Saudi Journal of Ophthalmology最新文献

{"title":"Bilateral horizontal gaze palsy as an initial presentation of a clinically isolated syndrome: A case report.","authors":"Ghadah Alnosair, Khalid A Alanazi, Fatima I Alhumaid, Bayan S Alshuhayb","doi":"10.4103/sjopt.sjopt_106_23","DOIUrl":"https://doi.org/10.4103/sjopt.sjopt_106_23","url":null,"abstract":"<p><p>Multiple sclerosis (MS) is the most common demyelinating disease affecting the central nervous system. It has a wide range of manifestations and commonly affects the visual system. Many patients with MS report decreased vision, diplopia, nystagmus, and abnormal ocular motility. Nevertheless, bilateral horizontal gaze palsies are exceptionally rarely seen. We present the case of a 24-year-old female who came to our pediatric ophthalmology clinic complaining of bilateral horizontal gaze palsy, photophobia, and eye pain for 2 days. Although the patient had a family history of MS, there was no similar or previous complaint, with an unremarkable past medical and surgical history. During the examination, she was found to have a complete bilateral absence of horizontal saccade and pursuit, with slight limitations in vertical ones. There was no nystagmus or skew deviation, and the rest of the cranial nerves (CNs) were intact. Her ocular vital signs were normal, and her corrected visual acuity was 20/20 with full-color vision. The rest of the physical and neurological examinations were unremarkable. After referral to neurology, the magnetic resonance imaging showed multiple hyperintense lesions in deep white matter, pons, and midbrain. The correlation of imaging findings with clinical presentation confirmed the diagnosis of a clinically isolated syndrome. Extra-ocular motility (EOM) significantly improved after pulse steroid therapy and five sessions of plasma exchange, but the patient developed 35 prism diopter of acquired concomitant esotropia. She underwent a right medial rectus botulinum toxin injection which dramatically improved her condition, and became orthotropic during the last 2 months of follow-up after the injection.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"38 1","pages":"59-63"},"PeriodicalIF":0.4,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11017011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857732","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":"Author reply to comments.","authors":"A M Stephen","doi":"10.4103/sjopt.sjopt_213_23","DOIUrl":"https://doi.org/10.4103/sjopt.sjopt_213_23","url":null,"abstract":"","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"38 1","pages":"96-97"},"PeriodicalIF":0.4,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11016996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868490","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":"Phenotype and genotype of 15 Saudi patients with achromatopsia: A case series.","authors":"Enam Danish, Amal Alhashem, Reham Aljehani, Anan Aljawi, Manar M Aldarwish, Fuad Al Mutairi, Majid Alfadhel, Muhammad T Alrifai, Saif Alobaisi","doi":"10.4103/sjopt.sjopt_108_23","DOIUrl":"10.4103/sjopt.sjopt_108_23","url":null,"abstract":"<p><strong>Purpose: </strong>Achromatopsia is a rare stationary retinal disorder that primarily affects the cone photoreceptors. Individuals with achromatopsia present with photophobia, nystagmus, reduced visual acuity (VA), and color blindness. Multiple genes responsible for achromatopsia have been identified (e.g. cyclic nucleotide-gated channel subunit alpha 3 [CNGA3] and activating transcription factor 6). Studies have assessed the role of gene therapy in achromatopsia. Therefore, for treatment and prevention, the identification of phenotypes and genotypes is crucial. Here, we described the clinical manifestations and genetic mutations associated with achromatopsia in patients from Saudi Arabia.</p><p><strong>Methods: </strong>This case series study included 15 patients with clinical presentations, suggestive of achromatopsia, who underwent ophthalmological and systemic evaluations. Patients with typical achromatopsia phenotype underwent genetic evaluation using whole-exome testing.</p><p><strong>Results: </strong>All patients had nystagmus (<i>n</i> = 15) and 93.3% had photophobia (<i>n</i> = 14). In addition, all patients (<i>n</i> = 15) had poor VA. Hyperopia with astigmatism was observed in 93.3% (<i>n</i> = 14) and complete color blindness in 93.3% of the patients (<i>n</i> = 14). In the context of family history, both parents of all patients (<i>n</i> = 15) were genetic carriers, with a high consanguinity rate (82%, <i>n</i> = 9 families). Electroretinography showed cone dysfunction with normal rods in 66.7% (<i>n</i> = 10) and both cone-rod dysfunction in 33.3% (<i>n</i> = 5) patients. Regarding the genotypic features, 93% of patients had variants in <i>CNGA3</i> (<i>n</i> = 14) categorized as pathogenic Class 1 (86.7%, <i>n</i> = 13). Further, 66.7% (<i>n</i> = 10) of patients also harbored the c.661C>T DNA variant. Further, the patients were homozygous for these mutations. Three other variants were also identified: c.1768G>A (13.3%, <i>n</i> = 2), c.830G>A (6.6%, <i>n</i> = 1), and c. 822G >T (6.6%, <i>n</i> = 1).