Seminars in Ophthalmology最新文献

{"title":"The Association Between Medical Insurance, Access to Care, and Outcomes for Patients with Uveal Melanoma in the United States.","authors":"Victoria A Marks, Basil K Williams, Michael S Leapman, Carol L Shields","doi":"10.1080/08820538.2024.2426479","DOIUrl":"10.1080/08820538.2024.2426479","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the association between insurance status and uveal melanoma (UM) care.</p><p><strong>Methods: </strong>We utilized the National Cancer Database to identify patients diagnosed with UM from 2004 to 2017. We examined the associations between patient sociodemographic characteristics, specifically insurance status, and UM care.</p><p><strong>Results: </strong>Of 7677 patients, 50% had private, 41% Medicare, 4% Medicaid, 3% other government, and 3% no insurance. Most initially received brachytherapy (66%), followed by enucleation/resection (19%) and other treatment (15%). Compared to private, Medicaid and no insurance were associated with higher odds of late-stage disease presentation (<i>p</i> < .05). Patients with Medicare, Medicaid, and no insurance had higher odds of enucleation/resection and lower odds of brachytherapy versus enucleation/resection (<i>p</i> < .05 for all). Medicaid and no insurance were associated with lower odds of other treatment versus enucleation/resection (<i>p</i> < .05).</p><p><strong>Conclusions: </strong>Access barriers to UM care may exist based on insurance status and may be associated with later-stage presentation and more radical treatment.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"223-234"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627713","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":"Effect of Implanted Capsular Tension Ring on Postoperative Refractive Shift: A Systematic Review and Meta-Analysis.","authors":"Su Xu, Yuhang Zhang, Xintong Li, Wei Si, Gengqi Tian, Yifan Yang, Yizhuo Hu, Fengyan Zhang","doi":"10.1080/08820538.2024.2381770","DOIUrl":"10.1080/08820538.2024.2381770","url":null,"abstract":"<p><strong>Background: </strong>The capsular tension ring is a novel assistant tool for cataract surgery; however, controversy exists in its co-implantation. The potential for hyperopic or myopic shift resulting from the co-implantation of the capsular tension ring and intraocular lens remains unclear. This study aimed to determine the postoperative refractive prediction error and the direction of refractive shift in cataract patients who underwent capsular tension ring co-implantation.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis,searching electronic databases for studies of individuals diagnosed with cataracts receiving surgery with or without capsular tension ring implantation. Systematic searches were performed based on five databases: PubMed, Cochrane Library, Web of Science, Medline, and China National Knowledge Infrastructure. The primary outcome was the mean arithmetic refractive prediction error. Secondary outcomes were mean absolute refractive prediction error and the number of eyes within a certain refractive prediction error range. We applied a fixed-effectsmodel to pool effect sizes across trials using weighted mean differences (WMD) and risk ratios (RR) with their 95% confidence intervals (95% CI). Statistical heterogeneity scores were assessed with the I²statistic.</p><p><strong>Results: </strong>A total of 407 affected eyes were included in eight independent clinical studies. Meta-analysis suggested significant differences both in short-term (≤1 month) co-implantation (WMD = 0.16, <i>p</i> < .001, 95% CI: -0.13 ~ 0.19) and long-term (≥3 months) co-implantation between the capsular tension ring co-implantation group and the control group (WMD = 0.19, <i>p</i> < .001, 95% CI: 0.15 ~ 0.23). However, no significant difference was observed in the high myopia subgroup whether capsular tension ring co-implantation (WMD = 0.03, <i>p</i> = .083, 95% CI: -0.27 ~ 0.34). Heterogeneity was not found among the studies.</p><p><strong>Conclusion: </strong>Compared to simple intraocular lens implantation, capsular tension ring co-implantation is more susceptible to developing hyperopic shifts in non-myopic cataract patients, probably related to anterior chamber depth. It requires careful consideration by clinicians when determining the target diopter preoperatively. However, interpretation is limited, because there is a lack of studies available for analysis. There still needs to be additional studies to expand the evidence base.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"162-168"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749004","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":"Intravitreal Anti-Vascular Endothelial Growth Factor Agents in Patients with Neovascular Age-Related Macular Degeneration and Retinal Pigment Epithelial Tear: A Systematic Review and Meta-Analysis.","authors":"Eleftheria P Mavridou, Theodoros N Sergentanis, Ioannis Kapetanios, Panagiotis Theodossiadis, Irini Chatziralli","doi":"10.1080/08820538.2025.2486328","DOIUrl":"https://doi.org/10.1080/08820538.2025.2486328","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this systematic review and meta-analysis is to evaluate the outcomes of continuing versus discontinuing intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment at various follow-up time-points in neovascular age-related macular degeneration (nAMD) patients who developed retinal pigment epithelium (RPE) tears following anti-VEGF therapy.