Taiwan Journal of Ophthalmology最新文献

{"title":"Alterations in the foveal avascular zone and surrounding capillary network as important indicators of visual prognosis for hereditary macular dystrophy.","authors":"Yen-Ching Lin, Ting-Chieh Ko, Chang-Hao Yang, Pei-Hsuan Chen, Chung-May Yang, Pei-Lung Chen, Bo-I Kuo, Ta-Ching Chen","doi":"10.4103/tjo.TJO-D-25-00089","DOIUrl":"10.4103/tjo.TJO-D-25-00089","url":null,"abstract":"<p><strong>Purpose: </strong>Hereditary macular dystrophy (MD) usually severely affects the central vision. This study aimed to explore macular microcirculation and its relationship with disease progression in different morphological patterns of MD.</p><p><strong>Materials and methods: </strong>Sixty-five patients with MD and 26 healthy participants were included. Panel-based next-generation sequencing (NGS), fundus autofluorescence (FAF), and optical coherence tomography angiography (OCTA) were used for genetic diagnosis, morphological classification, and evaluation of macular microcirculation, respectively. Patients were divided into two groups: the central lesion group (CLG) and the dispersed lesion group (DLG), based on FAF findings. The alterations in microcirculation between the groups and subgroups were analyzed and correlated with visual preservation.</p><p><strong>Results: </strong>A high diagnostic rate of disease-causing genes was achieved with a panel-based NGS test (72.3%). Compromised macular microcirculation was seen in MD of all genotypes. Enlargement of the foveal avascular zone and decreased foveal vessel density was significantly correlated with impaired vision (both <i>P</i> < 0.05). In Stargardt disease, the CLG had an earlier onset than the DLG, with more severely impaired central vision and compromised microcirculation.</p><p><strong>Conclusion: </strong>OCTA is a reliable, noninvasive tool for evaluating the microcirculation of MD. Our results demonstrate that compromised macular microcirculation occurs with MD, and foveal microcirculation is crucial for visual preservation.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"15 3","pages":"457-465"},"PeriodicalIF":1.2,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138916","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":"Quantitative optical coherence tomography angiography biomarkers of the choriocapillaris for objective detection of early diabetic retinopathy.","authors":"Zaara Haque, Albert Kofi Dadzie, Mansour Abtahi, Behrouz Ebrahimi, Tobiloba Adejumo, Taeyoon Son, Jennifer I Lim, Xincheng Yao","doi":"10.4103/tjo.TJO-D-25-00067","DOIUrl":"10.4103/tjo.TJO-D-25-00067","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate quantitative optical coherence tomography (OCT) angiography (OCTA) biomarkers from the choriocapillaris (CC) for detecting early microvascular changes associated with diabetic retinopathy (DR).</p><p><strong>Materials and methods: </strong>In this retrospective study, 191 macular OCTA images were analyzed from 78 healthy eyes, 64 eyes from diabetic individuals without clinical signs of DR (NoDR), and 49 eyes with mild nonproliferative DR (NPDR). Five CC biomarkers were extracted from 6 mm × 6 mm enface OCTA images: flow deficit density (FDD), FD number (FDN), mean FD size (MFDS), perfusion intensity density (PID), and normalized blood flow index (NBFI). Flow maps were binarized using Phansalkar local thresholding, and statistical comparisons were performed using one-way analysis of variance and two-sample t-tests.</p><p><strong>Results: </strong>All five biomarkers demonstrated significant differences across study groups (<i>P</i> < 0.001). FDD and MFDS were significantly elevated in both NoDR and mild NPDR eyes compared to controls, indicating increased nonperfusion and enlargement of flow voids. FDN decreased with disease severity, indicating spatial consolidation of capillary loss. PID and NBFI, which reflect flow signal intensity, also declined in diabetic eyes, suggesting a reduction in overall CC perfusion consistent with early vascular compromise.</p><p><strong>Conclusion: </strong>Quantitative OCTA biomarkers of the CC reveal early microvascular changes in diabetic eyes. Among them, FDN and MFDS demonstrated the highest sensitivity to early disease progression. These findings support the use of CC-derived OCTA features as potential imaging biomarkers for detecting and monitoring early diabetic microvascular dysfunction.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"15 3","pages":"428-434"},"PeriodicalIF":1.