</p><p><strong>Conclusion: </strong>Consanguinity and belonging to the same tribe are major risk factors for disease inheritance. The most common genotype was <i>CNGA3</i> with the c.661C>T DNA variant. We recommend raising awareness among families and providing genetic counseling for this highly debilitating disease.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"37 4","pages":"301-306"},"PeriodicalIF":0.4,"publicationDate":"2023-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10752271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058882","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":"Artificial intelligence in cornea and ocular surface diseases.","authors":"Luca Pagano, Matteo Posarelli, Giuseppe Giannaccare, Giulia Coco, Vincenzo Scorcia, Vito Romano, Alfredo Borgia","doi":"10.4103/sjopt.sjopt_52_23","DOIUrl":"https://doi.org/10.4103/sjopt.sjopt_52_23","url":null,"abstract":"<p><p>In modern ophthalmology, the advent of artificial intelligence (AI) is gradually showing promising results. The application of complex algorithms to machine and deep learning has the potential to improve the diagnosis of various corneal and ocular surface diseases, customize the treatment, and enhance patient outcomes. Moreover, the use of AI can ameliorate the efficiency of the health-care system by providing more accurate results, reducing the workload of ophthalmologists, allowing the analysis of a big amount of data, and reducing the time and resources required for manual image acquisition and analysis. In this article, we reviewed the most important and recently published applications of AI in the field of cornea and ocular surface diseases, with a particular focus on keratoconus, infectious keratitis, corneal transplants, and the use of <i>in vivo</i> confocal microscopy.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"37 3","pages":"179-184"},"PeriodicalIF":0.4,"publicationDate":"2023-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10701143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812467","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":"Acute dacryocystitis secondary to <i>Burkholderia cepacia</i> and <i>Sphingomonas paucimobilis</i> mixed infection: A novel case report.","authors":"Nasser Alsobaie, Humoud Alotaibi, Firas Madani, Fatima Sirajuddin, Rawan Althaqib","doi":"10.4103/sjopt.sjopt_29_23","DOIUrl":"10.4103/sjopt.sjopt_29_23","url":null,"abstract":"<p><p>Acute dacryocystitis caused by <i>Burkholderia Cepacia</i> and Sphingomonas Paucimobilis is uncommon. To the best of our knowledge, presence of mixed pathogens <i>Burkholderia Cepacia</i> and Sphingomonas Paucimobilis causing acute dacryocystitis in immunocompetent patients never been described. <i>Burkholderia Cepacia</i> and Sphingomonas Paucimobilis been reported only as a single microorganism causing other ocular infections in immunocompromised patients. Middle age, medically free female patient, presented to the emergency department at our hospital, with a history of nasolacrimal duct obstruct (NLDO) complaining of inferior preocular swelling associated with localized pain diagnosed as acute dacryocystitis. She was on oral Amoxicillin/clavulanic acid, oral Nitroimidazole antimicrobial and topical Tobramycin from elsewhere. However, no improvement had been noticed. We kept the patient on the same medications and swaps taken for culture and sensitivity. Patient presented to the first follow-up appointment with no improvement on her status. Culture and sensitivity revealed 2 pathogens: <i>Burkholderia Cepacia</i> and Sphingomonas Paucimobilis. We have changed the antibiotic to oral Trimethoprim/ Sulfamethoxazole as it showed positive sensitivity to the pathogens based on the sensitivity chart. Second follow-up appointment patient's condition improved.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"38 2","pages":"188-190"},"PeriodicalIF":0.6,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581218","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":"Can chromatic text/background improve Arabic reading performance?","authors":"Norah I Alsalem, Ali Almustanyir, Mosaad Alhassan, Essam Almutleb, Muhammed Alluwimi, Balsam Alabdulkader","doi":"10.4103/sjopt.sjopt_44_23","DOIUrl":"https://doi.org/10.4103/sjopt.sjopt_44_23","url":null,"abstract":"<p><strong>Purpose: </strong>Colors have been shown to improve reading performance; however, the effect of colors on Arabic orthography has not been studied. This study aimed to design and create a chromatic acuity chart to evaluate the effect of chromatic contrast on Arabic reading performance.