\/usaa449","article-title":"A novel stress fracture rehabilitation program: a pilot study","volume":"186","author":"Brown","year":"2021","journal-title":"Mil Med"},{"issue":"12","key":"2025070106322357500_R31","doi-asserted-by":"publisher","first-page":"1010","DOI":"10.3357\/amhp.4625.2016","article-title":"Home cervical traction to reduce neck pain in fighter pilots","volume":"87","author":"Chumbley","year":"2016","journal-title":"Aerosp Med Hum Perform"},{"issue":"21","key":"2025070106322357500_R32","doi-asserted-by":"publisher","first-page":"2303","DOI":"10.1097\/00007632-199511000-00008","article-title":"The effects of spinal flexion and extension exercises and their associated postures in patients with acute low back pain","volume":"20","author":"Dettori","year":"1995","journal-title":"Spine (Phila Pa 1976)"},{"issue":"11","key":"2025070106322357500_R33","doi-asserted-by":"publisher","first-page":"e1957","DOI":"10.7205\/milmed-d-17-00032","article-title":"Effectiveness of directional preference to guide management of low back pain in Canadian armed forces members: a pragmatic study","volume":"182","author":"Franz","year":"2017","journal-title":"Mil Med"},{"issue":"10","key":"2025070106322357500_R34","doi-asserted-by":"publisher","first-page":"1376","DOI":"10.1002\/lsm.23442","article-title":"Photobiomodulation as an adjunctive treatment to physiotherapy for reduction of anterior knee pain in combat soldiers: a prospective, double-blind, randomized, pragmatic, sham-controlled trial","volume":"53","author":"Gavish","year":"2021","journal-title":"Lasers Surg Med"},{"key":"2025070106322357500_R35","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1016\/j.ijsu.2017.08.584","article-title":"Shockwave treatment for medial tibial stress syndrome in military cadets: a single-blind randomized controlled trial","volume":"46","author":"Gomez Garcia","year":"2017","journal-title":"Int J Surg"},{"issue":"1","key":"2025070106322357500_R36","doi-asserted-by":"publisher","first-page":"40","DOI":"10.7205\/milmed.171.1.40","article-title":"A randomized controlled trial of a leg orthosis versus traditional treatment for soldiers with shin splints: a pilot study","volume":"171","author":"Johnston","year":"2006","journal-title":"Mil Med"},{"issue":"1","key":"2025070106322357500_R37","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1097\/AJP.0b013e3182478678","article-title":"Effect of targeted strength, endurance, and coordination exercise on neck and shoulder pain among fighter pilots: a randomized-controlled trial","volume":"29","author":"Lange","year":"2013","journal-title":"Clin J Pain"},{"issue":"1","key":"2025070106322357500_R38","first-page":"10","article-title":"The efficacy of orthotics for anterior knee pain in military trainees. A preliminary report","volume":"10","author":"Miller","year":"1997","journal-title":"Am J Knee Surg"},{"issue":"4","key":"2025070106322357500_R39","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1136\/jramc-156-04-06","article-title":"The additional value of a pneumatic leg brace in the treatment of recruits with medial tibial stress syndrome; a randomized study","volume":"156","author":"Moen","year":"2010","journal-title":"J R Army Med Corps"},{"issue":"5s","key":"2025070106322357500_R40","doi-asserted-by":"publisher","first-page":"S26","DOI":"10.1016\/j.outlook.2017.07.012","article-title":"The effect of pulsed electromagnetic frequency therapy on health-related quality of life in military service members with chronic low back pain","volume":"65","author":"Nayback-Beebe","year":"2017","journal-title":"Nurs Outlook"},{"issue":"3","key":"2025070106322357500_R41","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1136\/jramc-2018-001011","article-title":"General group exercise in low back pain management in a military population, a comparison with specific spine group exercise: a service evaluation","volume":"166","author":"Surtees","year":"2020","journal-title":"BMJ Mil Health"},{"issue":"5\u20136","key":"2025070106322357500_R42","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1093\/milmed\/usaa513","article-title":"Influence of self-managed rehabilitation on work efficiency in active duty military with a knee injury","volume":"186","author":"Talbot","year":"2021","journal-title":"Mil Med"},{"issue":"7\u20138","key":"2025070106322357500_R43","doi-asserted-by":"publisher","first-page":"e963","DOI":"10.1093\/milmed\/usaa037","article-title":"Electrical stimulation therapies for active duty military with patellofemoral pain syndrome: a randomized trial","volume":"185","author":"Talbot","year":"2020","journal-title":"Mil Med"},{"issue":"1\u20132","key":"2025070106322357500_R44","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1093\/milmed\/usab382","article-title":"Non-pharmacological home therapies for subacute low back pain in active duty military personnel: a randomized controlled trial","volume":"188","author":"Talbot","year":"2023","journal-title":"Mil Med"},{"issue":"7\u20138","key":"2025070106322357500_R45","doi-asserted-by":"publisher","first-page":"e174","DOI":"10.1093\/milmed\/usy347","article-title":"Self-managed strength training for active duty military with a knee injury: a randomized controlled pilot trial","volume":"184","author":"Talbot","year":"2019","journal-title":"Mil Med"},{"issue":"1\u20132","key":"2025070106322357500_R46","doi-asserted-by":"publisher","first-page":"e66","DOI":"10.1093\/milmed\/usac409","article-title":"Efficacy of conservative interventions for musculoskeletal conditions on pain and disability in active serving military personnel\u2014a systematic review","volume":"189","author":"Bounds","year":"2024","journal-title":"Mil Med"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/190\/7-8\/e1420\/61051359\/usae541.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/190\/7-8\/e1420\/61051359\/usae541.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T06:32:30Z","timestamp":1751351550000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/190\/7-8\/e1420\/7921405"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,11]]},"references-count":46,"journal-issue":{"issue":"7-8","published-online":{"date-parts":[[2024,12,11]]},"published-print":{"date-parts":[[2025,6,30]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usae541","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,7]]},"published":{"date-parts":[[2024,12,11]]}}}