Clinical and Experimental Ophthalmology最新文献

{"title":"Rethinking the Long-Term Degradation of Crosslinked Gelatin Stents","authors":"Ying Wei, Yajun Liu","doi":"10.1111/ceo.70026","DOIUrl":"10.1111/ceo.70026","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"54 1","pages":"174-175"},"PeriodicalIF":5.6,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hard Truth About Surveillance for Uveal Melanoma","authors":"Jasmine H. Francis","doi":"10.1111/ceo.70041","DOIUrl":"10.1111/ceo.70041","url":null,"abstract":"<p>There is a hard truth about cancer surveillance that does not appear to dissuade the vibrancy of cancer screening recommendations. The truth is that surveillance does not improve patient survival, except in very specific instances. For most common solid malignancies, routine surveillance in asymptomatic cases does not offer a survival advantage: In breast cancer, randomised trials do not advocate routine metastatic surveillance in asymptomatic survivors [<span>1</span>]. Even in the most common cancer type, lung cancer, routine imaging successfully detects more asymptomatic recurrences but fails to improve survival [<span>2</span>]. The exceptions occur in two specific scenarios: (1) Surveillance of CDKN2A/p16 carriers for pancreatic cancer fosters earlier detection, increased resectability and translates to a survival advantage [<span>3</span>]; and (2) Both randomised controlled trials and meta-analysis show rigorous surveillance after curative resection of Stage II/III colorectal cancer enhances detection and resection of recurrences and confers improved survival. However, interestingly, more frequent scans do not offer added benefit over less intense strategies [<span>4</span>]. This year, Van Ryan et al. reassert the hard truth also applies to uveal melanoma: patients complying with the National Comprehensive Cancer Network (NCCN) guidelines on uveal melanoma surveillance [<span>5</span>] derive no survival benefit [<span>6</span>].</p><p>Given the lack of high-quality evidence, recommendations for cancer surveillance are predominantly based on expert consensus. The systematic review on the ‘Systemic Surveillance Guidelines for Uveal Melanoma’ conducted by Zaman et al. [<span>7</span>] is an example of compiled expert consensus in an effort to homogenise guidelines in Australia. The published literature regarding surveillance for uveal melanoma could be summarised as follows: Surveillance does not impact overall survival; due to increased sensitivity and lack of radiation, Magnetic Resonance Imaging (MRI) is superior to Computed Tomography (CT) and ultrasound (US); risk stratification influences scan intervals: for high risk, q3-6 months for the first 5 years then q6-12 months; q6-12mos for intermediate risk, annual for low risk imaging through 10 years is reasonable [<span>7, 8</span>].</p><p>A word of caution when interpreting published surveillance literature is the notion of lead time bias which is a systematic error in research, particularly in medical screening, that can result in misleading conclusions [<span>9</span>]. To summarise, this bias occurs because survival time is measured from the time of diagnosis, and medical screening shifts this to an earlier time point in the disease's natural history, but without necessarily altering the time of death. Screened patients appear to live longer due to an earlier date of diagnosis afforded by their surveillance, but without necessarily a survival benefit. Lead time bias does not mean ","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":"54 1","pages":"6-8"},"PeriodicalIF":5.6,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ceo.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145844494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of Retinopathy of Prematurity Management in the Anti-VEGF Era: Evolving Global Paradigms, Persistent Challenges and Our AI-Assisted Future.","authors":"Kyle V Marra, Jimmy S Chen, Eric Nudleman, Shira L Robbins","doi":"10.1111/ceo.14598","DOIUrl":"10.1111/ceo.14598","url":null,"abstract":"<p><p>Retinopathy of prematurity (ROP) remains a major cause of preventable blindness in premature infants worldwide, with increasing incidence due to advancements in neonatal care. Management of ROP has been revolutionised by anti-vascular endothelial growth factor (anti-VEGF) treatments. Pivotal clinical trials have demonstrated the efficacy of anti-VEGF in the management of Type 1 ROP, while investigation of safety and long-term effects is ongoing. However, infants with