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138796","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":"Optical coherence tomography and optical coherence tomography angiography in systemic disease.","authors":"David J Merriott, Devayu Parikh, Michael J Najac, Luis Muncharaz Duran, Affan Haq, Richard B Rosen, Toco Y P Chui","doi":"10.4103/tjo.TJO-D-25-00053","DOIUrl":"10.4103/tjo.TJO-D-25-00053","url":null,"abstract":"<p><p>Optical coherence tomography (OCT) is an integral component of present-day ophthalmologic practice. As use of OCT has increased in popularity and frequency of use, a growing number of systemic diseases are now known to have associated findings on both OCT and OCT angiography (OCTA). This review was written to discuss how a multitude of cardiovascular, neurodegenerative, neoplastic, infectious, and autoimmune diseases manifest on OCT and OCTA. The findings thus far highlight the potential utility of OCT and OCTA for diagnosing and monitoring progression of these disease processes. Many current studies are limited by small sample sizes, varying image processing algorithms, image artifact, and differing machines used to acquire images, underscoring the need for further research with increased patient numbers and standardized image acquisition and image processing protocols. Despite these current limitations, the steadily increasing volume of data suggests that there will ultimately be a role for both OCT and OCTA to noninvasively monitor the progression of systemic disease over time.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"15 3","pages":"364-377"},"PeriodicalIF":1.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138531","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":"The path to clinical translation for visible light optical coherence tomography in retinal imaging.","authors":"Qingyu Chen, Stephanie Lauren Nolen, Sydni Adriana Spencer, Ji Yi","doi":"10.4103/tjo.TJO-D-25-00078","DOIUrl":"10.4103/tjo.TJO-D-25-00078","url":null,"abstract":"<p><p>Visible light optical coherence tomography (VIS-OCT) has made significant progress in the past decade from <i>in vivo</i> proof-of-concept retinal imaging in preclinical models to human clinical translation. The technical advances of VIS-OCT imaging devices include new light sources, optical fiber components, balanced detection methods, and an array of data processing methods. We summarize the unique features of using VIS-OCT in comparison with near-infrared OCT (NIR-OCT), including ultra-high resolution, retinal microvascular oximetry, and reflectance spectroscopy. The ultra-high resolution is granted by the shorter wavelengths in the visible light range ~500-650 nm, as compared with the conventional OCT wavelengths >800 nm. Detailed sub-bandings in the inner plexiform layer and outer segment of photoreceptors, as well as in the retinal pigment epithelium and Bruch's membrane, are consistently resolved in VIS-OCT. The three-dimensional resolving capacity of VIS-OCT allows better isolation of hemoglobin absorption features, allowing blood oxygen saturation (SO₂) calculation in retinal microvasculature. Oximetry calculations were performed down to the capillary level in humans, albeit through massive averaging, which was unattainable by previous methods. Advancing VIS-OCT technology has a high potential to produce significant clinical impact in ophthalmology in the near future.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"15 3","pages":"389-398"},"PeriodicalIF":1.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138810","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":"Shining light on photoreceptors: A minireview on the development and clinical applications of optoretinography.","authors":"Alexander Matteson, Anna Andrews, David Huang, Siyu Chen","doi":"10.4103/tjo.TJO-D-25-00066","DOIUrl":"10.4103/tjo.TJO-D-25-00066","url":null,"abstract":"<p><p>Retinal diseases often result in photoreceptor dysfunction and cell death, leading to progressive vision impairment and eventual blindness. Clinical management can benefit from assessing photoreceptor mediated visual function, such as for progression monitoring. Meanwhile, therapeutic development requires accurate and reliable vision end points. The emerging optoretinography (ORG) technologies promise noninvasive, objective, and highly sensitive markers of photoreceptor function. ORG is an umbrella term that covers several imaging modalities that use intrinsic optical signal, i.e., without dyes or labeling agents, to quantify photoreceptor responses to light. Early studies showed stimulus-evoked light scattering and morphological changes in isolated photoreceptor and retina, which provided the experimental foundation for subsequent inquires <i>in vivo</i>. Technology advancements allowed for optically quantifying photoreceptor light responses in live human subjects using two-dimensional (2D) fundus photography and 3D optical coherence tomography (OCT). The integration of adaptive optics (AO) with OCT enabled direct measurements of outer segment length changes of individual human photoreceptors, revealing essential steps of the phototransduction cascades. In an effort to enlarge measurement field of view, ease imaging workflow, and improve accessibility, more recent studies investigated ORG techniques without the need to resolve or track individual cells. Clinical ORG imaging culminated in demonstrating highly sensitive and reliable detection of photoreceptor dysfunction in patients with degenerative retinal diseases. Ongoing development of both AO and non-AO ORG approaches promises to advance our understanding of phototransduction and the visual processing pathway, while establishing a powerful clinical tool for assessing vision.