</p><p><strong>Methods: </strong>Relevant publications were identified through a systematic search in the PubMed and EMBASE databases. The standardized mean differences (SMD), with their 95% confidence intervals (95% CI), were estimated using random effects models (DerSimonian-Laird), as appropriate. Meta-regression analysis was also performed.</p><p><strong>Results: </strong>Thirty studies (including 479 eyes with RPE tear) were eligible for the systematic review and meta-analysis. These studies examined the outcomes in patients who continued anti-VEGF treatment post-tear and those who discontinued it, with comparisons made separately for different timepoints in each group. In patients who continued anti-VEGF treatment, the pooled best-corrected visual acuity (BCVA) showed no statistically significant difference compared to baseline at any time-point of the follow-up. The pooled central subfield thickness (CST) improved at 12 months, but did not reach a significant level (SMD -0.45; 95% CI: -0.99, 0.10, I² = 49.5%, <i>p</i> = .159). Long-term follow-up indicated a decrease in the presence of subretinal and intraretinal fluid. In patients who discontinued intravitreal anti-VEGF treatment, there was a non-significant improvement in BCVA within the first 3 months; however, BCVA fluctuated or worsened over time, and fibrosis development was observed.</p><p><strong>Conclusions: </strong>This systematic review and meta-analysis found that intravitreal injections of anti-VEGF do not significantly impact visual acuity in patients with RPE tears at various follow-up timepoints, but may provide anatomical improvement.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764958","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":"Application of Artificial Intelligence in the Diagnosis, Follow-Up and Prediction of Treatment of Ophthalmic Diseases.","authors":"Jinwei Yu, Fuqiang Li, Mingzhu Liu, Mengdi Zhang, Xiaoli Liu","doi":"10.1080/08820538.2024.2414353","DOIUrl":"10.1080/08820538.2024.2414353","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the application of artificial intelligence (AI) in ophthalmic diseases and its possible future directions.</p><p><strong>Methods: </strong>A retrospective review of the literature from PubMed, Web of Science, and Embase databases (2019-2024).</p><p><strong>Results: </strong>AI assists in cataract diagnosis, classification, preoperative lens calculation, surgical risk, postoperative vision prediction, and follow-up. For glaucoma, AI enhances early diagnosis, progression prediction, and surgical risk assessment. It detects diabetic retinopathy early and predicts treatment effects for diabetic macular edema. AI analyzes fundus images for age-related macular degeneration (AMD) diagnosis and risk prediction. Additionally, AI quantifies and grades vitreous opacities in uveitis. For retinopathy of prematurity, AI facilitates disease classification, predicting disease occurrence and severity. Recently, AI also predicts systemic diseases by analyzing fundus vascular changes.</p><p><strong>Conclusions: </strong>AI has been extensively used in diagnosing, following up, and predicting treatment outcomes for common blinding eye diseases. In addition, it also has a unique role in the prediction of systemic diseases.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"173-181"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142486251","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":"Second Intention Healing After Laser Ablation of Benign Eyelid Margin Tumors.","authors":"Gang Seok Jeon, In Hwan Hong, Tae Yeem Lee, Tae Geun Song, Jae Ryong Han","doi":"10.1080/08820538.2024.2435942","DOIUrl":"10.1080/08820538.2024.2435942","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to present the therapeutic outcomes of benign eyelid margin tumors treated with laser ablation, offering an alternative approach to traditional shaving biopsy.</p><p><strong>Methods: </strong>In all patients, tumors were eliminated through either laser ablation or shaving biopsy. Comparative analysis was conducted between two patient groups: the laser-assisted ablation group (Group 1) and the shaving excision surgery group (Group 2). A total of 66 patients with 67 benign eyelid margin tumors were retrospectively included in this study (2019-2023). Thity-four cases underwent laser ablation, and 33 cases were subjected to shaving excision biopsy. Postoperatively, histologic confirmation was obtained in 11 out of the 33 cases that underwent shaving excision.