Investigative ophthalmology & visual science最新文献

{"title":"Erratum in: Isolated Mitochondrial Transplantation as a Novel Treatment for Corneal Chemical Burns.","authors":"","doi":"10.1167/iovs.66.12.14","DOIUrl":"https://doi.org/10.1167/iovs.66.12.14","url":null,"abstract":"","PeriodicalId":14620,"journal":{"name":"Investigative ophthalmology & visual science","volume":"66 12","pages":"14"},"PeriodicalIF":4.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genome-Wide Insights Into the Genes and Pathways Shaping Human Foveal Development: Redefining the Genetic Landscape of Foveal Hypoplasia.","authors":"Callum Hunt, Ha-Jun Yoon, Alvin Lirio, Kayesha Coley, Jun Wang, Nick Shrine, Jianming Shao, Gail D E Maconachie, Zhanhan Tu, Jonathan H Zippin, Pirro G Hysi, Christopher J Hammond, Omar A Mahroo, Mariya Moosajee, Michel Michaelides, Andrew R Webster, Ala Moshiri, Rui Chen, Martin D Tobin, Chiara Batini, Mervyn G Thomas","doi":"10.1167/iovs.66.12.22","DOIUrl":"https://doi.org/10.1167/iovs.66.12.22","url":null,"abstract":"<p><strong>Purpose: </strong>To define the genetic architecture of foveal morphology and explore its relevance to foveal hypoplasia (FH), a hallmark of developmental macular disorders.</p><p><strong>Methods: </strong>We applied deep-learning algorithms to quantify foveal pit depth from central optical coherence tomography (OCT) B-scans in 61,269 UK Biobank participants. A genome-wide association study (GWAS) was conducted using REGENIE, adjusting for age, sex, height, and ancestry. Rare coding variants (frequency <1%) were analyzed in an exome-wide rare-variant association study (RVAS). Candidate genes were prioritized using integrative mapping; pathway, cross-ancestry, and genetic-correlation analyses were exploratory.</p><p><strong>Results: </strong>GWAS identified 126 sentinel variants, including 47 novel associations. Integrative mapping prioritized 129 putative causal genes, with 64 not previously implicated in foveal biology. Enriched pathways included retinoic acid metabolism (e.g., CYP26A1), photoreceptor differentiation (e.g., VSX2), extracellular matrix organization, and pigmentation. RVAS identified missense variants in ACTN3 and ESYT3 (P < 5 × 10-⁹) associated with FH features. Polygenic scores were predictive across African and South Asian ancestries. Overlap was observed with monogenic FH genes (TYR, OCA2, PAX6, AHR) and with genes underlying systemic diseases (COL11A1, KIF11, TUBB4B, PHYH). Re-examination of OCTs in affected individuals confirmed FH in select cases, including those with recurrent TUBB4B p.(Arg390Trp) variants.</p><p><strong>Conclusions: </strong>This is the first GWAS of human foveal morphology. Our findings redefine the genetic and biological framework underlying normal foveal development and foveal hypoplasia (FH). By linking common variation to rare monogenic disease, we establish a continuum model of FH with implications for future mechanistic and clinical investigation.</p>","PeriodicalId":14620,"journal":{"name":"Investigative ophthalmology & visual science","volume":"66 12","pages":"22"},"PeriodicalIF":4.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantification of Normative Human Choriocapillaris Measures Across the Macula.","authors":"Daniel X Hammer, Katherine Kovalick, Osamah J Saeedi, Emily Y Chew, Catherine Cukras, Zhuolin Liu","doi":"10.1167/iovs.66.12.26","DOIUrl":"https://doi.org/10.1167/iovs.66.12.26","url":null,"abstract":"<p><strong>Purpose: </strong>To assess macular choriocapillaris (CC) metrics in healthy volunteers (HVs) without ocular disease and demonstrate CC variations in patients with inherited retinal dystrophies (IRDs) using adaptive optics optical coherence tomography angiography (AO-OCTA).