Optometry and vision science : official publication of the American Academy of Optometry最新文献

{"title":"Uncorrected myopia affects the visual acuity of OFF-pathway more than ON-pathway.","authors":"Xiaotong Chen, Yi Pang, Zi Rui Li, Marilyn Vricella, Daniella Rutner, Xiaoying Zhu, Jose-Manuel Alonso, Jingyun Wang","doi":"10.1002/ovs2.70014","DOIUrl":"10.1002/ovs2.70014","url":null,"abstract":"<p><strong>Purpose: </strong>The balance of responses between the ON and OFF pathways is believed to play an important role in myopia. This pilot study compared the difference in visual acuity under two contrast polarities between myopic children (corrected and uncorrected) and emmetropic children.</p><p><strong>Methods: </strong>Two groups of children aged 8-12 years were enrolled: a myopic group (spherical equivalent [SEQ] between -0.75 D and -6.00 D, N = 11) and a normal control group (N = 16). Visual acuities were measured using an Early Treatment Diabetic Retinopathy Study program, which presented either white letters against a black background or black letters against a white background. Visual acuity (corrected and uncorrected for the myopic group) under both polarities was tested in randomized order and repeated after a 30-min interval. Visual acuities were reported as letter scores. The ON/OFF ratios of visual acuity scores under the two polarity conditions were calculated and correlated with SEQ.</p><p><strong>Results: </strong>When uncorrected, white-letter visual acuity was significantly better than black-letter visual acuity (p < 0.001) for the myopic group, with a difference of 6 letters (equivalent to 0.12 logMAR). No significant differences in visual acuity scores between the two polarities were found when the myopic group was corrected or in the control group. This suggests that uncorrected myopic eyes have greater difficulty in resolving the spatial resolution of black letters as compared to white letters. The ON/OFF ratio in the uncorrected myopic group was significantly higher than in the corrected myopic group and the control group (1.14 ± 0.09 vs. 0.99 ± 0.04, 1.00 ± 0.03, p < 0.001). When uncorrected, the ON/OFF ratio correlated with SEQ (R = 0.38, t = -2.4, p = 0.02), indicating that the ON/OFF imbalance increases with the magnitude of uncorrected myopic blur.</p><p><strong>Conclusions: </strong>Children with uncorrected myopic eyes had more difficulty in recognizing black letters compared to white letters, and the ON/OFF imbalance was correlated with the magnitude of uncorrected myopic blur.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 2","pages":"e70014"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147725458","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":"The impact of parental myopia on refractive changes in Chinese children.","authors":"Chenxi Zong, Huaying Xu, Jianing Pu, Zhen Zhou, Jianping Hu, Shimeng Bian, Wei Chen, Yanyan Yang, Dan Wang, Xuejing Mi, Yuxin Fang, Chuzhi Peng, Mingrui Jin, Binjie Zhao, Yonghong Jiao","doi":"10.1002/ovs2.70013","DOIUrl":"10.1002/ovs2.70013","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the impact of parental myopia on refractive changes in Chinese young children over a 3-year cohort.</p><p><strong>Methods: </strong>All data were collected in a prospective cohort study. Comprehensive eye examinations were conducted for all participants, including assessments of refraction, ocular biometry, and questionnaires. Parental refractive categories were classified based on both the severity of myopia and the number of myopic parents. A longitudinal analysis was carried out to evaluate the relationship between the children's refractive changes and parental myopia.</p><p><strong>Results: </strong>A total of 931 participants (484 boys and 447 girls) were followed annually over 3 years (mean baseline age: 4.21 ± 0.95 years). At baseline, participants' spherical equivalent refraction (SER) decreased and the prevalence of myopia increased significantly, with greater severity of parental myopia (all p < 0.0001). Over the 3-year observation period, greater severity of parental myopia was associated with lower SER, faster axial elongation, and increased axial length to corneal radius ratio in participating children. Participants with highly myopic mothers had a 12.69-fold higher risk of developing premyopia or myopia (p < 0.0001). Moreover, maternal high myopia had a more pronounced negative effect on the rate of SER decline compared to paternal high myopia (p < 0.05). Additionally, participants with highly myopic parents exhibited lower SER when their outdoor activity time was limited to 2 h or less (all p < 0.05).</p><p><strong>Conclusions: </strong>Parental high myopia was associated with lower baseline SER, accelerated refractive changes, and higher myopia incidence. Maternal high myopia has a strong influence on SER decline and myopia risk in children. Children with highly myopic parents appear more susceptible to reduced refractive power under similar lifestyle conditions.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 2","pages":"e70013"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597753","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":"Attention to text and pictures during storybook reading in preschool children with moderate hyperopia.","authors":"Tamara S Oechslin, Nick Fogt, Elise Ciner, T Rowan Candy, Marjean Taylor Kulp","doi":"10.1002/ovs2.70030","DOIUrl":"10.1002/ovs2.70030","url":null,"abstract":"<p><strong>Purpose: </strong>Uncorrected, moderate hyperopia has been associated with poor emergent literacy skills. However, the eye movements of preschoolers have not yet been used to determine how well young, hyperopic children attend to text and pictures during storybook reading compared to emmetropic children. In this study, the percentage of visual on-task time during storybook reading for 4- and 5-year-old children with uncorrected, moderate hyperopia was compared to that of their emmetropic peers. The relationship between percentage visual on-task time and near visual function was also assessed.