Strabismus最新文献

{"title":"Horizontal gaze palsy with ipsilateral esotropia with substituted convergence in a child with medulloblastoma.","authors":"Prachi Agashe, Marushka Aguiar, Ashish Doshi","doi":"10.1080/09273972.2025.2482248","DOIUrl":"https://doi.org/10.1080/09273972.2025.2482248","url":null,"abstract":"<p><p><i>Introduction</i>: Horizontal Gaze palsy with concurrent esotropia and substituted convergence is a rare clinical presentation. <i>Methods</i>: We report a case of a 6-year-old child being treated for pontine medulloblastoma who presented with bilateral abducens and bilateral facial nerve palsy. The patient progressed to develop right sided horizontal gaze palsy with bilateral abducens palsy and substituted convergence. In view of limited abduction in his right eye, a modified Nishida procedure was performed followed by botulinum toxin to the right medial rectus both of which failed in improving the ocular alignment. Subsequently, the patient underwent an asymmetric, bilateral recess-resect procedure. <i>Results</i>: The recess-resect procedure resulted in a correction of his compensatory face turn and ocular deviation with orthotropia in primary position and binocular single vision. <i>Conclusion</i>: This case report reiterates the importance of asymmetric recess-resect surgery rather than vertical rectus transposition surgery in such a case.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-7"},"PeriodicalIF":0.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical dose-responses of bilateral medial rectus muscle recession in acute acquired comitant esotropia compared to infantile esotropia.","authors":"Worawalun Honglertnapakul, Watcharakorn Lertduailap, Kidakarn Meethongkam, Parnchat Pukrushpan","doi":"10.1080/09273972.2025.2474430","DOIUrl":"https://doi.org/10.1080/09273972.2025.2474430","url":null,"abstract":"<p><p><i>Objective</i>: To determine the surgical dose-responses of the bilateral medial rectus recession in acute acquired comitant esotropia (AACE) compared to infantile esotropia. <i>Design</i>: Retrospective study. <i>Methods</i>: The medical records of patients diagnosed with AACE and infantile esotropia who underwent bilateral medial rectus muscle recession (BMRR) were reviewed. Patient characteristics, ocular examinations and surgical data were collected. A motor success was defined as horizontal deviation within 10 prism diopters (PD) of ortho, and a sensory success was defined as no diplopia at 6 months after the surgery. <i>Results</i>: A total of 114 patients were included. There were 39 patients with AACE [median (Q1-Q3) age was 20 (15-25) years, 56% was female] and 75 patients with infantile esotropia [median (Q1-Q3) age was 3 (1-5) years, 56% was female]. The surgical dose-responses of BMRR in AACE at distance and near were 2.67 PD/mm (r² = 22.8%) and 3.48 PD/mm (r² = 32.9%), respectively. The surgical dose-responses of BMRR in infantile esotropia at distance and near were 3.91 PD/mm (r² = 17.8%) and 4.64 PD/mm (r² = 18.0%), respectively. Seventy-four percent of patients with AACE and 63% of patients with infantile esotropia achieved a motor success. Eighty-five percent of patients with AACE achieved a sensory success. The postoperative drift at distance and at near was not significant in both groups [AACE 0 PD (-6 to 10), <i>p</i> = .26 and 2 PD (-2 to 6), <i>p</i> = .44; infantile esotropia [8 PD (0-14), <i>p</i> = .12 and 4 PD (0-10), <i>p</i> = .22]. <i>Conclusions</i>: The BMRR in infantile esotropia had a larger surgical dose-response than in AACE. In both groups, the surgical dose-responses at near were greater than at distance. There was no significant postoperative drift at distance and at near in both groups.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-8"},"PeriodicalIF":0.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study of the relative orientation of the extraocular rectus muscles: an advanced cadaveric approach.","authors":"Andrew T Barton, Viren K Rana, Eric J Kim, Surya Khatri, James Y Lee, Jamie Schaefer","doi":"10.1080/09273972.2024.2388076","DOIUrl":"10.1080/09273972.2024.2388076","url":null,"abstract":"<p><p><i>Purpose:</i> The anatomy of the extraocular rectus muscle insertions is clinically relevant in the field of ophthalmology. This descriptive cadaveric study determines the relative degree orientation of the superior, lateral, and inferior rectus muscles with respect to the medial rectus and investigates the distances between the rectus muscle insertions. <i>Method:</i> Thirty cadavers (50% female, mean age = 81.86 years, SD 12.16) were included for a total of 60 eyes. For each eye, a lateral canthotomy and cantholysis were performed followed by a peritomy. Muscle hooks were then used to access and isolate the rectus muscles. The degree orientation was determined by marking the muscle midpoints at insertion, using the center of the cornea as the vertex, and measuring the angle with the Angle Meter 360 application (© Alexey Kozlov) (Figure 1). The distances between rectus muscles were measured from the same muscle midpoints using calipers. <i>Results:</i> The degree orientations with