</p><p><strong>Methods: </strong>Twenty-one HVs and three IRD patients were imaged. Macular variation in 20 HVs in CC metrics (CC density, CC diameter, CC tortuosity, void diameter, void area, lobule count, lobule area, and RPE-CC distance) were assessed by imaging a 28° strip of overlapping AO-OCTA volumes (3° × 3°) from the optic nerve head to the temporal macula. En face projections of the CC at 1° intervals across the strip were created and metrics extracted using custom software.</p><p><strong>Results: </strong>CC density was mostly invariant across the macula at 0.523 ± 0.006, although it was slightly higher in the foveal region. The CC diameter decreased monotonically from 15.9 ± 0.7 µm in the nasal macula (-12°) to 14.2 ± 1.1 µm in the temporal macula (12°). Void measures also decreased from the nasal to the temporal macula: from 16.2 ± 1.4 µm to 14.6 ± 1.2 µm for void diameter and from 1418 ± 436 µm2 to 1243 ± 364 µm2 for void area. Lobule count peaked in the central macula. RPE-CC distance peaked at the fovea (fovea, 16.8 µm; periphery, ∼13-14 µm). CC tortuosity (1.17 ± 0.01) was constant across the macula. We observed a correlation with age in CC density, void diameter, and void area. AO-OCTA detected subclinical flow dropout in drusen regions. CC changes were observed in IRD patients with characteristics specific to the disease.</p><p><strong>Conclusions: </strong>Normative AO-OCTA-based CC metrics can provide insight into ocular disease pathology.</p>","PeriodicalId":14620,"journal":{"name":"Investigative ophthalmology & visual science","volume":"66 12","pages":"26"},"PeriodicalIF":4.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Grm6 Variant in a no b-wave (nob) Mouse Model: Phenotype Characterization and Gene Therapy.","authors":"Pei-Hsuan Lin, Eugene Yu-Chuan Kang, Neoklis Makrides, Winston Lee, Yun-Ju Tseng, Pei-Liang Wu, John Peregrin, Emmet Sherman, Jason Hunghsuan Wang, Theresa C Swayne, Tai-De Li, Melina A Agosto, Janet R Sparrow, Xin Zhang, Stephen H Tsang, Nan-Kai Wang","doi":"10.1167/iovs.66.12.20","DOIUrl":"10.1167/iovs.66.12.20","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize a no b-wave (nob) mouse model of congenital stationary night blindness (CSNB) caused by a Grm6 variant that disrupts photoreceptor-to-bipolar cell signaling. Additionally, we aim to evaluate the efficacy of gene therapy in restoring visual function.</p><p><strong>Methods: </strong>The nob mouse was generated through selective breeding to regenerate the nob phenotype. Adeno-associated viruses encoding Grm6 and GFP, driven by two promoters (hGRM6 and CMV), were administered to nob mice at postnatal days 5 (P5) and 30 (P30), respectively. Electroretinography and spectral domain optical coherence tomography (SD-OCT) were conducted three months after gene therapy.</p><p><strong>Results: </strong>The nob phenotype was successfully regenerated, and a homozygous missense variant c.1037G>A (p.Arg346His) in Grm6 was identified as the causal variant. Scotopic b waves were absent, whereas a waves remained normal, indicating intact rod function but impaired bipolar cell function. SD-OCT revealed thinning of the retinal nerve fiber layer and outer plexiform layer (OPL) in affected mice. Immunofluorescence and immunoblotting revealed decreased mGluR6 levels and associated signaling proteins. Gene therapy restored mGluR6 expression and reestablished synaptic protein localization in the OPL, although improvements in b/a ratios and OPL thickness were modest. Notably, the hGRM6 promoter at P5 was more effective at restoring OPL.</p><p><strong>Conclusions: </strong>We identified a new nob mouse model that mimics the CSNB phenotype in human patients. Whereas gene therapy successfully restored mGluR6 expression, functional improvements were limited. Early treatment using a specific promoter is critical, and increasing transduction efficiency may improve gene therapy strategies.</p>","PeriodicalId":14620,"journal":{"name":"Investigative ophthalmology & visual science","volume":"66 12","pages":"20"},"PeriodicalIF":4.