Clinical Optometry最新文献

{"title":"Prospective Evaluation of a Novel Multifocal Toric Daily Disposable Contact Lens in Presbyopic Adults with Astigmatism.","authors":"Ross Franklin, Jessica Lin Cannon-Hill, Ryan Sherrill, Giovanna E Olivares","doi":"10.2147/OPTO.S536323","DOIUrl":"10.2147/OPTO.S536323","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical performance of a novel multifocal toric contact lens design combining a pupil-optimized multifocal design with a blink stabilized toric design featuring a single cylinder power and a choice of 3 add powers in a group of presbyopic patients with low to moderate astigmatism.</p><p><strong>Patients and methods: </strong>A total of 171 subjects (105 myopic and 66 hyperopic) with refractive astigmatism of -1.00 diopter (D) to -1.75D with axes 90±15 or 180±15 degrees were fit with the study lenses in a two-week, multi-site prospective open-label clinical trial. The test lens was a multifocal toric soft contact lens with sphere powers of -1.00D to -4.00D and +1.00D to +4.50D, and a single cylinder power of -1.00D with axes 90±10 and 180±10 degrees. Outcome measures included logMAR Visual Acuity, subjective assessments of vision, comfort and handling, and fit metrics including orientation, rotational stability and fit success.</p><p><strong>Results: </strong>Over 96% of subjects were fit in the optimized lens power with 2 pairs of lenses or less. After 2-weeks of lens wear, the mean binocular high luminance high contrast (HLHC) logMAR visual acuities were -0.085, -0.023, and 0.083, for distance (4m), intermediate (64cm), and near (40cm), respectively. Subjective vision, comfort and handling scores established statistically higher scores for both hyperopes and myopes compared to the pre-defined margin. The percentage of eyes with absolute lens orientation error ≤10° was over 94% and rotational stability ≤5° was over 98%.</p><p><strong>Conclusion: </strong>The multifocal toric contact lens design provided clear and consistent vision for a variety of critical distance, intermediate and near tasks across varying lighting conditions and had a high rate of lens fit success.</p>","PeriodicalId":43701,"journal":{"name":"Clinical Optometry","volume":"17 ","pages":"353-363"},"PeriodicalIF":1.8,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12604522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Vision Therapy on Visual Skills and Oculomotor Functions in Children with Autism Spectrum Disorder: A Prospective Study.","authors":"Santosh Chhetri, Umesh Belbase, Manish Poudel, Deepak Dhakal, Aastha Bhandari, Mario Cantó-Cerdán, Anup Subedi, Oshin Shrestha","doi":"10.2147/OPTO.S551647","DOIUrl":"10.2147/OPTO.S551647","url":null,"abstract":"<p><strong>Purpose: </strong>Visual skills and Oculomotor function deficits are common in children with Autism Spectrum Disorder (ASD), potentially affecting their development and quality of life. This study aimed to evaluate the effectiveness of vision therapy in visual perceptual skills and oculomotor function in children with ASD.</p><p><strong>Patients and methods: </strong>This prospective interventional study was conducted using a convenience sampling method between February and May 2025. All children with a prior diagnosis of ASD who met the inclusion criteria were included in the study and underwent 45 sessions of vision therapy guided by the Developmental, Individual-Differences, Relationship-Based (DIR) model. Visual skills and oculomotor functions were assessed before and after vision therapy using the Wachs Analysis of Cognitive Structures (WACS) and the Northeastern State University College of Optometry (NSUCO) Oculomotor test, respectively. The paired <i>t</i>-test with Hedge's g effect size was used to compare pre and post vision therapy outcomes for normally distributed data, while the Wilcoxon signed-rank test with effect size r was applied for non-normally distributed variables. Analysis of Covariance was used to examine the effect of ASD severity on post-therapy outcomes while controlling for age and gender.</p><p><strong>Results: </strong>Among the 42 children with ASD enrolled in the study, 36 completed all 45 sessions of vision therapy. Significant post-therapy improvements with large effect size were observed in visual perceptual skills (WACS) and oculomotor functions (NSUCO). Children with mild to moderate ASD showed greater improvements than those with severe ASD. Analysis of covariance revealed a significant effect of ASD severity on post-therapy outcomes: WACS (F(1,32) = 36.80, p < 0.001, <i>R²</i> = 0.55), saccades (F(1,32) = 36.75, p < 0.001, <i>R²</i> = 0.54), and pursuits (F(1,32) = 35.54, p < 0.001, <i>R²</i> = 0.54). Age and gender showed no statistically significant effects on the outcomes.</p><p><strong>Conclusion: </strong>This prospective study provides preliminary evidence that DIR-guided vision therapy, particularly when combined with occupational and behavioral therapy, may enhance visual perceptual and oculomotor functions in children with ASD. However, randomized controlled studies with longer follow-up are needed to confirm these results.