</p><p><strong>Methods: </strong>Children received an eye exam with cycloplegic refraction to identify hyperopia (+3.00D to +6.00D with astigmatism ≤1.50D and anisometropia ≤1.00D) or emmetropia (hyperopia ≤1.0D; astigmatism, anisometropia, and myopia<|1.0|D) and to rule out amblyopia, strabismus, and ocular health concerns. Infrared video eye tracking systems were used to monitor eye position during storybook reading. Fixations were \"on-task\" if the child was looking at text or a picture in the story. Statistical comparisons of percentage visual on-task time between the emmetropic and hyperopic children were performed, and correlations between the percentage visual on-task time and the participants' near visual skills (visual acuity, stereoacuity, accommodative lag) were determined.</p><p><strong>Results: </strong>Fifty-five of 72 eligible children provided analyzable data. The average percentage visual on-task time for hyperopic children was 20% less than that of emmetropic children (Mann-Whitney U test, p = 0.02). Further, for all children combined, the percentage visual on-task time was moderately correlated with accommodative lag (Spearman, r = -0.32, p = 0.02) while there was no significant correlation between percentage visual on-task time and near acuity or near stereoacuity (p > 0.05).</p><p><strong>Conclusions: </strong>Moderately hyperopic, uncorrected 4- and 5-year-old children showed a significantly lower percentage of visual on-task time during shared storybook reading compared to their emmetropic peers. The percentage on-task time was moderately correlated with increased accommodative lag for the combined group of emmetropic and hyperopic children.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 2","pages":"e70030"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611144","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":"Designing a new \"turtle\" optotype for use with Aboriginal and Torres Strait Islander children.","authors":"Shelley Hopkins, Emily Banks, Sharon A Bentley, Alex A Black, Deb Duthie, Ashleigh Hawkins, Joanne M Wood","doi":"10.1002/ovs2.70009","DOIUrl":"10.1002/ovs2.70009","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether luminance-matching of non-target elements (Study 1) and incorporating artwork (Study 2) within the newly designed turtle optotype would impact visual acuity (VA) measures.</p><p><strong>Methods: </strong>Study 1 evaluated the redesigned four alternative forced choice (4-AFC) turtle optotype to confirm whether luminance-matching of the non-target and target elements was required, through comparing VA with different turtle optotype luminance designs to the Landolt C. Study 2 evaluated whether including artwork in the turtle optotype impacted on VA as compared with the Landolt C chart.</p><p><strong>Results: </strong>In Study 1 (n = 12, mean age = 34.9 ± 5.7 years), there was a significant effect of chart type (p < 0.001), where VA was significantly better in the non-luminance-matched design (M = -0.31 logMAR) compared to either of the luminance-matched designs (M = -0.09 logMAR) and the Landolt C (M = -0.13 logMAR) which were not significantly different from one another (p > 0.4). In Study 2 (n = 14, mean age = 29.1 ± 8.8 years), including the new artwork did not affect VA (p = 0.5); mean VA of the new 4-AFC turtle optotype (M = -0.10 logMAR) was not significantly different to the Landolt C (M = -0.13 logMAR).</p><p><strong>Conclusions: </strong>Findings confirmed that the optotype target needed to be luminance-matched with non-target elements and that new co-designed artwork could be incorporated without a significant effect on VA. Further work will validate the chart in children.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 2","pages":"e70009"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597792","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":"Measuring visual fields in children with cerebral visual impairment using Baby Vision Screener.","authors":"Monika Thakur, Tithi Halder, Anantha Padmanabhan, PremNandhini Satgunam","doi":"10.1002/ovs2.70005","DOIUrl":"10.1002/ovs2.70005","url":null,"abstract":"<p><strong>Purpose: </strong>This retrospective study was undertaken to (1) determine the feasibility and reliability of Baby Vision Screener (BaViS) and (2) to test and identify visual field defects in children with cerebral visual impairment (CVI).</p><p><strong>Methods: </strong>An in-house developed device, BaViS, was used to test the visual fields. A total of 32 children (mean age: 6.3 ± 3.2 years and range: 11 months to 14 years) with CVI were included after their medical records were reviewed (from June 2021 to October 2023). Kinetic perimetry was done using BaViS in all these children to plot the visual field isopter. Different tools were used for measuring visual acuity and contrast sensitivity as appropriate.