Eye & Contact Lens-Science and Clinical Practice最新文献

{"title":"Clinical Investigation of Short-Term Axial Elongation Control After Orthokeratology Lens Correction: Exploring Its Predictive Role in Long-Term Therapeutic Efficacy.","authors":"Xuemei Han, Feifei Li, Yu Zhang, Jinfei Tang","doi":"10.1097/ICL.0000000000001142","DOIUrl":"10.1097/ICL.0000000000001142","url":null,"abstract":"<p><strong>Objective: </strong>This study was developed with the goal of exploring the efficacy of orthokeratology (OK) as an approach to controlling axial length (AL) growth and identifying factors predictive of the long-term efficacy of this approach.</p><p><strong>Methods: </strong>This was a retrospective study that enrolled 157 myopic children 7 to 15 years of age undergoing OK correction for over 3 years. The short- and long-term effectiveness of this approach at 1 and 3 years post-OK correction, respectively, was assessed. All participants were classified into two groups based on whether they exhibited good or poor long-term efficacy outcomes. Measurements of changes in AL were made at baseline and at 1 and 3 years post-OK. Univariate analyses and binary logistic regression approaches were used to evaluate baseline age, baseline spherical equivalent refraction, baseline keratometry (K) values of flat and steep meridians, and short-term effectiveness with the goal of identifying predictors of long-term efficacy.</p><p><strong>Results: </strong>Univariate analyses led to the identification of significant differences in baseline age, baseline spherical equivalent refraction, baseline AL, and short-term efficacy between these two groups ( P <0.05), whereas gender, baseline flat K, and baseline steep K did not differ significantly ( P >0.05). In binary logistic regression analyses, baseline AL ( P =0.017) and short-term efficacy ( P <0.001) were both found to significantly influence long-term efficacy. Receiver operating characteristic curves demonstrated that short-term efficacy offered an area under the curve value >0.8, consistent with its highly accurate performance as a predictor of long-term efficacy.</p><p><strong>Conclusion: </strong>These results suggest that short-term efficacy outcomes can feasibly be used to predict the long-term effectiveness of OK correction in children. In patients exhibiting poor short-term efficacy, timely replacement or the incorporation of additional treatment modalities may aid efforts to better control the progression of myopia.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"85-91"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548722","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":"Intrastromal Corneal Ring Segments and Keratoconus Progression: A Case Series Study.","authors":"Blanca Benito-Pascual, Pedro Arriola-Villalobos, Olivia Rodríguez-Quet, Vittoria Termine, Ricardo Cuiña-Sardiña, David Díaz-Valle","doi":"10.1097/ICL.0000000000001137","DOIUrl":"10.1097/ICL.0000000000001137","url":null,"abstract":"<p><strong>Objective: </strong>To assess keratoconus (KC) progression following the implant of intrastromal corneal ring segments (ICRSs) in young patients.</p><p><strong>Materials and methods: </strong>Retrospective, longitudinal, observational, controlled nonrandomized case series study. Keratoconus patients aged 25 years or younger who underwent uneventful ICRS surgery and completed at least 3 years of follow-up were enrolled. Controls were of similar age and treatment-naive patients with KC. The following Pentacam imaging (Oculus, Wetzlar, Germany) data were analyzed: keratometric (maximum, in-flattest meridian, in-steepest meridian, and mean), aberrometric (higher-order aberrations and coma), pachymetric (thinnest corneal thickness), and elevation (maximum posterior elevation). The main outcome measure was KC progression.</p><p><strong>Results: </strong>The study sample comprised 20 eyes of 18 cases (age 20.20 ± 3.70 years, nine right eyes, 14 male patients) and 30 eyes of 24 controls (age 20.80 ± 3.20 years, 15 right eyes, 21 male patients). The mean follow-up duration was 4.90 ± 1.70 years (range 3-8 years) for cases and 4.50 ± 1.40 years (range 3-8 years) for controls. Four cases and two controls met criteria for KC progression.</p><p><strong>Conclusions: </strong>Intrastromal corneal ring segments did not have significant impact on KC progression in the cohort.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"65-69"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562994","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":"Size Matters: A Comparative Study on Midday Fogging and Lens Settling in Patients With Keratoconus Wearing Mini-Scleral Lenses With Two Different Diameters.","authors":"Elif Bagatur Vurgun, Semra Akkaya Turhan, Ayşe Ebru Toker","doi":"10.1097/ICL.0000000000001135","DOIUrl":"10.1097/ICL.0000000000001135","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study was to compare the changes in postlens fluid optical density, timing and quantity of lens settling, and the clinical performance between two different mini-scleral lenses.