Optometry and Vision Science最新文献

{"title":"Feature issue editors for Aging, the Eye and Vision System.","authors":"David B Elliott","doi":"10.1097/OPX.0000000000002232","DOIUrl":"https://doi.org/10.1097/OPX.0000000000002232","url":null,"abstract":"","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":"102 2","pages":"45-47"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of assessing vision in falls management: A narrative review.","authors":"Jignasa Mehta, Aishah Baig","doi":"10.1097/OPX.0000000000002222","DOIUrl":"10.1097/OPX.0000000000002222","url":null,"abstract":"<p><strong>Significance: </strong>A comprehensive falls assessment should include the assessment of key visual risk factors, namely, visual acuity, contrast sensitivity, and stereoacuity, to help prevent further falls in older adults. As a minimum, a thorough visual history and uniocular visual acuity assessment would allow appropriate onward referral for intervention.</p><p><strong>Purpose: </strong>Falls prevention is a global public health challenge. The etiology of falls is often complex due to multiple interacting risk factors contributing to postural instability in older adults. Despite national recommendations, the assessment of visual function is often overlooked in falls management. This may be due to a lack of clear guidance on key visual functions that need assessing in this patient group, professional roles, and responsibilities. This review gives an overview of visual risk factors for falls in older adults without cognitive impairment. It focuses on visual functions that can be assessed practically using standard clinical procedures. Possible test selection for a falls clinic or inpatient setting is discussed to help inform the implementation of vision assessments in falls management.</p><p><strong>Methods: </strong>Literature searches were conducted on Web of Science (1898 to current), MEDLINE (1946 to present), and APA PsycInfo (1887 to present) using relevant search terms and Boolean operators related to visual functions and falls. Retrospective and prospective studies including randomized controlled trials, observational, cohort, case-control, and qualitative studies were included.</p><p><strong>Results: </strong>Visual functions decline with age due to the normal aging process and age-related pathologies. Despite considerable heterogeneity across studies, the evidence supports the association of falls with declines in visual functions, including visual acuity, binocular single vision, and the visual field, but most notably contrast sensitivity and stereopsis. Existing vision screening tools, which assess multiple visual functions, are reviewed in light of their usefulness in falls.</p><p><strong>Conclusions: </strong>We recommend a vision assessment in the management of falls, which considers visual functions associated with falls, particularly contrast sensitivity and stereopsis. Existing vision screening tools could be adapted or developed for use in falls clinics or the inpatient setting. Eye health professionals should form part of falls multidisciplinary teams or offer training in assessing vision and help to develop intervention pathways for timely management of visual impairment.</p>","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":"102 2","pages":"110-120"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vision corrections used by presbyopic orienteers.","authors":"Keziah Latham, Louis P H Abbott, Matthew A Timmis","doi":"10.1097/OPX.0000000000002193","DOIUrl":"10.1097/OPX.0000000000002193","url":null,"abstract":"<p><strong>Significance: </strong>Evaluating the visual challenges and refractive correction solutions of presbyopic orienteers identifies features of relevance to optometric management of the visual needs of active presbyopes.</p><p><strong>Purpose: </strong>Orienteering is a unique sport requiring visual clarity at a range of viewing distances and has a high proportion of presbyopic participants. This study evaluates the vision corrections used by presbyopic orienteers, specifically aiming to characterize the prevalence of different vision correction options used and to explore the strengths and limitations of different vision correction solutions.</p><p><strong>Methods: </strong>Orienteers 40 years or older completed an online questionnaire consisting of multiple-choice questions covering personal demographics, orienteering participation, and visual corrections worn in everyday life and for orienteering. Free-text questions asked for further information about the corrections used and advice received from eye care practitioners were analyzed using content analysis.</p><p><strong>Results: </strong>There were 469 respondents (195 women, 274 men; median age category, 55 to 59 years). For the 187 people without distance refractive correction, the most frequent corrections for orienteering were \"off the shelf\" reading spectacles (n = 95) or use of a compass magnifier (n = 24), and for the 277 people with distance refractive correction, they were progressive addition spectacles (n = 96) and monovision contact lenses (n = 63). The main visual challenges faced by orienteers were seeing map detail, lens obstruction from fogging and rain, and difficulty orienteering in low light in the daytime. An ideal correction needed to provide visual clarity for both map and terrain. No visual correction type consistently addressed all challenges. Orienteers valued personalized discussion with eye care practitioners to address their needs.