ROP often have persistent avascular retina (PAR) despite treatment and require lifelong monitoring for myopia, glaucoma, amblyopia, strabismus, significant refractive error, retinal tears and detachment and adult reactivation of ROP. Alternative therapeutics, including beta-blockers, polyunsaturated fatty acids and vitamin A, remain under investigation. Alongside therapeutic advancements, artificial intelligence (AI) and telemedicine programmes have the potential to expand screening accessibility, particularly in underserved regions, and improve inter-observer variability, though challenges in implementation remain. Together, advanced therapeutics and AI-enhanced screening hold promise for improving outcomes and reducing ROP-related blindness globally.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":"1202-1217"},"PeriodicalIF":5.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12747480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Quality of Care Provided at Singapore's Primary Eye Care Model and Lessons Learned to Maintain Quality Care-Mixed-Methods Study.","authors":"Wanfen Yip, Adeline Kon, Michelle Jessica Pereira, Joseph Antonio De Castro Molina, Kiok Liang Teow, Vernon Khet Yau Yong, Hon Tym Wong, Tock Han Lim, Vivien Cherng Hui Yip","doi":"10.1111/ceo.14600","DOIUrl":"10.1111/ceo.14600","url":null,"abstract":"","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":"1221-1224"},"PeriodicalIF":5.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12747478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Out-Of-The-Bag Intraocular Lens Dislocation in Dead Bag Syndrome and Its Association With Eye Rubbing.","authors":"Soon-Phaik Chee, Nicole Shu-Wen Chan, Jia Xu Lim","doi":"10.1111/ceo.14606","DOIUrl":"10.1111/ceo.14606","url":null,"abstract":"<p><strong>Background: </strong>To describe clinical features, risk factors and outcomes of out-of-the-bag (OTB) intraocular lens (IOL) dislocation in dead bag syndrome (DBS).</p><p><strong>Methods: </strong>Retrospective review of a single-surgeon series of eyes with IOLs that developed OTB IOL dislocation, managed at Singapore National Eye Centre (January 2014-December 2021), with a minimum of 6 months of follow-up. Eyes with OTB IOL dislocation following secondary IOL implantation and intraoperative capsule complications were excluded. Patient demographics, ocular history, clinical findings, ocular trauma/eye rubbing, surgical procedures and postoperative outcomes were obtained.</p><p><strong>Results: </strong>Fifty eyes (40 unilateral, 5 bilateral) of 45 patients were included. Patients were predominantly male (82.2%), presenting at 61.9 ± 14.1 years old, 11.2 ± 6.0 years after cataract surgery. Eye rubbing was the only form of ocular trauma (n = 34; 68.0%). Compared to non-eye rubbers, eye rubbers were significantly more likely to have elevated intraocular pressure (IOP) (32.4% vs. 6.2%; OR 10.9, 95% confidence interval [CI] 1.12-107; p = 0.040), larger posterior capsule defects (median 60% vs. 50%; p = 0.029), vitreous in the anterior chamber (38.2% vs. 6.2%; OR 10.3, 95% CI 1.05-101; p = 0.045) and lower endothelial cell counts than the non-affected eye (-145 ± 507 vs. 315 ± 639 cells/mm²; p = 0.026). The most common complications after IOL exchange were elevated IOP (n = 11; 22.0%) including glaucoma (n = 8; 16.0%) and recurrent IOL subluxation (n = 7; 14.0%).</p><p><strong>Conclusions: </strong>Eye rubbing appears to play an important role in the development of OTB IOL dislocations in DBS and is associated with more severe clinical manifestations. Treating the underlying cause and counselling patients to avoid or minimise eye rubbing may reduce this complication.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":"1115-1124"},"PeriodicalIF":5.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BRAF Mutation Status in Inflamed Juvenile Conjunctival Nevus, Primary Acquired Melanosis and Conjunctival Common Nevus.","authors":"Lei-Chi Wang, Wei-Kuang Yu, Chih-Chien Hsu, Yu-Yun Huang, Chieh-Chih Tsai, Tai-Chi Lin","doi":"10.1111/ceo.14599","DOIUrl":"10.1111/ceo.14599","url":null,"abstract":"<p><strong>Background: </strong>To investigate BRAF mutation status and its associated clinicopathological features in conjunctival melanocytic lesions.