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"15 3","pages":"399-410"},"PeriodicalIF":1.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138893","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":"Proton beam radiotherapy as an alternative to enucleation in adult intraocular medulloepithelioma.","authors":"Wei-Hsiang Lin, Yueh-Ju Tsai, Shih-Ming Jung, An-Ning Chao","doi":"10.4103/tjo.TJO-D-25-00013","DOIUrl":"10.4103/tjo.TJO-D-25-00013","url":null,"abstract":"","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"15 3","pages":"499-501"},"PeriodicalIF":1.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138780","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":"Development of a high-resolution three-dimensional optical coherence tomography for characterization of epithelial cell products for corneal cell therapy.","authors":"Hsu-Hang Yeh, Vladlen Klochkov, Chia-Ying Tsai, Wei-Lun Huang, Sheng-Lung Huang, Wei-Li Chen","doi":"10.4103/tjo.TJO-D-25-00087","DOIUrl":"10.4103/tjo.TJO-D-25-00087","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop a high-resolution full-field optical coherence tomography (HR-FFOCT) system for automated three-dimensional (3D) imaging of cultivated epithelial cell sheets and biopsied tissue used in corneal regenerative therapy.</p><p><strong>Materials and methods: </strong>A commercial HR-FFOCT system (ApolloVue® S100, AMO, Taiwan), originally for dermatological imaging, was re-engineered for <2 μm resolution imaging of rabbit limbal and oral mucosal tissues for limbal stem cell deficiency treatment. Modifications included a piezoelectric transducer for precise Z-stack acquisition, customized LED illumination for registration, and a specialized platform for culture dishes. The system enabled en face and cross-sectional imaging with 3D reconstruction. Rabbit-derived products for cultivated limbal epithelial transplantation (CLET) and cultivated oral mucosal epithelial transplantation (COMET) were imaged before cultivation. Morphology, stratification, and protein expression were analyzed and validated with immunocytochemistry (ICC).</p><p><strong>Results: </strong>The optimized system produced high-resolution en face and Z-stack images with accurate alignment, capturing stratified epithelial layers in CLET and oral mucosal tissue. Reconstructed 3D images revealed structural detail consistent with ICC-verified expression of junctional proteins, including occludin and actin. Both two-dimensional and 3D visualization of biopsied oral mucosal tissue was achieved. The system enabled noninvasive monitoring of epithelial sheet architecture and thickness without sectioning.</p><p><strong>Conclusion: </strong>The reconstructed HR-FFOCT system provides a noninvasive, real-time imaging platform for assessing epithelial cell sheets and biopsied tissue in corneal regenerative therapy. It offers potential for standardizing quality evaluation of cell-based products before transplantation and advancing translational applications in regenerative medicine.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"15 3","pages":"435-442"},"PeriodicalIF":1.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138983","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":"Therapeutic targets for fibro-inflammation in Graves' orbitopathy.","authors":"Young Jae Kang, Jin Sook Yoon","doi":"10.4103/tjo.TJO-D-25-00057","DOIUrl":"https://doi.org/10.4103/tjo.TJO-D-25-00057","url":null,"abstract":"<p><p>Graves' orbitopathy (GO), a complex autoimmune disorder, remains the most common extrathyroidal manifestation of Graves' disease. Its pathogenesis is characterized by a progressive transition from inflammation to fibrosis, leading to debilitating ocular complications. While high-dose intravenous glucocorticoids have been the standard treatment for active moderate-to-severe GO, their lack of specificity to GO pathogenesis and limited efficacy in the fibrotic phase underscore the need for targeted therapies. This review explores emerging therapeutic targets in GO, focusing on pathways implicated in both inflammatory and fibrotic mechanisms. Teprotumumab, an insulin-like growth factor 1 receptor (IGF-1R) inhibitor, has revolutionized GO treatment, demonstrating clinical efficacy in reducing proptosis and inflammation. Interleukin-6 (IL-6) inhibitors including satralizumab are undergoing clinical trials. New studies on molecular pathways have been conducted regarding inflammation and fibrosis of GO, including platelet-derived growth factor/fibroblast growth factor signaling, yes-associated protein 1/transcriptional coactivator with PDZ-binding motif mechanotransduction, sphingosine-1-phosphate (S1P)/S1P receptor axis, bone morphogenic protein 7, IL-11, IL-17 and microRNAs as well as, IGF-1R/thyroid-stimulating hormone receptor crosstalk, and IL-6 trans-signaling. Most studies focus on exploring the potential of therapeutic agents through preclinical investigations but represent promising therapeutic avenues. Therapies targeting these pathways may offer a promising potential efficacy across the entire disease spectrum, from inflammation to fibrosis, thus overcome the limitations of conventional glucocorticoid therapy and expand therapeutic options in GO. Advances in <i>in vivo</i> GO models may bring forward a new era of GO treatment.