</p><p><strong>Conclusions: </strong>Optimal visual corrections for presbyopic orienteers are individual, but higher reading additions to clarify map detail, contact lenses to avoid lens obstruction, additional light, and solutions that provide clear vision at all viewing distances while avoiding the reading add blurring the ground at the orienteer's feet should be considered. Personalized care is necessary to optimize visual correction solutions.</p>","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":" ","pages":"53-60"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optometry and Vision Science in 2024: Year 1 of the 3-year plan.","authors":"David B Elliott","doi":"10.1097/OPX.0000000000002214","DOIUrl":"https://doi.org/10.1097/OPX.0000000000002214","url":null,"abstract":"","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":"102 1","pages":"1-2"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' response.","authors":"Grainne Scanlon, Susan O'Shea, George Amarandei, John S Butler, Veronica O'Dwyer","doi":"10.1097/OPX.0000000000002210","DOIUrl":"https://doi.org/10.1097/OPX.0000000000002210","url":null,"abstract":"","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":"102 1","pages":"5-6"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of transient increase in intraocular pressure on subfoveal choroidal thickness.","authors":"Hamed Niyazmand, Vibu Jeyakumar, Ian Feng, Lisa Jansen, Anson Mahindra, Amy Menage, Khyber Alam","doi":"10.1097/OPX.0000000000002203","DOIUrl":"10.1097/OPX.0000000000002203","url":null,"abstract":"<p><strong>Significance: </strong>Myopia prevalence has increased over the last few decades. Studies have documented that the choroid is considered an important biomarker in myopia development. As myopia and choroidal thinning are associated with increased glaucoma risk, understanding the role of the choroid in myopia and glaucoma is imperative.</p><p><strong>Purpose: </strong>This study investigates the effect of transiently elevated intraocular pressure on axial length, subfoveal choroidal thickness, and central retinal thickness in emmetropes, low myopes, and high myopes.</p><p><strong>Methods: </strong>This study involved 29 young adults (23 ± 1 years), including 10 emmetropes (-0.50 D < SE < +0.50 D), 10 low myopes (-6.00 D < SE ≤ -0.50 D), and 9 high myopes (SE ≤ -6.00 D). Participants were fitted with modified swimming goggles for 5 minutes to transiently change intraocular pressure. Noncontact tonometry, optical biometry, and optical coherence tomography were used to measure intraocular pressure, axial length, central retinal thickness, and subfoveal choroidal thickness, respectively. Measurements were taken at before, during goggle wear, immediately after, and 3 minutes after goggles removal. Repeated-measures analysis of variance with Bonferroni adjustment was used to assess the effect of transiently changed intraocular pressure and to elucidate any differences between refractive groups in response to the intraocular pressure change.</p><p><strong>Results: </strong>Intraocular pressure increased by 1.7 ± 2.1 mmHg (p=0.002) from baseline, accompanied by axial elongation of 14 ± 21 μm (p = 0.012) and subfoveal choroidal thinning of 13 ± 15 μm (p=0.01). However, central retinal thickness did not change significantly (p>0.05). Most of the changes in the axial length were due to changes in the choroidal thickness. Observed changes returned to baseline immediately following goggles removal. There was no significant difference between refractive error groups' changes associated with the transient increase in intraocular pressure (p>0.05).</p><p><strong>Conclusions: </strong>Transiently increased intraocular pressure caused temporary axial elongation and subfoveal choroidal thinning, with no significant differences between refractive groups. Further studies are required to assess the impact of long-term increased intraocular pressure on ocular components.</p>","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":" ","pages":"7-13"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internal validation of a convolutional neural network pipeline for assessing meibomian gland structure from meibography.","authors":"Charles Scales, John Bai, David Murakami, Joshua Young, Daniel Cheng, Preeya Gupta, Casey Claypool, Edward Holland, David Kading, Whitney Hauser, Leslie O'Dell, Eugene Osae, Caroline A Blackie","doi":"10.1097/OPX.0000000000002208","DOIUrl":"10.1097/OPX.0000000000002208","url":null,"abstract":"<p><strong>Significance: </strong>Optimal meibography utilization and interpretation are hindered due to poor lid presentation, blurry images, or image artifacts and the challenges of applying clinical grading scales. These results, using the largest image dataset analyzed to date, demonstrate development of algorithms that provide standardized, real-time inference that addresses all of these limitations.</p><p><strong>Purpose: </strong>This study aimed to develop and validate an algorithmic pipeline to automate and standardize meibomian gland absence assessment and interpretation.