</p><p><strong>Results: </strong>In Group 1, no functional or cosmetic complications were observed. The wound margin was clear after laser-assisted ablation in all cases. In Group 2, there was one instance of eyelid notching, loss of cilia, and two pigmentations. No wound infections were reported. The average wound epithelialization duration was 3.3 weeks in Group 1, significantly faster than 4.2 weeks in Group 2 (<i>p</i> < .01). The average lesion size was 3.0 × 2.9 mm in Group 1, significantly smaller than 3.5 × 3.4 mm in Group 2 (<i>p</i> < .05). No recurrences were observed during the follow-up period.</p><p><strong>Conclusions: </strong>Laser ablation for small benign eyelid margin tumors may be a favorable alternative to shaving excision biopsy surgery. All patients were satisfied with the cosmetic result. There was no definitive postoperative or intraoperative complication during or after laser application.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"246-249"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771840","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":"Metallic Intraocular Foreign Bodies Following Torsional Phacoemulsification Surgery.","authors":"Prabhjot Singh, Vikas Ambiya, Gaurav Kapoor, Vijay Kumar Sharma, Rahul, Jyothi Nandanan, Ashok Kumar","doi":"10.1080/08820538.2024.2443841","DOIUrl":"10.1080/08820538.2024.2443841","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine the rate of retained metallic intraocular foreign bodies (IOFBs) following torsional phacoemulsification cataract surgery by an experienced surgeon and elucidate related surgical factors, particle origin theories from existing literature, and postoperative visual impact.</p><p><strong>Methods: </strong>An observational study was conducted on 300 consecutive cases of cataract who underwent torsional phacoemulsification by a single surgeon using two-handed stop-and-chop technique. The incidence of retained IOFBs was observed and correlated with the surgical parameters and the density of cataract.</p><p><strong>Results: </strong>Retained IOFBs were observed in 6 of 300 (2%) cases operated. These were significantly associated with higher cumulative dissipated energy and the density of cataract, but without impacting final vision.</p><p><strong>Conclusion: </strong>Phacoemulsification retains inherent risks of metallic particle liberation from ultrasonically stressed instrumentation interacting within confined spaces. However, small retained IOFBs appear visually inconsequential over limited follow-up. Advances in technique, engineering design, and surgical quality control hold promise for further enhancing safety of the procedure.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"250-254"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839711","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":"Risk Factors for Eye and Orbital Injuries Related to Electric Scooters and Off-Road Vehicles.","authors":"Samantha A McLaughlin, Natalia Davila, Niloufar Bineshfar, Tejus Pradeep","doi":"10.1080/08820538.2024.2429633","DOIUrl":"10.1080/08820538.2024.2429633","url":null,"abstract":"<p><strong>Purpose: </strong>Electric scooters (e-scooters) have rapidly become a mainstream method of transportation in the U.S. but there is consequently limited data on their safety profile. This study evaluates ophthalmic injuries related to e-scooters compared to non-motorized scooters and off-road vehicles (ORV).</p><p><strong>Methods: </strong>This retrospective study uses the National Electronic Injury Surveillance System (2014 to 2023). Ocular injury profiles associated with conventional scooters, e-scooters, and off-road vehicles were included.</p><p><strong>Results: </strong>E-scooter ocular injuries rose by 1950% between 2014 and 2023. E-scooter riders were 4.3 times more likely to sustain orbital fractures and 2.7 times more likely to be hospitalized than non-motorized scooter riders. ORV and e-scooter riders had comparable injury and hospitalization patterns. Alcohol use and lack of helmet use were significant contributors to injury severity.</p><p><strong>Conclusions and relevance: </strong>Injury patterns and hospitalization rates in e-scooter accidents resemble those of ORV incidents. Findings highlight the need for public health interventions to reduce the burden of e-scooter-related injuries.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"239-245"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639708","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":"Tear Film and Dry Eye Characteristics as Predictors of Photophobia in 374 Patients with Dry Eye Disease.","authors":"Swati Singh, Moumi Maity, Md Hasnat Ali, Sayan Basu","doi":"10.1080/08820538.2024.2429630","DOIUrl":"10.1080/08820538.2024.2429630","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the tear film parameters associated with photophobia in dry eye disease (DED).</p><p><strong>Methods: </strong>Three hundred seventy-four patients with DED (mean age, 42.2 ± 12.8 years) had their tear film and OSDI scores evaluated using Oculus keratograph 5 M (TMH, NIBUT, Meibography), Lipiview interferometer (LLT), and TearLab osmolarity system. Photophobia scoring from OSDI sheets was used to calculate the odds ratio via multivariate logistic regression analysis. Data from the eye with severely affected NIBUT was used.