</p><p><strong>Methods: </strong>We analysed surgical specimens from 79 conjunctival melanocytic lesions, including inflamed juvenile conjunctival nevi, primary acquired melanosis (PAM) and conjunctival common nevi collected from 2013 to 2022. PAM lesions were further categorised into those without atypia and with mild, moderate or severe atypia. Conjunctival common nevi were subcategorized into junctional, subepithelial and compound nevi. BRAF V600E immunohistochemistry was performed on all specimens, with PCR-mass spectrometry used for ambiguous cases. The main outcome measures were the BRAF V600E mutation rate and related clinicopathological features.</p><p><strong>Results: </strong>Inflamed juvenile conjunctival nevi showed a BRAF V600E mutation rate of 36.8% (7/19), while the mutation was rare in PAM (4.3%, 1/23). The mutation rate in conjunctival common nevi (67.6%, 25/37) was similar to that in cutaneous common nevi, and most BRAF V600E-mutated cases were found in the subepithelial nevus group (93.8%, 15/16). BRAF mutations were significantly associated with intralesional inflammatory stroma and subepithelial growth pattern, but not with age, lesion location, intralesional cyst and solar elastosis.</p><p><strong>Conclusions: </strong>BRAF mutations are key driver mutations in inflamed juvenile conjunctival nevi and conjunctival common nevi. Histologically, an 'inflamed juvenile conjunctival nevus'-like inflammatory stroma correlated with BRAF mutations. In our study, solar elastosis was infrequently observed in conjunctival nevi, suggesting that the mutational signature of conjunctival melanocytic lesions resembles that of cutaneous non- or low-level cumulative solar damage type. For cases with equivocal BRAF staining, high-sensitivity sequencing is recommended to confirm mutation status.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":"1191-1201"},"PeriodicalIF":5.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes After Switching to Faricimab in Neovascular Age-Related Macular Degeneration: Data From the Fight Retinal Blindness! Registry.","authors":"Adrian Hunt, Yohei Hashimoto, Stephanie Young, Jennifer Arnold, Justin Game, Claire Hooper, Andrew Field, Richard Barry, Daniel Barthelmes, Mark Gillies","doi":"10.1111/ceo.14589","DOIUrl":"10.1111/ceo.14589","url":null,"abstract":"<p><strong>Background: </strong>We aimed to describe 1-year outcomes of eyes switched to faricimab from first-generation vascular endothelial growth factor (VEGF) inhibitors for neovascular age-related macular degeneration (nAMD) in routine care.</p><p><strong>Methods: </strong>Multicentre, observational study of 383 eyes tracked in the Fight Retinal Blindness! registry switched to faricimab from aflibercept 2 mg, ranibizumab, or bevacizumab between 1st January-1st August 2023 in Australia.</p><p><strong>Results: </strong>One-year completion rates were high (335/383 [88%]). The proportion of choroidal neovascular (CNV) lesions graded as inactive increased from 39% at switch to 63% at 12 months (p < 0.01). Mean visual acuity (95% Confidence Interval) decreased from 70.0 (68.6, 71.5) to 68.4 (66.7, 70.1) logarithm of the minimum angle of resolution letters (both approx. 6/12). Mean treatment intervals increased from 7.2 to 10.5 weeks (p < 0.01). Eyes with active CNV at switch maintained mean VA -0.5 (-1.7, +0.7) letters; 50% were inactivated at 12 months. Eyes with inactive CNV at switch lost -3.5 (-5.0, -1.9) letters; 15% had reactivation at 12 months. Switchback occurred in 64/383 eyes (17%), predominantly to aflibercept 2 mg, that lost -1.9 letters without interval change at 12 months. Adverse outcomes were in keeping with previous reports, with no cases of occlusive retinal vasculitis.</p><p><strong>Conclusions: </strong>We found that faricimab inactivated a significant proportion of CNV lesions that had been active using 1st generation VEGF inhibitors, with a significant extension of the treatment interval. A small reduction in VA occurred in switchers and eyes not switched through the same period.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":"1156-1167"},"PeriodicalIF":5.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12747468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Familial Exudative Vitreoretinopathy-Like Retinal Findings in Adams-Oliver Syndrome Type 2.","authors":"You Wang, Aohan Hou, Wenjia Yan, Jinglin Lu, Qiong Wang, Limei Chen, Xiaoyan Ding","doi":"10.1111/ceo.14594","DOIUrl":"10.1111/ceo.14594","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the clinical characteristics and the genotype-phenotype correlation of DOCK6-associated autosomal recessive Adams-Oliver Syndrome in a large cohort of familial exudative vitreoretinopathy patients.