</p>","PeriodicalId":43701,"journal":{"name":"Clinical Optometry","volume":"17 ","pages":"341-351"},"PeriodicalIF":1.8,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12599212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Illumination on Near Positive Fusional Vergence in Young Adults [Letter].","authors":"Nir Erdinest, Naama Bura","doi":"10.2147/OPTO.S573946","DOIUrl":"10.2147/OPTO.S573946","url":null,"abstract":"","PeriodicalId":43701,"journal":{"name":"Clinical Optometry","volume":"17 ","pages":"339-340"},"PeriodicalIF":1.8,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12581868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Wearing Defocus Incorporated Multiple Segments Spectacle Lenses for 12 Months on Accommodation and Binocular Functions in Myopic Children.","authors":"Fatin Nur Najwa Norazman, Bariah Mohd-Ali, Syarifah Faiza Syed Mohd Dardin, Mizhanim Mohamad Shahimin, Norliza Mohamad Fadzil, Mohd Norhafizun Mohd Saman","doi":"10.2147/OPTO.S526690","DOIUrl":"10.2147/OPTO.S526690","url":null,"abstract":"<p><strong>Introduction: </strong>Spectacle lens design for myopia control incorporates either lenslet or diffusion technology to slow down the eye growth, which may impact the binocular vision functions of a myopic child. This study aimed to investigate the changes in accommodation and binocular functions in myopic children over 12 months wear of myopia control spectacle lenses.</p><p><strong>Methods: </strong>21 myopic children aged 7-12 years were prescribed with Defocus Incorporated Multiple Segments (DIMS) lenses and assessed at baseline, 1, 3, 6, 9, and 12 months. The parameters measured were refractive error, axial length (AL), visual acuity (VA), accommodative lag (LA), amplitude of accommodation (AA), negative/positive relative accommodation (NRA/PRA), stereoacuity, near point of convergence (NPC), phoria, negative/positive fusional vergence (NFV/PFV), and accommodation convergence per accommodation ratio (AC/A).</p><p><strong>Results: </strong>Mean spherical equivalent (SE) and AL increase from -2.90 ± 1.15 D and 24.51 ± 0.99 mm to -3.19 ± 1.25 D and 24.60 ± 0.97 mm at 12 months respectively. Visual acuity (VA) significantly improved (p < 0.001) in both high-contrast and low-contrast conditions at distance and near. Regarding accommodation and binocular functions, significant improvements were observed in lag of accommodation (LA), stereoacuity and gradient AC/A ratio (p < 0.001). The NPC reduced slightly but was still within normal limits. Distance and near phoria shifted toward esophoria with changes less than 1 PD. Additionally, distance NFV and near PFV recovery points increased significantly.</p><p><strong>Conclusion: </strong>This study demonstrated insignificant changes in accommodation and binocular functions in myopic children after 12 months of wearing DIMS lenses. However, the absence of a control group limits causal interpretation, as observed changes may be influenced by natural development, repeated testing, or regression to the mean. Further research with controlled designs is warranted to clarify these effects.</p>","PeriodicalId":43701,"journal":{"name":"Clinical Optometry","volume":"17 ","pages":"327-338"},"PeriodicalIF":1.8,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12537798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"African Facial Anthropometry and Spectacle Frame Design: A Review.","authors":"Sanele Buthelezi, Nabeela Hasrod","doi":"10.2147/OPTO.S536358","DOIUrl":"10.2147/OPTO.S536358","url":null,"abstract":"<p><p>This narrative review explores the relationship between African facial anthropometry and spectacle frame design. Despite the global eyewear market's growth, a significant gap exists in designs accommodating African facial features. Through a comprehensive literature analysis, this review examines key anthropometric measurements relevant to eyewear fit across diverse African populations, current challenges in spectacle frame design, and emerging solutions. Findings reveal persistent underrepresentation of African facial measurements in global design standards, leading to poor fit, discomfort, and reduced compliance. The review identifies opportunities for innovative frame designs, material selection, and manufacturing approaches that could better serve African populations. Recommendations include increased anthropometric research across different African ethnicities, integration of digital technologies, and development of region-specific design parameters. This review contributes to the growing body of knowledge advocating for more inclusive and culturally appropriate eyewear solutions.</p>","PeriodicalId":43701,"journal":{"name":"Clinical Optometry","volume":"17 ","pages":"315-326"},"PeriodicalIF":1.