Strabismus最新文献

{"title":"Impact of ocular misalignment on social trait attribution in children: a cross-sectional study.","authors":"Emine Tınkır Kayıtmazbatır, Sadagat Guluzade","doi":"10.1080/09273972.2026.2708089","DOIUrl":"https://doi.org/10.1080/09273972.2026.2708089","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the influence of ocular misalignment on social trait attribution in children and to evaluate whether isolated variations in ocular alignment affect early social perception.</p><p><strong>Methods: </strong>In this prospective, cross-sectional study, 100 children aged 8-14 years evaluated standardized visual stimuli depicting characters that differed in ocular alignment (orthotropic, esotropic, and exotropic). The illustrations were neutrally designed to control for facial expression, symmetry, gender, and skin tone. Four questionnaire forms were created, each containing three images, and each participant completed only one form. Within each form, one image represented each ocular alignment condition, so that no child viewed more than one alignment version of the same base character. This design was intended to reduce direct comparison bias. Participants assigned predefined social traits - including intelligence, bravery, success, and friendliness - to each character. Responses were recorded in a binary format and statistically compared across alignment conditions.</p><p><strong>Results: </strong>Characters with ocular misalignment were less frequently assigned favorable attributes. Orthotropic characters were significantly more likely to be rated as intelligent, successful, and brave compared with both esotropic and exotropic characters (<i>p</i> < .05 for all comparisons). For friendliness, orthotropic characters were more frequently perceived as friendly than exotropic characters (<i>p</i> = .002). No significant differences were observed between esotropic and exotropic depictions. Age subgroup analysis (8-11 vs. 12-14 years) revealed similar perception patterns across groups.</p><p><strong>Conclusion: </strong>Ocular alignment appears to influence social trait attribution in childhood. Even under controlled visual conditions, misalignment was associated with reduced attribution of positive characteristics. These findings highlight the potential role of early perceptual bias in the psychosocial experience of children with strabismus and underscore the broader clinical and societal relevance of ocular alignment beyond visual function.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-8"},"PeriodicalIF":0.7,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610062","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":"Marcus Gunn jaw-winking ptosis and contralateral lid retraction: management with Müller muscle-conjunctival resection with tarsectomy.","authors":"Emirhan Ozkul, Mehmet Serhat Mangan, Seda Mazmanoglu Atilman","doi":"10.1080/09273972.2026.2708082","DOIUrl":"https://doi.org/10.1080/09273972.2026.2708082","url":null,"abstract":"<p><strong>Purpose: </strong>Marcus Gunn jaw-winking syndrome (MGJWS) is a rare congenital cranial dysinnervation disorder characterized by synkinetic eyelid elevation during jaw movement. Standard surgical management often involves levator excision with bilateral frontalis suspension, which abolishes levator function but carries morbidity and variable cosmetic outcomes. Posterior ptosis approaches such as Müller muscle-conjunctival resection (MMCR) are well established for phenylephrine-responsive ptosis, but their role in MGJWS remains unclear.</p><p><strong>Methods: </strong>A 12-year-old male with congenital left upper eyelid ptosis, jaw-winking, and contralateral lid retraction underwent clinical and phenylephrine testing. The phenylephrine test demonstrated a partial positive response, guiding surgical planning. An 8-mm MMCR combined with a 2-mm tarsectomy was performed under general anesthesia using a Putterman clamp technique. The excised tarsoconjunctival specimen was submitted for histopathological evaluation.</p><p><strong>Results: </strong>Preoperatively, margin reflex distance (MRD1) measured 2 mm in the left eye and 5 mm in the right. Post-phenylephrine instillation, MRD1 improved to 3 mm in the left eye. Surgery proceeded uneventfully. Histopathology revealed preserved Müller's muscle fibers without structural abnormalities. At the 2-year postoperative follow-up, MRD1 measured 5 mm in the right eye and 3 mm in the left eye. The jaw-winking movement persisted postoperatively but decreased clinically from moderate to mild synkinesis. No lagophthalmos, exposure keratopathy, or other postoperative complications were observed.</p><p><strong>Conclusion: </strong>This case illustrates the use of MMCR combined with tarsectomy for correction of baseline ptosis and improvement of eyelid symmetry in a selected MGJWS patient with partial phenylephrine responsiveness. The procedure was not intended to abolish jaw-winking synkinesis; however, the synkinetic movement persisted postoperatively with clinical reduction from moderate to mild severity. Although posterior ptosis approaches are well established, this case suggests that MMCR with tarsectomy may have a limited role in carefully selected MGJWS cases when the primary goal is ptosis correction rather than elimination of synkinetic eyelid movement. Further studies are needed to evaluate the reproducibility and long-term stability of this approach.