</p><p><strong>Results: </strong>Most children (91%, n = 29/32) were testable, and large majority (72%, n = 21/29) had reliable visual field isopters plotted with BaViS. Of the children with reliable visual field results, 38% had visual field defects, either in isolation or with other visual function deficits. Generalized field extent reduction and inferior visual field reduction were the most common visual field defect patterns. 62% of children had visual impairment in more than one visual function domain.</p><p><strong>Conclusions: </strong>BaViS shows good potential to be used for quantifying visual fields even in younger children with CVI. About two-fifths of the children with CVI in our test cohort showed visual field defects. Measuring visual fields, along with other visual functions, will be important for managing children with CVI.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 2","pages":"e70005"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597770","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":"Optometry & Vision Science in 2025: Year 2 of the 3-year plan.","authors":"David B Elliott","doi":"10.1002/ovs2.70050","DOIUrl":"https://doi.org/10.1002/ovs2.70050","url":null,"abstract":"","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 1","pages":"e70050"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583566","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":"Does order matter? Evaluating the impact of binocular vision test sequence.","authors":"Pauline Kang, Lisa Asper, Alice Chan, Angie Tang, Kathleen Watt","doi":"10.1002/ovs2.70008","DOIUrl":"10.1002/ovs2.70008","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the repeatability of common clinical tests of accommodative and vergence function and evaluate the impact of sequence of testing on outcomes.</p><p><strong>Methods: </strong>Participants underwent a series of accommodative and vergence function tests under associated and dissociated conditions over 3 study visits. At the first study visit, participants were randomized to undergo associated or dissociated tests first. The testing order was reversed at the second visit (to evaluate sequence of testing), and the third visit replicated the order of testing of the first visit (to evaluate intersession repeatability). Associated tests (in order) included binocular modified push-in/out amplitude of accommodation, Fused Cross Cylinder, negative and positive relative accommodation, and binocular ±2.00 D lens flippers to assess accommodation, and Randot Stereo Test to measure local stereoacuity and fixation disparity. Dissociated tests (in order) were monocular modified push-in/out amplitude of accommodation, distance and near phorias measured with the Howell Phoria card and Modified Thorington test to assess vergence function, and monocular ±2.00 D lens flippers to assess accommodation.</p><p><strong>Results: </strong>There were no significant differences in binocular vision function measures when associated or dissociated tests were conducted first (all p < 0.003). Additionally, there were no significant differences in mean measures tested across the first and third study visits where testing sequence remained consistent. Push-in/out methods to measure binocular and monocular accommodative amplitudes, ±2.00 D lens flippers to measure binocular and monocular accommodative facilities, horizontal distance and near phoria measured with the Howell Phoria card, and near phoria with the Modified Thorington test had ICC >0.75 indicating good intersession repeatability. All other tests had ICC <0.75 indicating poor repeatability of repeated measurements.</p><p><strong>Conclusions: </strong>The sequence of testing of associated and dissociated techniques did not influence outcomes. Additionally, when the testing sequence was kept consistent between the first and third study visits, there were no statistically significant differences in accommodative and vergence function measures obtained with investigated methods. The generally high variability of some measurements across sessions suggests that individual techniques alone may not reliably detect clinically meaningful changes in accommodation or vergence function and a battery of tests is likely needed for monitoring binocular vision disorders.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 1","pages":"e70008"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477817","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":"Trends in optometrist burnout in the Veterans Health Administration.","authors":"Shelly Kim, Sarah Rogers, David C Mohr","doi":"10.1002/ovs2.70001","DOIUrl":"10.1002/ovs2.70001","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the burnout trends among Veterans Affairs (VA) optometrists.</p><p><strong>Methods: </strong>A repeated cross-sectional analysis using individual-level data from the VA All Employee Survey during 2018-2024 and system-level data. Burnout was assessed using two items from the Maslach Burnout Inventory. One item represented emotional exhaustion and asked, 'I feel burned out from my work' and another item represented depersonalization asked, 'I worry this job is hardening me emotionally.'</p><p><strong>Results: </strong>We identified 4574 responses from VA optometrists. Mean burnout rates were 36.9% in 2018 and increased to 47% for 2022-2024. Females and supervisors/managers reported higher rates of burnout. Optometrists between 30 and 39 years of age, those working in medical centers in rural areas, and in regions other than the Northeast US were more likely to report burnout.