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Anatomy of Ocular Counter-Rolling in Superior Oblique Palsy.","authors":"Joseph L Demer, Robert A Clark","doi":"10.1167/iovs.66.12.6","DOIUrl":"10.1167/iovs.66.12.6","url":null,"abstract":"<p><strong>Purpose: </strong>Simulations suggest that displacement of rectus extraocular muscle pulleys in superior oblique (SO) palsy accounts for incomitant strabismus patterns even without postulating SO contractile weakness. We asked how rectus extraocular muscle pulleys reorient during head tilt in SO palsy.</p><p><strong>Methods: </strong>In 13 subjects with unilateral SO palsy, supine magnetic resonance imaging (MRI) in 2-mm-thick quasi-coronal planes in target-controlled central gaze was repeated in both lateral decubitus positions equivalent to 90° head tilts. From extraocular muscle centroids, we computed oculocentric pulley coordinates and compartmental posterior partial volumes (PPVs) of the rectus and SO muscles.</p><p><strong>Results: </strong>Validating atrophy, PPV of the palsied SO was smaller than its fellow (P < 10-4). In fellow orbits, the array of all four rectus pulleys exhibited counter-rotation during head tilt (P < 0.03), averaging 5.9°. The palsied pulley array was in both tilts excyclorotated relative to the fellow orbit, particularly by 4° to 5° for horizontal rectus pulleys (P < 0.03), and also counter-rotated with head tilt similarly to the fellow orbit. Differential compartmental changes in PPV were significant in the lateral and superior rectus and SO muscles of the fellow orbit that were consistent with observed torsion, but were absent in the palsied orbit.</p><p><strong>Conclusions: </strong>Similar counter-rotation of the rectus pulley array during head tilt occurs in both eyes in unilateral SO palsy, but superimposed on excyclorotation of the array in the palsied orbit. Differential compartmental change in PPV occurs during head tilt in the lateral and superior rectus muscles of the fellow but not palsied orbit and could augment ocular counter-rolling.</p>","PeriodicalId":14620,"journal":{"name":"Investigative ophthalmology & visual science","volume":"66 12","pages":"6"},"PeriodicalIF":4.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954287","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 of Reflectivities of RPE, ELM, EZ, and Their Relationship With Subretinal Fluid Properties in Central Serous Chorioretinopathy.","authors":"Ekin Ece Oskan, Abdullah Agin, Mine Ozturk, Feyza Onder","doi":"10.1167/iovs.66.12.19","DOIUrl":"10.1167/iovs.66.12.19","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to assess the reflectivity of the outer retinal layers (ORLs) in patients with central serous chorioretinopathy (CSCR) and to examine the relationship between the dimensions of the subretinal fluid (SRF) and ORL.</p><p><strong>Methods: </strong>This retrospective, cross-sectional study included 33 eyes of 33 patients with CSCR and 33 age- and gender-matched controls. Unnormalized and relative reflectivities for the retinal pigment epithelium (RPE), the external limiting membrane (ELM), and the ellipsoid zone (EZ), as well as SRF height, base width, and area, were measured on optical coherence tomography images. Reflectivity measurements for each retinal layer were performed at three anatomic locations (foveal center, nasal, and temporal regions, 1 mm apart), and the average of these three values was used to calculate average reflectivity (RPEav, EZav, ELMav).</p><p><strong>Results: </strong>RPEav, EZav, and ELMav were lower in patients with CSCR (P < 0.001). In the pigment epithelium detachment (PED) group, EZn and EZav were significantly lower than in the non-PED group (P = 0.012 and P = 0.013, respectively). A negative correlation was observed between SRF base width and EZav (P = 0.018) and ELMav (P = 0.021). SRF area was negatively correlated with both EZav (P = 0.049) and ELMav (P = 0.025). RPEc was negatively correlated with SRF elevation (P = 0.016).