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-6"},"PeriodicalIF":0.7,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610093","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":"Effect of vision therapy on children and adults with amblyopia who showed plateaued improvement after occlusion therapy.","authors":"Hassan Hashemi, Alireza Jamali, Ebrahim Jafarzadehpur, Alireza Mohammadi, Abbasali Yekta, Mehdi Khabazkhoob","doi":"10.1080/09273972.2026.2702347","DOIUrl":"https://doi.org/10.1080/09273972.2026.2702347","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate long‑term visual acuity (VA) trends following a structured vision therapy protocol in patients with amblyopia who had plateaued after conventional occlusion therapy.</p><p><strong>Methods: </strong>This prospective cohort study included 157 patients diagnosed with amblyopia who showed no further VA improvement over at least three consecutive assessments during standard patching. All participants received individualized vision therapy comprising monocular and binocular exercises, fusion training, fixation stabilization, and perceptual tasks, combined with limited daily occlusion (1-3 hours). Therapy was delivered over 15 weekly in‑clinic sessions, followed by a structured home program. Visual acuity was monitored every 6 months over a 48‑month follow‑up period.</p><p><strong>Results: </strong>A total of 177 amblyopic eyes from 157 patients (mean age 15.56 ± 10.6 years) were analyzed. Mean VA improved from 0.50 ± 0.23 at baseline to 0.70 ± 0.28 at 48 months (<i>p</i> < .001); 48.6% of eyes achieved a final VA of ≥0.8 decimal. Significant VA gains were observed across all age groups, with mean improvements of 0.24, 0.21, and 0.16 in decimal VA for ages ≤ 8 years, 8-18 years, and >18 years, respectively. The proportion of patients gaining ≥ 2 lines of VA was highest in the ≤8 years (62.5%) and 8-18 years (62.5%) groups, compared with 35.4% in those > 18 years. Isoametropic amblyopia showed the highest rate of ≥2‑line improvement (65.0%), followed by strabismic (63.6%) and anisometropic (44.2%) types. No statistically significant difference in visual outcomes was observed between the two protocols (Haidinger's brushes/flashing vs. adding perceptual learning; <i>p</i> = .385).</p><p><strong>Conclusion: </strong>Vision therapy can produce clinically meaningful and durable visual improvements in amblyopic patients who no longer respond to occlusion alone. The present study also supports extending amblyopia treatment into adolescence and adulthood, while emphasizing the need for tailored approaches based on the etiology of amblyopia and age.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-10"},"PeriodicalIF":0.7,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551301","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":"Motor and sensory outcomes after botulinum toxin A injection versus unilateral medial rectus recession in small-to-moderate angle esotropia.","authors":"Merve Umur, Ahmet Özdemir, Mertcan Esenkaya, Leyla Niyaz","doi":"10.1080/09273972.2026.2695402","DOIUrl":"https://doi.org/10.1080/09273972.2026.2695402","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the motor and sensory outcomes of botulinum toxin A (BTA) injection and unilateral medial rectus recession (MRR) in patients with small-moderate angle esotropia.</p><p><strong>Methods: </strong>This retrospective cohort study included patients with 10-25 prism diopter (PD) esotropia, including non-accommodative, partially accommodative, residual, and infantile subtypes, who underwent either BTA injection or unilateral MRR. Preoperative and postoperative ocular alignment was evaluated at 1, 3, 6, and 12 months. Motor success was defined as postoperative deviation within 0-10 PD. Sensory outcomes were assessed based on stereopsis and worth 4 dot test changes. Non-parametric tests (Mann - Whitney U, Wilcoxon signed-rank) were used for continuous variables, and Chi-square or Fisher's exact tests for categorical variables.</p><p><strong>Results: </strong>A total of 38 patients were included (18 BTA, 20 MRR). The surgical group demonstrated significantly better early alignment at 1 month (<i>p</i> < .001). However, the differences in motor alignment between the groups gradually decreased, and by the 3rd, 6th, and 12th months their alignment values had become similar (<i>p</i> = .577, <i>p</i> = .067, and <i>p</i> = .083, respectively). Undercorrection was more frequent in the BTA group (33.3% vs. 5.0%, <i>p</i> = .038), and five patients required a repeat injection. Sensory outcomes (stability/improvement/deterioration) showed no significant differences between groups (<i>p</i> > .05 for all). No major complications occurred in either group.</p><p><strong>Conclusion: </strong>Both BTA injection and unilateral MRR provide satisfactory motor alignment in moderate-angle esotropia, although early postoperative outcomes favor surgery. The long-term similarity of motor outcomes and comparable sensory results suggest that BTA may serve as a minimally invasive, repeatable alternative particularly in younger patients or those with small-to-moderate deviations.