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"16 1","pages":"58-67"},"PeriodicalIF":1.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700093","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":"How optical coherence tomography has changed the management of macular holes: A narrative review.","authors":"Kotaro Tsuboi, Masaki Fukushima, Ryota Akai","doi":"10.4103/tjo.TJO-D-25-00056","DOIUrl":"10.4103/tjo.TJO-D-25-00056","url":null,"abstract":"<p><p>Optical coherence tomography (OCT) has revolutionized the diagnosis and management of macular holes (MHs). Before OCT, physicians relied on slit-lamp biomicroscopy and angiographic findings, which were often insufficient for differentiating subtle pathologies. By enabling cross-sectional visualization of the retina, OCT has confirmed vitreomacular traction as a key factor in MH formation and supports the safety of surgical intervention. Quantitative OCT parameters have allowed the development of prognostic biomarkers, while spectral-domain OCT has further improved assessment by revealing postoperative photoreceptor integrity, with restoration of the ellipsoid zone and external limiting membrane correlating with visual recovery. OCT imaging under intraocular gas has enabled early confirmation of MH closure, allowing OCT-guided face-down positioning protocols that reduce postoperative burden without compromising outcomes. En face OCT and three-dimensional volumetric analysis have uncovered new biomarkers, such as preretinal abnormal tissue and inner retinal fluid volume, which aid in surgical planning and visual prognosis. Structural changes, such as dissociation of the optic nerve fiber layer and epiretinal proliferation (EP), are also better understood through OCT, thereby influencing decisions on internal limiting membrane peeling and EP preservation. OCT has not only revolutionized the diagnosis and classification of MHs but also continues to shape their surgical management, bringing us closer to optimizing visual recovery through personalized and data-driven approaches.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"15 3","pages":"344-353"},"PeriodicalIF":1.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137578","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":"Differentiation of choroidal metastases based on primary cancer site: An imaging study.","authors":"Anjali Maheshwari, Vishal Raval, Priyanka Walvekar, Purva Agarwal, Swathi Kaliki","doi":"10.4103/tjo.TJO-D-25-00040","DOIUrl":"https://doi.org/10.4103/tjo.TJO-D-25-00040","url":null,"abstract":"<p><strong>Purpose: </strong>The objective is to differentiate choroidal metastases (CM) arising from various primary cancer sites based on clinical presentation and imaging.</p><p><strong>Materials and methods: </strong>A retrospective, observational study of 67 eyes (58 patients).</p><p><strong>Results: </strong>The mean age at presentation was 60 years (range, 29-83 years). At presentation, 37 patients (64%) with CM had a known primary systemic cancer, whereas in 21 patients (36%) CM was the first manifestation of systemic cancer. Overall, the primary cancer sites were lung (<i>n</i> = 32, 55%), breast (<i>n</i> = 12, 21%), gastrointestinal tract (<i>n</i> = 6, 10%), genitourinary tract (<i>n</i> = 3, 5%), and others (<i>n</i> = 5, 9%). Most choroidal lesions were creamy yellow in color (84%), while 5 eyes (7%) displayed orange-colored lesions secondary to lung neuroendocrine tumors. On multimodal imaging, A-scan showed medium-high internal reflectivity in 35 eyes (69%), and medium-low reflectivity in 16 eyes (31%). Fundus fluorescein angiography (FFA) demonstrated late hypofluorescence in 17 eyes (94%), whereas indocyanine green angiography (ICG) demonstrated hypofluorescence throughout all phases in 11 eyes (69%). Optical coherence tomography (OCT) showed the presence of a lumpy-bumpy choroid with compression of the overlying choriocapillaries (<i>n</i> = 52, 91%), subretinal fluid (<i>n</i> = 40, 75%), and hyperreflective foci (HRF) (<i>n</i> = 25, 47%). Factors such as right eye involvement, orange tumor, the presence of HRF, increased tumor thickness, CM as the first presentation, and a shorter interval between diagnosis of primary cancer and CM were found to be strongly correlated with the origin of primary cancer from the lung compared with breast (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Ancillary imaging along with clinical presentation can provide clues to the origin of CM from various cancer sites, thereby aiding in the early diagnosis, staging, and treatment of primary cancer. CM from lung cancer is more likely to precede the diagnosis of a primary tumor than breast metastases.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"16 1","pages":"132-140"},"PeriodicalIF":1.2,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699986","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}