</p><p><strong>Methods: </strong>A total of 143,476 images were collected from sites across North America. Ophthalmologist and optometrist experts established ground-truth image quality and quantification (i.e., degree of gland absence). Annotated images were allocated into training, validation, and test sets. Convolutional neural networks within Google Cloud VertexAI trained three locally deployable or edge-based predictive models: image quality detection, over-flip detection, and gland absence detection. The algorithms were combined into an algorithmic pipeline onboard a LipiScan Dynamic Meibomian Imager to provide real-time clinical inference for new images. Performance metrics were generated for each algorithm in the pipeline onboard the LipiScan from naive image test sets.</p><p><strong>Results: </strong>Individual model performance metrics included the following: weighted average precision (image quality detection: 0.81, over-flip detection: 0.88, gland absence detection: 0.84), weighted average recall (image quality detection: 0.80, over-flip detection: 0.87, gland absence detection: 0.80), weighted average F1 score (image quality detection: 0.80, over-flip detection: 0.87, gland absence detection: 0.81), overall accuracy (image quality detection: 0.80, over-flip detection: 0.87, gland absence detection: 0.80), Cohen κ (image quality detection: 0.60, over-flip detection: 0.62, and gland absence detection: 0.71), Kendall τb (image quality detection: 0.61, p<0.001, over-flip detection: 0.63, p<0.001, and gland absence detection: 0.67, p<001), and Matthews coefficient (image quality detection: 0.61, over-flip detection: 0.63, and gland absence detection: 0.62). Area under the precision-recall curve (image quality detection: 0.87 over-flip detection: 0.92, gland absence detection: 0.89) and area under the receiver operating characteristic curve (image quality detection: 0.88, over-flip detection: 0.91 gland absence detection: 0.93) were calculated across a common set of thresholds, ranging from 0 to 1.</p><p><strong>Conclusions: </strong>Comparison of predictions from each model to expert panel ground-truth demonstrated strong association and moderate to substantial agreement. The findings and performance metrics show that the pipeline of algorithms provides standardized, real-time inference/prediction of meibomian gland absence.</p>","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":" ","pages":"28-36"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of different artificial tears on tear film parameters in dry eye disease.","authors":"Moumi Maity, Manindra Bikram Allay, Md Hasnat Ali, Sayan Basu, Swati Singh","doi":"10.1097/OPX.0000000000002206","DOIUrl":"10.1097/OPX.0000000000002206","url":null,"abstract":"<p><strong>Significance: </strong>Artificial tears remain the cornerstone for managing dry eye disease. The current study's real-world efficacy test of carboxymethylcellulose (CMC), polyethylene glycol (PEG) 400, or sodium hyaluronate (SH)-based lubricants highlights their similar effects on noninvasive tear film parameters over the short term. However, patients reported better relief with SH-based lubricants.</p><p><strong>Purpose: </strong>This study aimed to compare the short-term impact of different artificial tear formulations on tear film in moderate dry eye disease patients.</p><p><strong>Methods: </strong>A prospective, double-masked, controlled study randomly allocated moderate dry eye disease patients into five groups of artificial tears: 0.5% CMC, 1% CMC, 0.1% SH-trehalose, 0.4% PEG 400-0.3% propylene glycol (PG), and 0.1% SH-0.4% PEG 400-0.3% PG. Noninvasive tear breakup time (NIBUT), tear meniscus height, and bulbar redness (Keratograph 5M; OCULUS Optikgeräte, Wetzlar, Germany) were assessed (in a controlled environment chamber 68 to 70°F; 35% relative humidity) at baseline and every 15 minutes for 1 hour after a drop instillation in the left eye. The right eye was an internal control. At 1 hour, subjects were asked for a change in subjective symptomatology (scales 0 to 4). A linear mixed-effect model was used for analysis.</p><p><strong>Results: </strong>Each artificial tear group had 20 patients (100 patients). All groups had similar dry eye disease types and durations, baseline ocular surface disease index scores, and tear film parameters. All artificial tears showed significant improvement in NIBUT values at all time points from baseline compared with contralateral eyes. The change in NIBUT values was similar between different artificial tears at all time points. Bulbar redness scores and tear meniscus height showed no significant change in either eye with time or artificial tears. All patients reported improvement in dry eye disease symptomatology, with significant differences observed between 1% CMC and SH-PEG-PG (p=0.01), 0.5% CMC and SH-PEG-PG (p<0.0001), and 0.5% CMC and 0.1% SH-trehalose (p=0.01), where SH-based tear drops performed better.</p><p><strong>Conclusions: </strong>Tear film stability improves following a single drop of CMC, SH, and PEG-based artificial tears, although these artificial tears do not differ in their short-term effect.