</p><p><strong>Conclusions: </strong>This study reveals novel associations between SRF dimensions, PED presence, and outer retinal layer damage in CSCR. Monitoring ORL reflectivity changes may provide insights into disease pathogenesis and help evaluate treatment efficacy.</p>","PeriodicalId":14620,"journal":{"name":"Investigative ophthalmology & visual science","volume":"66 12","pages":"19"},"PeriodicalIF":4.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015362","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":"RP1 Dual-AAV Gene Therapy Preserves Retinal Structure and Ameliorates Photoreceptor Degeneration in a Murine Model of Retinitis Pigmentosa.","authors":"Fanfei Liu, Qiqi Li, Jing Su, Jiamei Fu, Xiaoyi Wu, Qiuxia Xu, Chengda Ren, Xiu Jin, Li Song, Fang Lu, Yang Yang","doi":"10.1167/iovs.66.12.29","DOIUrl":"https://doi.org/10.1167/iovs.66.12.29","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop and compare dual-adeno-associated virus (AAV) gene therapy utilizing protein trans-splicing versus mRNA trans-splicing to restore RP1 expression, and to evaluate their safety and efficacy in rescuing photoreceptor degeneration in a mouse model of RP1-associated retinitis pigmentosa (RP).</p><p><strong>Methods: </strong>By screening various split sites within the RP1 sequence in combination with different inteins or adopting mRNA trans-splicing binding sequences, we generated several plasmid pairs capable of reconstituting RP1 in vitro. Next, we conducted dual-AAV gene therapy via subretinal injection in RP1-/- mice. We validated the RP1 protein reconstitution in vivo by Western blotting. To assess the safety and efficacy of dual-AAV systems in RP1-/- mice, retinal structure was evaluated by histological analysis and transmission electron microscopy (TEM), and visual function was assessed by electroretinography (ERG) and visually guided behavioral tests at 1 and 6 months post-treatment.</p><p><strong>Results: </strong>The protein trans-splicing dual-AAV system achieved 72.35% of wild-type RP1 expression levels, significantly outperforming the mRNA trans-splicing approach (37.84%) at 1 month post-treatment. Both dual-AAV gene therapies preserved photoreceptor morphology and restored retinal function. The protein trans-splicing dual-AAV system exhibited higher ERG amplitudes and better performance in the water maze than the mRNA trans-splicing system.</p><p><strong>Conclusions: </strong>Our study demonstrates protein trans-splicing mediated dual-AAV gene therapy as a promising strategy for RP1-associated RP, offering potential therapeutic avenue for patients with RP.</p>","PeriodicalId":14620,"journal":{"name":"Investigative ophthalmology & visual science","volume":"66 12","pages":"29"},"PeriodicalIF":4.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cystoid Macular Edema in Non-Syndromic Retinitis Pigmentosa: Associations With Causative Genes in a Large Cohort.","authors":"Francesco Testa, Marianthi Karali, Rosa Boccia, Danila Pisani, Luciana Damiano, Antonio Nicolò, Emanuele Madonna, Luigi De Rosa, Raffaella Colucci, Antonella De Benedictis, Valentina Di Iorio, Paolo Melillo, Sandro Banfi, Francesca Simonelli","doi":"10.1167/iovs.66.12.5","DOIUrl":"10.1167/iovs.66.12.5","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the prevalence of cystoid macular edema (CME) in relation to the disease-causing genes in a large cohort of genetically defined patients with non-syndromic retinitis pigmentosa (RP).</p><p><strong>Methods: </strong>Spectral-domain optical coherence tomography (SD-OCT) imaging has been retrospectively reviewed in order to assess the presence of CME over the disease course in a cohort of 580 patients with a clinical and genetic diagnosis of non-syndromic RP.