</p><p><strong>Methods: </strong>Seventeen eyes of 10 patients with keratoconus were fitted with a 15-mm mini-scleral lens (AirKone Scleral Lenses; Laboratoire LCS, Normandy, France), and 15 eyes of 10 patients with keratoconus were fitted with 16.5-mm mini-scleral lenses (Misa Lenses; Microlens Contactlens Technology, Arnhem, The Netherlands). The lens fit was evaluated with biomicroscopy and anterior segment optical coherence tomography (AS-OCT). At 0, 2, and 4 hrs, corneal clearances were measured with AS-OCT, and optical density measurements were made by Scheimpflug tomography. High-contrast visual acuity (HCVA) and contrast sensitivity (CS) were assessed at each time point. At the end of the 4th hour, participants' comfort, visual quality, and general satisfaction were evaluated with a 5-point Likert scale and 100-mm Visual Analog Scale (VAS) scale.</p><p><strong>Results: </strong>The mean age (24.4 ± 5.4 vs. 21.7 ± 4.5, P = 0.145) and best spectacle-corrected HCVA (0.36 ± 0.15 vs. 0.35 ± 0.20, P = 0.984) were similar in both groups. The mean Snellen HCVA significantly improved with dispensing both mini-scleral lenses and remained stable at 4 hrs in both groups. In comparison, CS significantly decreased at 4 hrs in both groups ( P = 0.02). Both groups' optical density significantly increased over time ( P = 0.003). In the 15-mm mini-scleral lens group, the settling amount was 62.2 ± 11.9 μm (62.6%) and 99.5 ± 14.2 μm (100%) at 2 and 4 hrs, respectively; in the 16.5-mm mini-scleral lens group, it was 46.4 ± 22.3 μm (56.4%) and 82.1 ± 37.3 μm (100%) at 2 and 4 hrs, respectively. More than 50% of settling occurred in the first 2 hrs in both groups. No significant difference was observed between the two groups with regard to visual acuity, CS, optical density, and total settling amount at 4 hrs ( P > 0.05). Patient in the 15-mm mini-scleral lens group scored higher in comfort (4.65 ± 0.7 vs. 3.60 ± 0.9), visual quality (4.76 ± 0.4 vs. 3.73 ± 0.7), and overall satisfaction (95.7 ± 6.0 vs. 65.3 ± 20.3) ( P < 0.0001).</p><p><strong>Conclusion: </strong>Patients reported a heightened level of contentment with the smaller-diameter lens; however, it is crucial to emphasize that both diameter scleral lenses showcase comparable clinical efficacy, midday fogging, and settling.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"53-57"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958270","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":"A Sneaky Culprit: Secondary Infectious Keratitis Due to Brevundimonas diminuta.","authors":"Suma K Thareja, Susan Luo, Sarah Carballo","doi":"10.1097/ICL.0000000000001170","DOIUrl":"10.1097/ICL.0000000000001170","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a rare case of infectious keratitis secondary to Brevundimonas diminuta , a gram-negative bacillus with fluoroquinolone resistance and rare clinical isolation.</p><p><strong>Methods: </strong>A 50-year-old man with contact lens overuse presented with a large corneal ulcer and hand motion visual acuity. Initial treatment with fortified topical tobramycin and vancomycin yielded slow improvement, and initial culture grew Staphylococcus epidermidis , Staphylococcus hominis , and Corynebacterium bovis . Therapy was tapered to topical moxifloxacin. Loteprednol was added to reduce corneal inflammation after presumed sterilization. Persistent epithelial defect and worsening infiltrate after 3 weeks prompted repeat culture and corneal punch biopsy.</p><p><strong>Results: </strong>Repeat culture revealed B. diminuta resistant to moxifloxacin. Treatment was modified to tobramycin, and therapeutic penetrating keratoplasty was pursued to prevent further stromal loss. Four months postoperatively, the cornea remained clear without recurrence or neovascularization.</p><p><strong>Conclusion: </strong>To our knowledge, this is the second reported culture-positive case of secondary infectious keratitis with B. diminuta , highlighting its rarity and potential for delayed identification. The atypical response to initial therapy underscores the importance of repeat cultures and corneal biopsy in persistent cases. This case contributes to the growing understanding of rare ocular pathogens, advocating for a vigilant clinical approach.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"244-246"},"PeriodicalIF":2.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061217","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":"Evaluation of Scleral Thickness in Patients With Keratoconus.","authors":"Mukaddes Damla Ciftci, Cumali Degirmenci, Melis Palamar","doi":"10.1097/ICL.0000000000001169","DOIUrl":"10.1097/ICL.0000000000001169","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate scleral thickness of patients with keratoconus by anterior segment optical coherence tomography (AS-OCT).