</p>","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":" ","pages":"37-43"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refrigeration reduces instillation discomfort of a 0.09% cyclosporine A solution.","authors":"William Ngo, Nijani Nagaarudkumaran, Cassandra Bonnie Huynh","doi":"10.1097/OPX.0000000000002205","DOIUrl":"10.1097/OPX.0000000000002205","url":null,"abstract":"<p><strong>Significance: </strong>Topical cyclosporine A (CsA) for the treatment of dry eye disease is often associated with instillation discomfort, which may negatively influence patient adherence to therapy. This study found that refrigerating topical CsA reduced instillation discomfort compared with instillation of warm CsA. Thus, refrigerating CsA prior to instillation may improve patient experience when using CsA to manage dry eye disease.</p><p><strong>Purpose: </strong>This study aimed to quantify instillation discomfort associated with cold or warm instillation of a 0.09% CsA.</p><p><strong>Methods: </strong>Forty participants with symptomatic aqueous deficient dry eye were enrolled. A drop of cold (4°C) CsA was instilled in one eye, and a drop of warm (23°C) CsA was instilled in the other eye. The order and eye receiving the cold drop were randomized. Participants rated the discomfort of each eye (0, no discomfort; 10, maximal discomfort) prior to drop instillation, immediately post-instillation, and at each subsequent minute for 10 minutes. Area under the curve was used to quantify cumulative discomfort.</p><p><strong>Results: </strong>Forty participants (39.6 ± 18.9 years old, 82% female) completed the study. A majority of participants (n = 24, 60%) experienced reduced cumulative discomfort with cold CsA, whereas the remainder experienced minimal difference (n = 10, 25%) or increased cumulative discomfort (n = 6, 15%). For those with reduced discomfort (n = 24), cumulative discomfort associated with cold instillation (median, 11.5 [2.2, 20.0]) was significantly lower (p<0.01) than cumulative discomfort associated with warm instillation (median, 17.5 [11.2, 32.2]). Cold instillation was associated with a median reduction of 1 discomfort point immediately post-instillation and at all subsequent time points (all p≤0.04, but not significant at t = 10), compared with warm instillation.</p><p><strong>Conclusions: </strong>Up to 60% of participants found that cold instillation of CsA solution induced less discomfort than warm instillation, lasting up to 9 minutes post-instillation. In contrast, although 15% of participants found reduced discomfort with warm instillation, the magnitude of discomfort associated with warm instillation was not significantly different than cold instillation.</p>","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":" ","pages":"14-19"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized clinical trial: MGrx versus standard debridement and expression for meibomian gland dysfunction.","authors":"David A Semp, Debarun Dutta, James S Wolffsohn","doi":"10.1097/OPX.0000000000002204","DOIUrl":"10.1097/OPX.0000000000002204","url":null,"abstract":"<p><strong>Significance: </strong>Evaporative dry eye disease, due to meibomian gland dysfunction, causes significant suffering for millions of people globally, yet satisfactory long-term treatment remains elusive for many. Investigation of potential therapies for meibomian gland dysfunction is therefore of high importance to clinicians and their patients.</p><p><strong>Purpose: </strong>This study aimed to compare the efficacy of a new device for meibomian gland debridement and expression to that of the conventional way of providing this treatment.</p><p><strong>Methods: </strong>Thirty participants (mean age, 36.4 ± 15.4 years; 77% female) fulfilling current Tear Film & Ocular Surface Society diagnostic criteria for dry eye disease and meibomian gland dysfunction were recruited (Research Registry, 10340). Fifteen participants each were randomized to receive a single treatment with either traditional debridement (using a golf-club spud), heating (10 minutes of Blepha EyeBag, Théa Laboratories, Clermont-Ferrand, France) and expression (with forceps), or the multimodal MGrx, which comprises a handheld device with heated debridement, massage, and expression attachments. Symptomatology, tear film, and ocular surface measures were assessed at baseline and at 4 and 8 weeks post-treatment.</p><p><strong>Results: </strong>Ocular Surface Disease Index, 5-Item Dry Eye Questionnaire, and Symptom Assessment in Dry Eye symptom questionnaire scores all improved significantly with both treatments (all p<0.001), with no subsequent deterioration for at least 8 weeks. The improvement was similar between treatment groups (all p>0.05). Clinical signs, of blink rate, tear film quality and quantity, ocular surface characteristics, and meibomian gland expressibility, were all unchanged with both treatments (all p>0.05) except for noninvasive tear breakup time, which deteriorated in the conventional treatment group (p=0.006) between 4 and 8 weeks post-treatment. No adverse reactions were reported, and all participants were able to tolerate treatment.</p><p><strong>Conclusions: </strong>A single application of meibomian gland debridement and expression resulted in sustained improvements in the symptoms of dry eye disease, in both treatment groups. The MGrx device provides a safe and effective in-office treatment for evaporative dry eye disease, and has time and space advantages compared with conventional treatment.</p>","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":" ","pages":"20-27"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}