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-9"},"PeriodicalIF":0.7,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354763","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":"Bimedial rectus recession versus botulinum toxin injection for the treatment of infantile esotropia.","authors":"Shatha Alfreihi, Abdulrahman Kaki, Taghreed Alnajjar","doi":"10.1080/09273972.2026.2689715","DOIUrl":"https://doi.org/10.1080/09273972.2026.2689715","url":null,"abstract":"<p><strong>Purpose: </strong>To compare botulinum toxin injection (BTX) to the standard of care, bilateral medial rectus recession (BMR) for infantile esotropia (IET).</p><p><strong>Methods: </strong>A retrospective case-control study. IET was defined as inward deviation, onset before 6 months, full motility, and no significant refractive error. We included patients from 2015 to 2023, aged 6-36 months of age, with at least 3 months of follow-up. Success was defined as esotropia 0-10 PD after one surgery or ≥ 1 BTX.</p><p><strong>Result: </strong>151 patients were included: 101 in the BTX and 50 in the BMR group. The mean age at surgery was 21.8 (±12.9) months. The preoperative angle means 40.7 (±15.5) PD in BTX and 39.5 (±10.2) in the BMR group, <i>p</i> = .974. The mean first dose of BTX was 6.56 ± 2.52 IU (range 5-15 IU). The success rate was 50% in the BTX group (cumulative success after up to 3 injections) and 46% in the BMR group (<i>p</i> = .05). The postoperative angle mean was 15.5 (±15.4) PD in BTX and 13.0 (±10.6) in the BMR group, <i>p</i> = .584. The BMR group had a longer postoperative follow-up (54.2 ± 20.2 vs. 32.1 ± 25.8 months, <i>p</i> < .001). Persistent vertical deviations were observed in 10% of the patients in the BTX group and none in the BMR group, <i>p</i> = .031.</p><p><strong>Conclusion: </strong>Our study showed that BTX could be an alternative to BMR for IET.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-9"},"PeriodicalIF":0.7,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279872","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":"Worsening abducens paresis and chronic orbital venous congestion after carotid-cavernous fistula embolization: long-term motility outcomes.","authors":"Catarina Francisco, Carolina Mendes Cerqueira, Alberto Lemos","doi":"10.1080/09273972.2026.2690187","DOIUrl":"https://doi.org/10.1080/09273972.2026.2690187","url":null,"abstract":"<p><strong>Purpose: </strong>Carotid-cavernous fistulas (CCFs) produce abnormal arteriovenous communication between the carotid circulation and the cavernous sinus, leading to orbital venous hypertension and neuro-ophthalmic manifestations. Although endovascular embolization is the treatment of choice and usually results in rapid hemodynamic normalization, delayed ocular motor sequelae after successful closure remain incompletely characterized. We report a case of persistent and worsening abducens nerve paresis and chronic orbital venous congestion following embolization of a direct CCF.</p><p><strong>Methods: </strong>This case report describes longitudinal neuro-ophthalmologic follow-up over more than four years. Clinical assessment included best-corrected visual acuity, slit-lamp examination, intraocular pressure measurement, dilated fundus examination, and structured ocular motility evaluation using serial Hess chart testing. Retinal morphology was assessed with spectral-domain optical coherence tomography, and orbital and intracranial vascular structures were evaluated with MRI and time-of-flight MR angiography.</p><p><strong>Results: </strong>A 78-year-old woman presented with intermittent diplopia and mild right abduction deficit. Imaging confirmed a right-sided direct CCF, which was successfully treated with endovascular embolization. Shortly after treatment, she developed marked worsening of right abducens nerve paresis with constant diplopia and transient visual acuity reduction. Retinal venous complications developed after treatment, with central retinal vein occlusion and macular edema resolving after intravitreal aflibercept. Persistent VI nerve paresis gradually improved after botulinum toxin injection into the right medial rectus muscle, and serial Hess chart analysis documented progressive expansion of the binocular single vision field, indicating partial functional recovery of abducens nerve function. Long-term imaging showed persistent asymmetry of orbital venous drainage and later development of >50% stenosis of the intracavernous-ophthalmic segment of the internal carotid artery without recurrent fistulous flow.</p><p><strong>Conclusion: </strong>This case highlights that delayed neuro-ophthalmic complications and venous congestion may occur despite successful CCF embolization. Post-embolization worsening of the abducens nerve paresis may reflect hemodynamic alterations affecting the cavernous sinus and orbital venous circulation. Gradual functional improvement was observed during long-term follow-up, although interpretation of the natural recovery trajectory is limited by botulinum toxin treatment. These findings further support that angiographic cure does not necessarily indicate complete functional recovery and emphasize the importance of long-term neuro-ophthalmologic and motility follow-up after CCF embolization.