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wear Experience with a Silicone Hydrogel 1-Week Replacement Lens in Current Wearers of a 2-Week Replacement Lens.","authors":"Jennifer Swingle Fogt, Madison Roth, Tiffany C Lu, Hope Patterson Gardner","doi":"10.2147/OPTO.S536378","DOIUrl":"10.2147/OPTO.S536378","url":null,"abstract":"<p><strong>Purpose: </strong>More frequent replacement of contact lenses may be beneficial for ocular health, but satisfied wearers often have prescriptions renewed in the same lens. This study sought to evaluate the wear experience of a newly released 1-week replacement lens among currently satisfied wearers of a 2-week replacement lens.</p><p><strong>Methods: </strong>This open-label, non-comparative study of single vision lenses recruited satisfied wearers of senofilcon A and refit them in serafilcon A. Participants wore the study lenses for two weeks. Assessments included visual acuity and surveys regarding wear experience: the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8); visual analog scale (VAS) ratings of vision quality and comfort; VAS ratings of vision and comfort during a variety of activities; and ratings of convenience, satisfaction and ease of use on a 0 to 10 Likert scale.</p><p><strong>Results: </strong>Sixty-two participants completed the study. Median (interquartile range) distance LogMAR acuity with the study lenses was -0.15 (0.12) OD, -0.16 (0.10) OS, and -0.22 (0.08) OU. The median (IQR) CLDEQ-8 score was 10 (10). Median (IQR) VAS responses were 91 (22) for overall quality of vision and 83 (30), for overall comfort. Median VAS responses regarding specific activities ranged from 87 to 91 for vision and 81 to 90 for comfort. Median (IQR) ratings were 8 (2) for convenience, 10 (1) for ease of use, and 9 (2) for satisfaction.</p><p><strong>Conclusion: </strong>In this study, satisfied wearers of a commonly prescribed 2-week replacement soft contact lens reported median wear experience VAS scores in the upper quartile for all assessments of vision and comfort and a median CLDEQ-8 score below that associated with dryness. Findings suggest that these lenses are a viable option for practitioners interested in the weekly replacement modality of soft lenses.</p>","PeriodicalId":43701,"journal":{"name":"Clinical Optometry","volume":"17 ","pages":"307-313"},"PeriodicalIF":1.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Illumination on Near Positive Fusional Vergence in Young Adults.","authors":"George Nnamdi Atuanya, Godspower Itua Okhaifoh, Babatunde Ismail Bale, Comfort Peace Ayikoru","doi":"10.2147/OPTO.S534389","DOIUrl":"10.2147/OPTO.S534389","url":null,"abstract":"<p><strong>Purpose: </strong>Positive fusional vergence (PFV) is important for binocular fusion, yet the influence of illumination on near PFV remains underexplored. This study investigated the effect of different illumination levels on PFV parameters (blur, break, recovery) to provide insights that could help eye care professionals optimize clinical assessments and make recommendations for near-vision activities.</p><p><strong>Methods: </strong>Using a within-subjects design, thirty young adults (mean age: 21.87 ± 2.79 years; range 18-30) with normal binocular vision were evaluated at the University of Benin Optometry Teaching Clinic. PFV was measured under three controlled lighting conditions (50, 100, and 150 lux) using a phoropter, photometer, and LED lighting system. Preliminary tests (visual acuity, cover test and Von Graefe phoria) preceded PFV measurement, with participants reporting blur, break, and recovery points. Data were analysed using Friedman and Wilcoxon Signed Ranks tests (SPSS v25.0; <i>p</i> < 0.05), with effect sizes calculated via rank-biserial correlation.</p><p><strong>Results: </strong>PFV values significantly decreased with increasing illumination (all <i>p</i> < 0.001). At 50 lux, mean PFV measures were highest (blur: 12.93 ± 1.62^Δ, break: 22.87 ± 3.06^Δ, recovery: 15.67 ± 2.78^Δ). These declined progressively at 100 lux (blur: 11.40 ± 1.28^Δ; break: 20.80 ± 2.71^Δ; recovery: 14.07 ± 2.72^Δ) and 150 lux (blur: 10.27 ± 1.72^Δ; break: 18.83 ± 2.09^Δ; recovery: 12.70 ± 2.74^Δ). The steepest reductions occurred between 50 and 150 lux (blur: -20.5%; recovery: -19.0%), and rank-biserial correlations indicated large effect sizes (-0.798 to -1.000).</p><p><strong>Conclusion: </strong>Higher illumination significantly reduces PFV, which suggests that lower-to-moderate lighting optimises binocular coordination during near tasks. These findings support adjusting ambient lighting in educational, occupational, and clinical settings to reduce visual fatigue during near tasks.</p>","PeriodicalId":43701,"journal":{"name":"Clinical Optometry","volume":"17 ","pages":"297-306"},"PeriodicalIF":1.8,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra- and Inter-Observer Agreement of a Portable A-Scan Ultrasound Biometer in Sitting and Supine Positions and Validity Against an Optical Biometer.","authors":"Joshua Jeyandran, Cynthia J Roberts, Phillip T Yuhas","doi":"10.2147/OPTO.S535433","DOIUrl":"10.2147/OPTO.S535433","url":null,"abstract":"<p><strong>Purpose: </strong>The purposes of this study were to test the validity of a portable ultrasound biometer (6000 Scanmate-A, DGH Technology) against an optical biometer and to establish its repeatability and reproducibility on patients in sitting and supine positions.