</p><p><strong>Methods: </strong>Color selection for the newly developed chromatic acuity chart was based on the contrast between the L, M, and S cones. The colors were chosen to have a luminance of approximately 13.6 cd/m² with red text on a green background. A Pantone color guide set was used to choose the colors. Fifteen healthy individuals aged 19-27 years were recruited. Reading performance was measured using the newly developed red-green (R-G) chart and compared with the original achromatic Balsam Alabdulkader-Leat (BAL) chart with a luminance of 95 cd/m². The outcomes were maximum reading speed in standard-length words per minute (SLWPM), reading acuity (RA), and critical print size (CPS).</p><p><strong>Results: </strong>The mean R-G SLWPM of 201 wpm was similar to that of the BAL chart (<i>P</i> < 0.05). The mean RA for the R-G chart was - 0.05 logMAR and - 0.20 logMAR for the BAL chart (<i>P</i> < 0.05). The CPS for the R-G chart was 0.36 logMAR, significantly higher than the original chart of 0.17 logMAR (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>This study showed that the reading performance for a text that varies only in chromatic contrast along the R-G axis reduces the reading performance for CPS and RA. Individuals showed an approximate decline of two lines on an Arabic continuous text chart compared with a high-contrast achromatic chart. This information can be used to further develop a set of near-reading charts that can efficiently determine whether there is a differential loss in chromatic and achromatic sensitivity in patients with various vision disorders.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"37 3","pages":"218-221"},"PeriodicalIF":0.4,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10701150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812468","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":"Weight and sight: Association between body mass index and visual efficiency skills of university students.","authors":"Aayushi Gupta, Renu Thakur","doi":"10.4103/sjopt.sjopt_95_23","DOIUrl":"https://doi.org/10.4103/sjopt.sjopt_95_23","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to investigate the association between body mass index (BMI) and visual efficiency skills of university students.</p><p><strong>Methods: </strong>This study adopted an analytical and descriptive methodology whereby a comprehensive screening of 385 university students was conducted. Ultimately, 116 subjects were selected to ensure judicious distribution of subjects across the four categories of BMI. These 116 subjects were subjected to visual efficiency testing parameters, as referenced from \"Clinical Management of Binocular Vision,\" by Scheiman and Wick.</p><p><strong>Results: </strong>BMI and visual efficiency anomalies were observed to be correlated with statistical significance to each other as indicated by a <i>P</i> = 0.018 and <i>χ</i>² = 15.22. It was also observed that the obese category exhibited the highest prevalence of accommodation and vergence anomalies, followed by the underweight category, as discerned from a detailed analysis of subjects classified according to the BMI categories. These findings imply a noteworthy and potentially deleterious impact of BMI on the visual system and underscore the importance of regular screening for visual efficiency skills in individuals across various BMI categories.</p><p><strong>Conclusion: </strong>This study established a compelling association between BMI and visual efficiency skills anomalies. Consistent with prior research, the findings of this study suggest that individual with higher BMI is more prone to experiencing such anomalies.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"37 3","pages":"227-232"},"PeriodicalIF":0.4,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10701155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138795622","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":"Efficacy of estimations of Hartmann-Shack sensors in small pupil sizes.","authors":"Francisco de Asís Bartol-Puyal, Galadriel Giménez, Silvia Méndez-Martínez, José M Larrosa, Vicente Polo, Luis Pablo","doi":"10.4103/sjopt.sjopt_123_23","DOIUrl":"10.4103/sjopt.sjopt_123_23","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate the <i>in vivo</i> efficacy of the estimations of wavefront analyzers using Hartmann-Shack technology to measure optical aberrations when the pupil size is smaller than the evaluated pupil area.</p><p><strong>Methods: </strong>Patients implanted with the monofocal ZCB00 intraocular lens (Johnson and Johnson) were examined with the KR-1W Wavefront Analyzer (Topcon) without pharmacological mydriasis and with it afterward. Optical aberrations were analyzed considering a 4-mm pupil and a 6-mm pupil for both examinations.</p><p><strong>Results: </strong>Sixty-six eyes of 33 patients with a mean axial length of 23.35 ± 0.91 mm were assessed. The mean pupil diameter at the baseline examination was 5.05 ± 0.88 mm and under pharmacological mydriasis, it was 6.29 ± 0.84 mm. Outcomes were similar with and without dilation in the 4-mm comparison. However, there was a great disparity in the 6-mm comparison. Most of the values obtained under mydriasis were statistically lower than at baseline (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The iris interferes with measurements of wavefront aberrations, and therefore, real pupil size should always be checked before evaluating optical aberrations with Hartman-Shack sensors. When pupil size is smaller than the analyzed diameter, ocular, and internal, and sometimes, corneal aberrations are estimated far more positive than real values.