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-6"},"PeriodicalIF":0.7,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267160","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":"Strabismus following Endonasal sinus surgery: a 10-year retrospective analysis of clinical profile and outcomes.","authors":"Lily Myint, Nandini Bothra, Manjushree Bhate","doi":"10.1080/09273972.2026.2685668","DOIUrl":"https://doi.org/10.1080/09273972.2026.2685668","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical characteristics, motility deficits, strabismus patterns, and management outcomes in patients developing strabismus following Endonasal Sinus Surgery (ESS).</p><p><strong>Methods: </strong>This retrospective study was conducted over 10 years (2015-2025) at a tertiary eye care center. Demographic details, type and severity of ocular motility restriction, strabismus pattern, imaging findings, and management (surgical, prisms, or observation) were documented. Outcomes were assessed in terms of ocular alignment and symptomatic improvement.</p><p><strong>Result: </strong>Ten patients were identified, with male-to-female ratio of 4:1 (8:2) and mean age of 40.3 years (range 24-62 years). Ocular motility limitation was present in (<i>n</i> = 9; 90%) patients. Limitation of adduction was most commonly present involving the medial rectus <i>n</i> = 7; 70%. Large angle exotropia was the predominant pattern, with a deviation range of 30-75 prism diopters (PD). Management varied: five patients (50%) underwent strabismus surgery, showing improvement but residual deviation in most; one patient (10%) was managed with prisms, achieving partial symptomatic relief; and three patients (30%) were observed conservatively. One patient (10%) was lost to follow up and did not receive further management. Despite intervention, restrictive cases showed incomplete recovery.</p><p><strong>Conclusion: </strong>Strabismus is a rare but a significant (functional) complication following Endonasal sinus surgery, typically presenting as restrictive large-angle exotropia. Surgical correction and prisms provide functional improvement, though complete resolution is uncommon considering the extent of the injury. Early recognition and multidisciplinary management are crucial to optimize outcomes.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-6"},"PeriodicalIF":0.8,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260389","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":"Correction.","authors":"","doi":"10.1080/10999922.2026.2679388","DOIUrl":"https://doi.org/10.1080/10999922.2026.2679388","url":null,"abstract":"","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"i"},"PeriodicalIF":0.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213338","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 management of iatrogenic medial rectus transection following functional endoscopic sinus surgery: a report of two cases.","authors":"Nora Aldhefeery, Mansoor A Alshammari, Hadeel Alyami","doi":"10.1080/09273972.2026.2683474","DOIUrl":"https://doi.org/10.1080/09273972.2026.2683474","url":null,"abstract":"<p><strong>Introduction: </strong>Functional endoscopic sinus surgery (FESS) is a widely used procedure for chronic sinusitis. Although it is generally considered a safe procedure, serious ophthalmic complications might occur. In this report, we discuss the results of Foster augmented full tendon vertical muscle transposition (VRT) with and without resection for two cases presented with iatrogenic complete medial rectus transection following FESS.</p><p><strong>Methods: </strong>Case 1: A 43-year-old female presented with significant left eye motility limitation after FESS. Examination revealed left very large-angle exotropia 60 prism diopters (PD), severe limitation in adduction of -4, and MRI confirmed medial rectus muscle transection. The patient underwent left eye Foster augmented full tendon vertical rectus transposition (VRT), followed by maximum left lateral rectus muscle recession with Botox injection. Case 2: A 31-year-old male presented with diplopia and left eye motility limitation following FESS. On examination, there was a large angle exotropia of 40 PD, hypotropia of 20 PD, and limitation in adduction of -4 in the left eye. Imaging showed medial orbital wall injury and complete medial rectus transection. He underwent Foster augmented full tendon VRT surgery with resection.</p><p><strong>Results: </strong>Case 1: Over 3 years, alignment stabilized at 25 PD exotropia with improved adduction -2, no diplopia in the primary position. Case 2: Postoperatively, the patient achieved orthophoria and no diplopia in the primary position, maintained for 1 year of follow-up.<i>Discussion</i>: Early recognition of medial rectus injury and appropriate selection of surgical techniques are essential to optimize ocular alignment and reduce diplopia. These cases illustrate that Foster augmented full tendon VRT, with or without resection, can provide meaningful functional and cosmetic improvement in patients with iatrogenic medial rectus transection.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-5"},"PeriodicalIF":0.8,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151213","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":"Current status and future refinement of optical treatment in amblyopia therapy.","authors":"Merrick J Moseley, Alistair R Fielder, Catherine E Stewart","doi":"10.1080/09273972.2025.2592645","DOIUrl":"10.1080/09273972.2025.2592645","url":null,"abstract":"","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":"34 2","pages":"121-124"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935291","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}