respect to the medial rectus are displayed in Figure 2 and were as follows: superior rectus (mean = 93.14, SD = 3.04, min. 82.3, max. 100.3), lateral rectus (mean = 180.21, SD = 5.65, min. 170.5, max. 190.6), and inferior rectus (mean = 90.57, SD = 4.47, min. 84.0, max. 98.9). The distances (measured in mm) between rectus muscle midpoints at insertion included medial rectus to inferior rectus (mean = 13.64, SD = 0.54), inferior rectus to lateral rectus (mean = 13.79, SD = 0.75), lateral rectus to superior rectus (mean = 13.54, SD = 0.63), and superior rectus to medial rectus (mean = 13.83, SD = 0.75). The relative distances between the midpoints of the extraocular muscles observed in males versus females showed statistically significant differences in medial rectus to inferior rectus (13.8 vs. 13.5, <i>p</i> = .01), inferior rectus to lateral rectus (14.1 vs. 13.5, <i>p</i> = .03), and superior rectus to medial rectus (14.0 vs. 13.5, <i>p</i> = .04), respectively (Table 1). <i>Conclusion:</i> This is an important study of the extraocular muscle degree orientation performed with an innovative measuring approach. The degree orientation of the insertions relative to the medial rectus may have surgical application in the field of ophthalmology.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"54-57"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of stereopsis in unilateral amblyopia subjects using syntonic phototherapy.","authors":"Shakila Abbas, Malaika Younus, Ayesha Bukhari, Mahnoor Anwar, Aalia Iqrar","doi":"10.1080/09273972.2024.2389228","DOIUrl":"10.1080/09273972.2024.2389228","url":null,"abstract":"<p><strong>Introduction: </strong>Amblyopia is two Snellen line difference between both eyes. Red filter therapy is a treatment option for amblyopia based on principle of syntonic phototherapy. The purpose of this study is to assess the stereopsis in amblyopic patient using syntonic phototherapy.</p><p><strong>Methods: </strong>A Qusai experimental study was conducted from August 2021 to December 2021 at Madina Teaching Hospital Faisalabad. A total 30 subjects of both gender and ages ranging between 8 to 18 years were included through a non-probability purposive sampling technique. The sample was considered of 15 anisometropic amblyopes and 15 strabismic amblyope. Data was collected using a Performa and pre assessments of stereopsis by Titmus fly chart were recorded without red filter. Red filter glasses were prescribed for 4 week, post assessment data was recorded after 4 weeks. Data was analyzed by using Paired sample T test and Independent Sample T test in SPSS 20 software.</p><p><strong>Results: </strong>After syntonic phototherapy significant improvement was seen, mean stereopsis was 48.00000 (<i>p</i> = 0.002) in anisometropic amblyopes while mean improvement of stereopsis 1.670.93333 (<i>p</i> = 0.00) in strabismic amblyopes. Anisometropic amblyopic patients showed significantly better improvement in stereopsis (<i>p</i> = 0.00) by syntonic phototherapy as compared to strabismic amblyopes.</p><p><strong>Conclusion: </strong>Significant improvement was seen in stereopsis, while improvement was more significant in anisometropic amblyopes as compared to strabismic amblyopes. Children were obsessed with the red filter glasses while their parents found syntonic therapy simple plus facile and gave good results. So, eye care professionals must be aware of this new therapy and they should keep syntonic phototherapy in mind whenever they are dealing with amblyopic patients.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-5"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of strabismus in Pakistan: a systematic review and meta-analysis.","authors":"Zainab Zehra, Christopher S von Bartheld, Wishal Khan, Maleeha Azam, Raheel Qamar","doi":"10.1080/09273972.2024.2408416","DOIUrl":"10.1080/09273972.2024.2408416","url":null,"abstract":"<p><p><i>Purpose</i>: Strabismus is an ocular condition characterized by misalignment of the visual axis. The global prevalence of strabismus is about 2-3%, which varies between different countries and ethnicities. The aim of this study was to conduct a meta-analysis of studies, which had previously reported the prevalence of strabismus in Pakistan, in order to obtain the overall prevalence of strabismus in the country. <i>Methods</i>: All community-based studies reporting the prevalence of strabismus from Pakistan were searched using international databases and local ophthalmology journals. Information about sample size, number of individuals with strabismus, and location and duration of the study was recorded. Statistical analysis including heterogeneity testing, pooled prevalence calculation and regression analysis were done using the R software. <i>Results</i>: Heterogeneity tests, P_{heterogeneity} < .01, suggested high heterogeneity between the different studies. The pooled prevalence of strabismus was 0.7% [95% confidence interval (CI): 0.39%-1.23%] according to the random effects model, with a decreasing trend in prevalence from 1995 to 2020. Esotropia was more frequent than exotropia in both population-based and clinic-based studies. <i>Conclusion</i>: The prevalence of strabismus in Pakistan is comparatively lower than the worldwide prevalence, and it appears to be decreasing over the last three decades, consistent with global trends.