</p><p><strong>Conclusions: </strong>The prevalence of burnout reported among VA optometrists is increasing. Interventions are required from an organizational level to target and address burnout among VA optometrists, especially females and those practicing in rural areas. Successful improvement in burnout rates among VA Optometrists could result in improved mental health of optometry providers and improved care to veterans.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 1","pages":"e70001"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477892","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":"Using data from both eyes of participants: Evaluating the power and Type-I error rates of common approaches to ocular data analysis via a simulation study.","authors":"Morgan C Ollinger, Patricia M Cisarik, Meredith A Ray","doi":"10.1002/ovs2.70027","DOIUrl":"10.1002/ovs2.70027","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to evaluate and quantify model performance for commonly used statistical approaches when using data from both eyes of participants. These models highlight different methods of accounting for interocular correlation.</p><p><strong>Methods: </strong>We simulated a continuous outcome variable, a predictor variable measured per-eye (two correlated values per subject - termed bivariate), and a predictor measured once per subject (termed univariate). Both the outcome and the bivariate predictor shared the same correlation level in all simulations. Correlations were varied 0-0.9 in 0.1 steps, with sample sizes of 50, 100, and 150. Two thousand datasets were simulated under each correlation-sample size combination. The datasets were modeled using single-eye, averaged-eye, and assumed-independent two-eye approaches within linear regression, along with a mixed effects model and a generalized estimating equation (GEE).</p><p><strong>Results: </strong>Mixed effects models, modeling one eye per subject, and averaging eyes within subjects all controlled Type-I error at 0.05 across simulated conditions. GEEs slightly inflated Type-I error, especially with smaller sample sizes. Modeling both eyes independently inflated Type-I error as high as 0.194 in high correlation scenarios. This inflation increased with increasing correlation. For univariate predictors, GEEs, mixed effects modeling and averaging eyes within subjects attained similar power across scenarios. Single-eye modeling resulted in lower power, particularly in low correlation scenarios. For bivariate predictors, mixed effects modeling and GEEs yielded greater power than single-eye or averaged-eye modeling across scenarios.</p><p><strong>Conclusions: </strong>Mixed effects models and GEEs out-perform other approaches when the predictor of interest is bivariate and correlated, assuming correlations are similar for the predictor and outcome. For univariate predictors, averaging the outcome across eyes within each subject performs similarly to mixed effects modeling. Treating correlated measurements as independent (such as when using data from both eyes without averaging or factored into a model) inflates Type-I error rates and yields inappropriately high power, especially as correlation increases; this modeling approach leads to inference errors and should be avoided.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 1","pages":"e70027"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483147","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":"Invited Review: Tools to quantify environmental and behavioral risk factors for myopia.","authors":"Lisa A Ostrin","doi":"10.1002/ovs2.70000","DOIUrl":"10.1002/ovs2.70000","url":null,"abstract":"<p><p>The increasing global prevalence of myopia has prompted increased efforts to identify, quantify, and modify risk factors associated with its onset and progression. Myopia risk factors can be broadly categorized into four areas: (1) genetics and inheritance, (2) demographics, (3) ocular metrics, and (4) environmental and behavioral influences. Environmental and behavioral factors, including near work, screen time, light exposure, and outdoor activity, are increasingly recognized as modifiable contributors, and therefore, offer promise as prevention strategies. However, inconsistencies across studies regarding their contribution highlight the challenges of subjective data collection and population variability. This review aims to equip researchers, clinicians, and public health professionals with a comprehensive understanding of available tools to quantify myopia risk factors and their applications in research and clinical practice. Traditional and emerging methods for quantifying environmental and behavioral risk factors for myopia are critically evaluated. First, subjective methods, including questionnaires, diaries, and experience sampling, are discussed, and their practical advantages and inherent limitations, such as recall bias and low temporal resolution, are highlighted. Further, objective approaches, enabled by advances in wearable technology, including light sensors, rangefinders, and integrated devices, are explored. The capabilities and constraints of currently available tools, future directions for wearable innovations, and necessary analytical techniques are considered. Improving the precision and standardization of these measurements will enhance the ability of researchers and clinicians to detect myopia risk early, tailor interventions, and develop evidence-based guidelines for myopia control.</p>","PeriodicalId":520732,"journal":{"name":"Optometry and vision science : official publication of the American Academy of Optometry","volume":"103 1","pages":"e70000"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147535666","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}