</p><p><strong>Results: </strong>Over the course of the disease, 179 patients (30.9%) developed CME in at least one eye. Based on the patients' genotypes, we found a statistically significant difference in CME prevalence according to the inheritance pattern (P < 0.001), with autosomal dominant forms being more frequently associated with CME (51.4%), followed by autosomal recessive forms (28.1%), but CME was rarely observed in X-linked RP (7.5%). By analyzing the most recurrent causative genes, we found the highest prevalence of CME in patients with autosomal dominant RP forms due to variants in RHO (58.2%), PRPF8 (72.7%), and PRPF3 (75.0%), whereas the lowest prevalence was observed in X-linked cases with mutations in RP2 (3.4%) and RPGR (8.8%).</p><p><strong>Conclusions: </strong>This study revealed a strong association of CME with the underlying causative gene in non-syndromic RP in the largest genotyped cohort so far reported, adding new insights in the etiopathogenesis of CME in RP. Our findings emphasize the importance of SD-OCT morphological assessments of RP patients both to improve disease management and to better explore genotype-phenotype correlations.</p>","PeriodicalId":14620,"journal":{"name":"Investigative ophthalmology & visual science","volume":"66 12","pages":"5"},"PeriodicalIF":4.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954043","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 Prevalence of Myopia in Finnish Conscripts Has not Increased in Recent Decades and Is Lower Than in Many East and Southeast Asian Countries.","authors":"Olavi Pärssinen, Marja-Liisa Franssila, Klaus Nordhausen, Mika Mattinen, Roope Sovelius, Markku Kauppinen, Jukka Moilanen, Niko Setälä, Ian Morgan","doi":"10.1167/iovs.66.12.10","DOIUrl":"10.1167/iovs.66.12.10","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine the prevalence of myopia among Finnish conscripts and to identify the factors associated with its occurrence in Finland.</p><p><strong>Methods: </strong>A total of 1694 conscripts (mean age: 19.3 ± 1.55 years) participated in the study. Refraction was performed on 1522 participants under tropicamide-induced cycloplegia. The final analyses included 1286 male conscripts who had completed the Finnish schooling system. A structured questionnaire collected data about education, time spent doing near work, smartphone use, and outdoor time. Univariate analyses and multivariate logistic regression models were used to determine the factors associated with myopia.</p><p><strong>Results: </strong>The overall prevalence of myopia was 23.5%, of which 0.4% had high myopia (SE ≤ -6 D). The main factors associated with myopia included (adjusted odds ratio; 95% confidence interval) near work time (1.184; 1.113-1.259), time spent outdoors (0.823; 0.754-0.895), and basic schooling versus higher education (1.256; 0.796-1.988). Among the higher-educated group, increased smartphone use was associated with a higher prevalence of myopia, whereas in the other educational groups, no association could be established.</p><p><strong>Conclusions: </strong>The prevalence of myopia among Finnish conscripts was relatively low, and high myopia was rare compared to the rates reported in many East and Southeast Asian countries. Higher education, prolonged near work, reduced time outdoors, and increased smartphone use (in the higher-educated group) were factors associated with myopia prevalence. The reduced educational pressure may be attributed to the lower prevalence of myopia among Finnish conscripts compared to many East and Southeast Asian countries, where myopia is much more prevalent.</p>","PeriodicalId":14620,"journal":{"name":"Investigative ophthalmology & visual science","volume":"66 12","pages":"10"},"PeriodicalIF":4.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954463","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":"Erratum in: Characterization of the Retinal Circulation of the Mouse.","authors":"","doi":"10.1167/iovs.66.12.15","DOIUrl":"https://doi.org/10.1167/iovs.66.12.15","url":null,"abstract":"","PeriodicalId":14620,"journal":{"name":"Investigative ophthalmology & visual science","volume":"66 12","pages":"15"},"PeriodicalIF":4.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}