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"44-53"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332089","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":"Anteriorization of the inferior oblique muscle versus anteriorization and resection for asymmetrical dissociated vertical deviation.","authors":"Ghada Osama, Hala Elhilali, Magda Salah, Heba M Fouad","doi":"10.1080/09273972.2024.2402925","DOIUrl":"10.1080/09273972.2024.2402925","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the efficacy of two methods: first, bilateral symmetric anteriorization of the inferior oblique muscle and second: combined resection and anteriorization of the inferior oblique (IO) muscle for asymmetric dissociated vertical deviation (DVD).</p><p><strong>Design: </strong>Prospective randomized clinical trial.</p><p><strong>Methods: </strong>This study included fifty-four patients presenting with bilateral asymmetric DVD and inferior oblique overaction (IOOA). Two equal groups were randomly allocated by odd and even number distribution. Twenty-seven patients underwent bilateral symmetric anteriorization of the IO muscle and twenty-seven patients underwent anteriorization of the IO of one eye and anteriorization with IO resection in the eye with the larger deviation. According to the difference in measured DVD between the two eyes whether less or more than 5 PD; a 3 or 5 mm resection was done, respectively.</p><p><strong>Results: </strong>The mean post-operative reduction of DVD in the anteriorization group was 9.19 ± 3.40 PD in the right eye and 8.78 ± 4.17 PD in the left eye, which were highly significant. (<i>p</i>-value .0002). The resection group had a mean post-operative DVD reduction of 11.7 ± 2.74 PD in resected eyes and 7.3 ± 3.72 PD in non-resected eyes. These reductions were also highly significant (<i>p</i>-value 0.0001). Reduction of inter-ocular difference between both groups failed to show a statistical difference (<i>p</i>-value 0.285). The IOOA was significantly reduced in both groups. Improvement in the average post-operative DVD between the two groups and the post-operative improvement in IOOA failed to show a statistically significant difference (<i>p</i>-value 0.265 and 0.804 respectively) which showed that both procedures are effective.</p><p><strong>Conclusion: </strong>Both surgical modalities are effective in managing asymmetric dissociated vertical deviation associated with IOOA.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"28-35"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Angiographically silent macular retinoschisis and vitreomacular traction in a patient with same - side Duane retraction syndrome.","authors":"Işıl Kefeli, Aylin Yaman, Ali Osman Saatci","doi":"10.1080/09273972.2024.2399351","DOIUrl":"10.1080/09273972.2024.2399351","url":null,"abstract":"<p><p><i>Introduction:</i> To report the unusual fundus features of a case with unilateral Duane retraction syndrome (DRS) with same-side extensive macular retinoschisis. <i>Methods:</i> A 75-year-old woman was diagnosed to have DRS type 3 and several multimodal fundus imaging modalities were performed. <i>Results:</i> There was limited abduction and adduction, globe retraction, and narrowing of the palpebral fissure on the adduction of the left eye without a compensatory face turn. Concurrently, spectral domain optical coherence tomography revealed marked macular retinoschisis and severe vitreoretinal traction without any evidence of dye leakage or pooling on fluorescein angiography in the left eye. <i>Discussion:</i> Various ocular abnormalities may rarely accompany DRS and the present case is the first reported case of most likely coincidental macular retinoschisis in association with DRS.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"58-60"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stability of the angle of deviation in basic intermittent exotropia (IXT) following surgical correction: a retrospective observational study from southern India.","authors":"Sandra Chandramouli, Rebecca Claire Lusobya, Jaga Janani A, John Mukisa, Kalpana Narendran","doi":"10.1080/09273972.2024.2391413","DOIUrl":"10.1080/09273972.2024.2391413","url":null,"abstract":"<p><p><i>Introduction</i>: Intermittent exotropia (IXT) is commonly seen in areas with more sunlight, females and Asians. Surgical alignment is recommended to improve binocular function, but a high recurrence rate has been reported. This study aimed to assess the stability of ocular alignment and factors contributing to exodrift post-surgery for IXT over 6-month follow-up. <i>Methods</i>: We retrospectively reviewed the medical records of patients with IXT who underwent unilateral recess resect procedures and attended follow-up examinations for at least six months post-surgery. A significant exodrift was defined as exodrift of more than 10PD at distance and near. Ocular deviation, binocularity, and stereopsis at one