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"38 2","pages":"168-172"},"PeriodicalIF":0.6,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581220","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":"Assessment of refractive outcomes in eyes that underwent intraocular lens implantation in the posterior chamber but not \"in-the-capsular bag:\" A comparative retrospective study.","authors":"Halah Bin Helayel, Nasser T Balbaid, Rafah Fairaq, Turki A Bin Dakhil, Mohammed Al-Blowi, Samar A Al-Swailem, Rajiv Khandekar, Mohammed AlMutlak","doi":"10.4103/sjopt.sjopt_186_22","DOIUrl":"https://doi.org/10.4103/sjopt.sjopt_186_22","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to report visual and refractive outcomes in eyes that underwent intraocular lens (IOL) fixation in the absence of capsular support.</p><p><strong>Methods: </strong>This was a retrospective chart review of cases undergoing posterior chamber iris-fixated IOL (IFIOL) and scleral-fixated IOL (SFIOL) implants from June 2014 to March 2020 with more than 3 months of follow-up and having a preoperative best-corrected visual acuity of 20/80 and more.</p><p><strong>Results: </strong>Records of 120 eyes of 112 patients were reviewed. The mean age of the patients was 46.9 ± 22.3 (14.4-98.0) years, and 62% (<i>n</i> = 70) of participants were male. Most of the eyes (102: 85%) were aphakic at the time of surgery. The mean follow-up was 22.95 ± 17.1 months. The efficacy index of sutured IFIOL and glued SFIOL outperformed sutured SFIOL at 3 months and final visits postoperatively (<i>P</i> < 0.001<b>)</b>. All techniques studied here resulted in a similar safety index at 3 months (<i>P</i> = 0.4). The mean predictive error (postoperative spherical equivalent refraction minus intended target refraction) was +0.07 ± 1.5 D and -0.12 ± 1.4 D at 3 months and the final postoperative visit, respectively.</p><p><strong>Conclusion: </strong>The studied techniques have relatively good visual and refractive outcomes in this series. In addition, techniques involving a small corneal incision with foldable IOL fixation to the iris or scleral tissue have superior efficacy and safety indices compared to creating large corneoscleral wounds for rigid IOL fixation techniques.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"38 1","pages":"71-77"},"PeriodicalIF":0.4,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11017000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852324","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":"Visual outcomes and recurrence rate of macular corneal dystrophy following phototherapeutic keratectomy in Saudi Arabia.","authors":"Sara M AlHilali, Deema E Jomar, Eman D Albalawi","doi":"10.4103/sjopt.sjopt_194_22","DOIUrl":"10.4103/sjopt.sjopt_194_22","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the study was to evaluate the visual outcomes and recurrence rate of patients with macular corneal dystrophy (MCD) who have undergone phototherapeutic keratectomy (PTK).</p><p><strong>Methods: </strong>This retrospective, single-centered study enrolled patients from King Khaled Eye Specialist Hospital who had undergone PTK for MCD between 2000 and 2020. Pre-, intra-, and post-operative data were collected, and the primary outcome measures included uncorrected visual acuity, best-corrected visual acuity (BCVA), spherical equivalent, central keratometry, keratometric astigmatism, recurrence rate, and necessity of subsequent surgery.</p><p><strong>Results: </strong>This study evaluated 42 eyes of 29 patients. BCVA improved from 0.41 (±0.17) preoperatively to 0.30 (±0.16) postoperatively. Sixteen out of 42 eyes (38%) had the recurrence of macular dystrophy deposits within the stroma; the average time from PTK to recurrence was 37 months (range: 5.5-115.4 months). The overall success rate of PTK at 2 years was 44.8%. Eleven eyes (26%) required subsequent surgery following PTK at an average of 43 months postoperatively. Deeper ablation and longer application of mitomycin C (MMC) were both found to be statistically significant factors associated with visual improvement and lower recurrence rate following PTK.</p><p><strong>Conclusion: </strong>PTK can be considered a treatment modality for younger patients to defer keratoplasty to a later stage. Deeper ablation is associated with improved postoperative visual acuity, and longer application of MMC is associated with lower recurrence rates of MCD.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"37 4","pages":"337-341"},"PeriodicalIF":0.4,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10752283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058888","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}