</p><p><strong>Results: </strong>Of 374, 127 had aqueous deficient dry eye disease (ADDE), and 247 had evaporative DED. The mean age, female sex, Schirmer I, TMH, NIBUT, LLT, and tear osmolarity values in patients with photophobia versus no or mild photophobia were 42.2. vs. 40.9 years, 42% vs. 40%, 11.6 vs. 10.5 mm, 0.27 vs. 0.29 mm, 4.6 vs. 4.7s, 60.3 vs. 60.9 nm and 305 vs. 307 mOsm/L, respectively. Multivariate analysis revealed no tear film parameters predictive of photophobia in evaporative DED, whereas tear osmolarity had a weak negative association with photophobia (odds ratio of 0.96, 95% C.I, 0.92-1, <i>p</i> = .04) in ADDE patients.</p><p><strong>Conclusion: </strong>Tear film parameters do not predict the presence or absence of photophobia in DED except for a weak inverse association with tear osmolarity in ADDE. This suggests the role of central sensitization in regulating photophobia in DED patients.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"235-238"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676247","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":"Pupillary Peaking & Presence of Dysphotopsias Following Glaucoma Tube Shunt Surgery.","authors":"Orlando G Gonzalez Martinez, Marko Oydanich, Siri Uppuluri, Rashika Verma, Albert S Khouri","doi":"10.1080/08820538.2024.2421475","DOIUrl":"10.1080/08820538.2024.2421475","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the presence of pupillary peaking and dysphotopsias in a sample of eyes following glaucoma drainage device (GDD) surgery.</p><p><strong>Methods: </strong>Cross-sectional analysis of 68 glaucoma patients with GDD, 45 patients with glaucoma and no GDD, and 50 control patients was conducted in a single academic center. Patients with an appropriate diagnosis that met the inclusion criteria were asked to enroll in the study. All patients received an 8-item dysphotopsia questionnaire and were age-matched. Photographs of pupils were taken to assess pupillary peaking. One-way analysis of variance (ANOVA) testing was performed for statistical analysis.</p><p><strong>Results: </strong>Of the 68 patients with GDD, 25 (36.76%) had pupillary abnormalities with peaking most commonly occurring in the direction of the tube entry superotemporally, and 50 (73.53%) had reported one or more dysphotopsias. In patients reporting one or more dysphotopsias, the rate of lines, crescents, ghost images, and shadows was significantly higher when compared to glaucoma patients without GDD and control patients (<i>p</i> < .01). This corresponded to a lower best-corrected visual acuity in the GDD group compared to the glaucoma and control groups (<i>p</i> < .001).</p><p><strong>Conclusions: </strong>Over a third of glaucoma patients receiving GDD had pupillary abnormalities, and nearly 3 out of 4 patients with GDD reported one or more dysphotopsias when compared to glaucoma patients without GDD and an age-matched control group. Glaucoma specialists and patients should be aware of these complications when proceeding with GDD surgery.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"204-209"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142507449","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":"Protocol for a Randomized Controlled Trial Comparing Intravitreal Brolucizumab with Placebo for Chronic Central Serous Chorioretinopathy with Persistent Macular Fluid Without Choroidal Neovascular Membrane - BRICS Report #1.","authors":"Srishti Raksheeth Ramamurthy, Saarang Hansraj, Ritesh Narula, SriniVas R Sadda, Sobha Sivaprasad, Jay K Chhablani, Mudit Tyagi, Nikitha Gurram Reddy, Umesh Chandra Behera, Raja Narayanan","doi":"10.1080/08820538.2025.2478072","DOIUrl":"https://doi.org/10.1080/08820538.2025.2478072","url":null,"abstract":"<p><strong>Purpose: </strong>Established consensus is lacking for the management of chronic central serous chorioretinopathy (CSCR). The role of anti-VEGF agents in treating chronic CSCR in the absence of choroidal neovascular membrane (CNVM) is equivocal. We aim to study intravitreal brolucizumab in the treatment of persistent macular fluid in chronic CSCR without CNVM.</p><p><strong>Methods: </strong>This study is a prospective randomized, placebo-controlled trial to be conducted among 42 patients with chronic CSCR (>3 months duration) with persistent intraretinal and/or subretinal fluid. Patients will be randomized in a 1:1 ratio to receive brolucizumab or oral multivitamins. Primary endpoint will be fluid resolution on OCT at 1 and 3 months. Secondary outcome measures will include the best-corrected visual acuity, microperimetry and NEI-VFQ 25 subjective questionnaire.</p><p><strong>Conclusion: </strong>The results of this study will provide an understanding of the efficacy and safety of brolucizumab in achieving fluid resolution in chronic CSCR without CNVM.</p>","PeriodicalId":21702,"journal":{"name":"Seminars in Ophthalmology","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731522","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}