and six-month post-operative visits were studied to assess the incidence of exodrift post-surgery and the probable factors causing such drift. <i>Results</i>: Of the 50 patients studied, 26 (52%) were males, 42 (84%) were <20 years. The median age at surgery was 10 years (range 6-14), and the median preoperative angle of deviation was 37 PD. Majority of patients (62%) had exodrift within six months of surgery, and about a quarter of the study population had significant exodrift >10 PD. No clinical factors were found to contribute significantly to exodrift in this study.16 (61.5%) patients attained near and distance BSV post-surgery (<i>p</i>-value: <0.001). Six (12%) and 10 (20%) patients with subnormal near and distance stereopsis, respectively, attained normal stereopsis post-surgery. <i>Conclusion</i>: Over half of the patients operated for IXT had some Exodrift, and one-fourth had significant exodrift within six months post-surgery. Despite improved BSV, many patients failed to attain normal stereopsis with just motor alignment.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"6-12"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One- vs Two- vertical muscle surgery in the management of unilateral superior oblique muscle palsy with hypertropia over 20 PD.","authors":"Hajar Farvardin, Fatemeh Ebrahimi, Hadi Farvardin, Majid Farvardin","doi":"10.1080/09273972.2024.2401439","DOIUrl":"10.1080/09273972.2024.2401439","url":null,"abstract":"<p><p><i>Purpose:</i> To compare the surgical outcomes of One- versus Two-vertical muscle surgery in patients with unilateral superior oblique muscle palsy (SOP) with primary position hypertropia (HT) over 20 PD. Patients in Group 1 underwent inferior oblique anterior transposition plus resection (IOATR), while patients in Group 2 underwent inferior oblique anterior transposition (IOAT) along with contralateral inferior rectus (IR) recession. <i>Methods:</i> Medical data of all SOP patients treated by either procedure from 2000 to 2023 in our strabismus center were recruited. We compared surgical outcomes between Group 1 and Group 2 by analyzing HT correction, rate of under-correction, and over-correction. <i>Results:</i> The study included 33 patients in Group 1 and 23 in Group 2. Both groups were similar in age, sex, etiology, affected side, diplopia, and head tilt. Group 2 achieved higher HT correction in all measured gazes. Group 1 had a higher risk of under-correction (18.18% in Group 1 vs 8.69% in Group 2) while Group 2 had a higher rate of over-correction (21.73% vs 0% in Group 1). <i>Conclusion:</i> In patients with severe unilateral SOP, Two-vertical muscle surgery achieved higher amounts of HT correction in all gazes despite a significantly higher risk of over-correction.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"13-19"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corneal changes after large (9mm) lateral rectus muscle recession measured with Pentacam®.","authors":"Konstantinos Paraskevopoulos, Christina Karakosta, Georgios Feretzakis, Maria Liaskou, Vassilios S Verykios, Konstantinos Droutsas, Dimitrios Papakonstantinou, Ilias Georgalas","doi":"10.1080/09273972.2024.2402455","DOIUrl":"10.1080/09273972.2024.2402455","url":null,"abstract":"<p><p><i>Introduction:</i> The aim of this study was to evaluate alterations in corneal astigmatism, axial anterior corneal curvature, anterior chamber depth, and central corneal thickness (CCT) two months after the unilateral recession of lateral rectus muscle in children. <i>Methods:</i> This prospective study included 37 children with intermittent exotropia who would undergo unilateral lateral rectus muscle recession. All measurements were performed using Pentacam®. Comparisons were made between the operated and fellow unoperated eyes, pre- and post-operatively. The assessment was made for changes in the radius of axial curvature on major meridians at 3 and 3.5 mm from the optical corneal center in the mid-peripheral zone. Astigmatism changes of the anterior and posterior corneal surface were calculated using vector analysis software (astigMATIC®). The interaction between age or CCT and postoperative changes in anterior and posterior surface corneal astigmatism were examined with ANOVA model. <i>Results:</i> In the intervention group, changes in anterior and posterior corneal surface astigmatism were statistically significant, with a mean increase of 0.56Dx90 and 0.08Dx87, respectively. In the mid-peripheral corneal zone, an increase was observed in the radius of anterior corneal axial curvature, more evident temporal 3 and 3.5 mm from the corneal center on the horizontal meridian, with corresponding decrease superiorly and inferiorly at 3 and 3.5 mm from the corneal center on the vertical meridian. <i>Discussion:</i> The changes in total astigmatism of the operated eyes are mainly attributed to the anterior corneal surface. These changes are associated with flattening in the 180 meridian of the cornea, leading to a shift to \"with-the-rule\" astigmatism.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"20-27"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}