</p><p><strong>Materials and methods: </strong>Fifty-two eyes of 42 patients with keratoconus (group 1) and 42 right eyes of 42 healthy individuals (group 2) were included. Scleral thickness measurements were taken with AS-OCT 6, 4, and 2 mm behind the scleral spur in four gaze positions: superior, inferior, temporal, and nasal. The data including central corneal thickness (CCT) by Pentacam from patients with keratoconus was also analyzed and its relationship with scleral thickness was evaluated.</p><p><strong>Results: </strong>In group 1, mean scleral thickness from 6 mm posterior to scleral spur in superior, inferior, temporal, and nasal quadrants were 397±35.3 (320-482), 408±29.5 (341-467), 393±40.8 (297-469), and 403±35.8 (310-482) μm, respectively. In group 2, mean scleral thickness from 6 mm posterior to scleral spur in superior, inferior, temporal, and nasal quadrants were 440±42.2 (346-552), 461±33.9 (390-563), 451±46.6 (340-549) and 448±34.3 (350-521) μm, respectively. The mean scleral thickness in group 1 was significantly lower in all quadrants compared with group 2 ( P <0.001). The mean CCT in group 1 was 478.22±87.55 (306-632) μm. Positive correlation was found between scleral thickness measurements taken at 4 mm (ϱ=0.312, P =0.037) and 2 mm (ϱ=0.308, P =0.039) posterior from the scleral spur in the inferior quadrant and CCT.</p><p><strong>Conclusion: </strong>Scleral thickness was significantly lower in patients with keratoconus. Scleral thickness and CCT were positively correlated in inferior quadrant. Even though it is not yet known whether scleral changes are progressive or not, scleral thickness measurement may also find a place in the diagnosis and follow-up of patients with keratoconus in the future.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"214-219"},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015423","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":"Impact of Neurostimulation, Immunomodulation, Topical Medication Application, and Surgical Reconstruction on Corneal Nerve Function and Regeneration.","authors":"Taylor N Drake, John D Sheppard","doi":"10.1097/ICL.0000000000001130","DOIUrl":"10.1097/ICL.0000000000001130","url":null,"abstract":"<p><strong>Abstract: </strong>The corneal epithelium, supplied by thousands of nerve endings, plays a substantial role in absorbing and distributing nutrients along the ocular surface. Many studies have explored the influence of various modalities in regulating tear production to manage corneal disorders and dry eye disease. These findings have highlighted the advantages of enhancing corneal nerve function and regeneration through neurostimulation, neural signaling, immunomodulation, topical medication application, and surgical reconstruction. The purpose of this narrative review article was to provide an overview of the current state of knowledge on this topic based on a PubMed database literature search for relevant animal and human studies investigating the modification of the trigeminal pathway to restore corneal nerve function and improve overall ocular health. Further investigation into this area of research is important to help guide new therapeutic targets for the prevention and development of treatments of corneal degeneration.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"3-13"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401841","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":"Evaluation of the Microbiology of Removed Punctal Plugs and Intracanalicular Devices.","authors":"Jay J Meyer, Karissa Culbreath, Edward Ager, Neda Esmaili, William C Fowler, Peter Gilligan, Amy M Fowler","doi":"10.1097/ICL.0000000000001145","DOIUrl":"10.1097/ICL.0000000000001145","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this observational study was to characterize the microorganisms colonizing punctal plugs and intracanalicular stents.</p><p><strong>Methods: </strong>Devices were removed from participants who previously underwent placement of punctal plugs for tear insufficiency and lacrimal stents for dacryocystorhinostomy and canalicular reconstruction procedures. After removal of the devices, they were cultured for organisms both with and without sonication to loosen any biofilms or adherent microorganisms. Primary outcome measures included culture positivity, identification of isolated microorganisms, recovery of microorganisms from culture after sonication, and clinical evidence of ocular infection.</p><p><strong>Results: </strong>There were no cases of clinical infection. A total of 181 specimens were processed (174 punctal plugs, seven intracanalicular stents), of which 98 (54%) were culture positive. Of the punctal plugs, 92 (52.9%) were culture positive, including 42 with a single organism isolated, whereas 22 yielded two organisms, 7 yielded three organisms, and the remaining 21 yielded a polymicrobial culture with four or more organisms. The most common isolates from punctal plugs were coagulase negative staphylococci (27.6%), diphtheroids (16.4%), and streptococcus viridans (10.2%). Those plugs with polymicrobial culture results grew a mixture of organisms most consistent with skin or upper respiratory flora. Of the intracanalicular stents, 6 (85.6%) were culture positive.