</p><p><strong>Patients and methods: </strong>Healthy adults (N = 51) were recruited prospectively. At two study visits, Observer 1 made five measurements of AL and ACD in the right eye using an optical biometer (IOLMaster, Zeiss). Then two sets of three measurements of AL and ACD were made using the Scanmate-A, one while participants were sitting and another while they were supine. Observer 2 made the same measurements at one visit on a subset of participants (n = 42). Averages of the measurements were prepared for analysis (significance threshold set to α = 0.01) according to Bland and Altman, repeated-measures analyses of variance, linear correlations, and intraclass correlation coefficients (ICC).</p><p><strong>Results: </strong>AL and ACD were significantly shorter when measured by the Scanmate-A (median [interquartile range] = 23.4 [22.5, 24.7] mm and mean ± standard deviation = 3.22 ± 0.45 mm, respectively) than when measured by IOLMaster (23.8 [23.1, 25.2] mm and 3.51 ± 0.33 mm, respectively). For both body positions, there were no differences in ACD and AL between visit 1 and visit 2. Correlations were strong between the visits, but the limits of agreement varied. Similarly, there were no significant differences between Observer 1 and Observer 2. Correlations and ICC were strong-to-moderate between the observers, and the limits of agreement varied.</p><p><strong>Conclusion: </strong>Consistent with reports on other a-scan devices, the Scanmate-A measured shorter AL and shallower ACD than the IOLMaster. Although, mean or median AL and ACD did not differ across study visits, observers, and body positions, large limits of agreement on Bland-Altman analyses must be accounted for by users of the Scanmate-A.</p>","PeriodicalId":43701,"journal":{"name":"Clinical Optometry","volume":"17 ","pages":"283-296"},"PeriodicalIF":1.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Objective Evaluation of Relationship Between Tear Film Stability and Visual Fatigue [Response to Letter].","authors":"Maki Watanabe, Masakazu Hirota, Ryusei Takigawa, Kanako Kato, Yuka Ikeda","doi":"10.2147/OPTO.S558482","DOIUrl":"10.2147/OPTO.S558482","url":null,"abstract":"","PeriodicalId":43701,"journal":{"name":"Clinical Optometry","volume":"17 ","pages":"281-282"},"PeriodicalIF":2.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Access to and Utilization of the Advanced Diagnostic and Management Equipment for Early Keratoconus in Public and Private Healthcare Facilities Across Nyanza and Western Kenya.","authors":"Millicent Muthoni Njeru, Sheilah Nangena Maina, Isabel Signes-Soler, Hussein Adams Golicha","doi":"10.2147/OPTO.S520763","DOIUrl":"10.2147/OPTO.S520763","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the availability and utilization of the advanced equipment for the diagnosis and management of early keratoconus in the public and private healthcare facilities in Nyanza and Western Kenya.</p><p><strong>Methods: </strong>A cross-sectional study design was applied. An online questionnaire was sent to the eyecare practitioners. Data on socio-demographics, equipment availability, and utilization for early keratoconus diagnosis and management were obtained and analyzed using SPSS V 29.</p><p><strong>Results: </strong>A total of 134 eyecare practitioners (out of 143), with the majority 80 (59.7%) being males, responded to the questionnaire. The study found that advanced equipment were scarcely available, such as Tomographer 14 (10.4%), Topographer 17 (12.7%) and Pachymeter 21 (15.7%) as compared to basic equipment: distance VA chart 134 (100%), trial lens/phoropter 129 (96.3%), retinoscope 128 (95.5%) and slit-lamp 111 (82.8%), with level 6 having the highest availability. Additionally, the available advanced equipment had working conditions far below standards and below standards: topographer 6 (35.2%) and contact lens fitting set 12 (46.1%). The utilization rates of the advanced equipment were low as follows: contact lens fitting set 8 (31.0%), pachymeter 11 (52.4%) and topographer 9 (52.9%). A chi-square test found a significant association between equipment availability and their utilization, VA chart (p=0.03333), trial lens/phoropter (p=0.00292), slit-lamp (p=0.00283) and keratometer (p=0.00001).</p><p><strong>Conclusion: </strong>The study revealed a lack of advanced diagnostic equipment, with some existing tools falling below standard and underutilized. It recommends that healthcare institutions prioritize the acquisition and maintenance of essential equipment. Additionally, the Ministry of Health should collaborate with stakeholders to incorporate early keratoconus detection into national eyecare guidelines.</p>","PeriodicalId":43701,"journal":{"name":"Clinical Optometry","volume":"17 ","pages":"269-279"},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12375311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}