</p><p><strong>Conclusions: </strong>Punctal plugs and intracanalicular devices can become colonized with bacteria composed of oropharyngeal flora, skin flora, and other rare but potentially significant pathogens.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"25-29"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562993","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":"Spotlight on Amniotic Membrane Extract Eye Drops: A Review of the Literature.","authors":"Raphael Kilian, Erika Bonacci, Ruth Donner, Jan Lammer, Clara Rizzo, Emanuele Crincoli, Valentino De Ruvo, Gerald Schmidinger, Emilio Pedrotti, Giorgio Marchini","doi":"10.1097/ICL.0000000000001136","DOIUrl":"10.1097/ICL.0000000000001136","url":null,"abstract":"<p><strong>Objective: </strong>To review the literature focusing on the effectiveness of amniotic membrane extract eye drops (AMEDs) in the treatment of ocular surface diseases.</p><p><strong>Methods: </strong>PubMed/MEDLINE, Scopus, and CENTRAL databases were searched until March 4, 2024. Overall, we identified 1,121 studies, 26 of which were selected for a full-text review. Twelve studies met the inclusion criteria and were analyzed for clinical improvements, time to resolution of corneal staining, adverse events, and preparation methods. Strength of clinical data was graded according to the Oxford Center for Evidence-Based Medicine.</p><p><strong>Results: </strong>Overall, AMED compounds were used in 296 eyes of 205 patients. Fifty-nine percent of eyes were treated for dry eye disease, 23% for an epithelial defect, and the rest (18%) for other corneal wound healing disorders. Three main types of eye drops preparation were described, that is, lyophilized, homogenized, and fresh AMED. Although the methods of outcome reporting were heterogeneous, all included studies showed various grades of improvement in both signs and symptoms. The overall incidence of ocular side effects was 2.3%.</p><p><strong>Conclusions: </strong>Despite the suboptimal quality of evidence, overall, the available literature suggests that AMED is a valuable tool in the treatment of ocular surface disorders.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"14-19"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584891","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":"Letters to the Editor.","authors":"Maria A Henriquez, Luis Izquierdo, Perry S Binder","doi":"10.1097/ICL.0000000000001133","DOIUrl":"10.1097/ICL.0000000000001133","url":null,"abstract":"","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"50"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394917","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":"A New Method to Measure Ocular Surface Sensitivity: Repeatability and Reproducibility of the Liquid Jet Esthesiometer.","authors":"Klaus Ehrmann, Cristian Talens-Estarelles, Fiona Stapleton, Brenda Truong, Jessica Chen, Blanka Golebiowski","doi":"10.1097/ICL.0000000000001146","DOIUrl":"10.1097/ICL.0000000000001146","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the reliability of the liquid jet esthesiometer (LJA) for measurement of corneal sensitivity.</p><p><strong>Methods: </strong>Two separate studies were conducted to assess intrasession repeatability (study 1) and intersession reproducibility (study 2) of corneal sensitivity measured using the LJA. Thirty participants (13 female and 17 male participants, age 23±6 years) participated in study 1 and another 30 (18 female and 12 male participants, 35±10 years) participated in study 2. For study 1, mechanical sensation threshold of the central cornea was measured three times on the same day, with a 30-min break between repeats. For study 2, central corneal sensation threshold was measured on five different days by one of eight randomly assigned examiners.</p><p><strong>Results: </strong>Corneal sensation thresholds obtained in studies 1 and 2 were 2.3±1.0 and 2.5±1.2 μL, respectively. No significant differences between repeated measurements were obtained in either study ( P ≥0.19). Thresholds were lower (i.e., corneal sensitivity was higher) in female than male participants (2.1±1.0 vs. 2.7±0.9 μL in male participants, P =0.02) but were not affected by contact lens wear. Clinical reliability of the LJA was good for intrasession repeatability (coefficient of repeatability ±1.6 μL, intraclass correlation coefficient 0.74, within-subject coefficient of variation (CV W ) 24%) and moderate for intersession reproducibility (Coefficient of Reproducibility ±2.2 μL, CV W 32%). Measurement variability was independent of threshold level ( P =0.84).</p><p><strong>Conclusions: </strong>The LJA offers good clinical repeatability and is a reliable tool to measure corneal sensitivity in different population groups, regardless of stimulus thresholds. Day-to-day fluctuations in corneal sensitivity probably account for the relatively lower reproducibility.</p>","PeriodicalId":50457,"journal":{"name":"Eye & Contact Lens-Science and Clinical Practice","volume":" ","pages":"30-38"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958315","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}