</p><p><strong>Methods: </strong>Comprehensive ocular examinations were conducted on probands and their family members. Whole-exome sequencing (WES) was performed on the probands, with Sanger sequencing validation for family members. In vitro experiments validated copy number variation (CNV) and splice-site mutations.</p><p><strong>Results: </strong>A total of 642 families with FEVR phenotypes were included, leading to the identification of seven probands with biallelic pathogenic DOCK6 mutations, corresponding to a prevalence of 1.09%. Thirteen mutation sites were identified, including seven frameshift mutations, four splice mutations, one CNV, and one nonsense mutation, indicating the pathogenic mechanism of DOCK6 in FEVR is more likely due to functional loss. Among the 14 eyes of the seven probands, five eyes (35.71%) and four eyes (28.57%) exhibited total retinal detachment and retinal folds, respectively.</p><p><strong>Conclusions: </strong>Biallelic DOCK6 mutations represent a genetic cause of FEVR. These pathogenic mutations typically result in loss of function, leading to severe ocular and systemic manifestations. These findings highlight the importance of considering DOCK6 mutations in patients presenting with atypical or severe FEVR phenotypes.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":"1181-1190"},"PeriodicalIF":5.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Premyopia Management With Ophthalmic Referral Slows Myopic Shift After School Entry: A Population-Based Longitudinal Study in Taiwan.","authors":"Yu-Chieh Yang, Hsin-Yu Yang, Chiao-Yu Wang, Shao-You Fang, Chia-Wei Lee, Pei-Wei Huang, Mong-Ping Shyong, Yen-Lin Chen, Nai-Wei Hsu, Der-Chong Tsai","doi":"10.1111/ceo.14595","DOIUrl":"10.1111/ceo.14595","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the impact of early ophthalmic referral for premyopic preschoolers on myopic spherical equivalent (SE) shift after school entry; and to identify risk factors for nonadherence to follow-up care.</p><p><strong>Methods: </strong>A population-based longitudinal study followed 742 premyopic preschoolers (-0.5 D < SE ≤ +0.75 D) from a countywide screening in Yilan, Taiwan (2021-2022), into first or second grade in elementary school (2023). Cycloplegic autorefraction and caregiver questionnaires were collected at baseline and follow-up. Children screened in 2022 comprised the intervention cohort, while those screened in 2021 formed the comparison cohort. Multiple regression analyses assessed factors associated with myopic SE shift and nonadherence to follow-up care.</p><p><strong>Results: </strong>Amongst 742 premyopic children (mean [SD] age at follow-up, 7.2 [0.4] years; 57.8% boys), the overall SE progression was -0.19 (0.39) D/year and the incidence of myopia was 14.8 per 100 person-years. The intervention cohort had a slower myopic SE shift than the comparison cohort (-0.15 vs. -0.22 D/year; p = 0.009). Referral at baseline was independently associated with slower SE progression (β = 0.070; p = 0.03). Amongst those referred in the intervention cohort, 63.2% adhered to follow-up care. Nonadherence was associated with greater baseline hyperopia (adjusted OR, 3.77; 95% CI, 1.69-8.41) and rural residency (adjusted OR, 2.01; 95% CI, 1.23-3.30).</p><p><strong>Conclusions: </strong>Early ophthalmic referral reduced myopic progression, but follow-up adherence was suboptimal, especially in children with greater hyperopia or living in rural areas.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":"1104-1114"},"PeriodicalIF":5.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12747476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eye Injury Epidemiology in Australia: A 25-Year Systematic Review and Public Health Perspective.","authors":"Qiang Li, Jocelyn J Drinkwater, Annette Hoskin, Angus W Turner","doi":"10.1111/ceo.14596","DOIUrl":"10.1111/ceo.14596","url":null,"abstract":"<p><strong>Background: </strong>Eye injuries are a significant cause of monocular blindness, contributing to individual morbidity and substantial healthcare costs. Despite this burden, eye injury prevention remains underrepresented in Australian public health initiatives. This systematic review (PROSPERO ID: CRD42024551054) aims to provide the first comprehensive nationwide synthesis of eye injury epidemiology in Australia.</p><p><strong>Methods: </strong>Three databases (MEDLINE, Embase, Web of Science) were searched to identify Australian studies on eye injuries from 1 January 2000 to 1 May 2024. Studies were excluded per the following criteria: not in English; did not exclusively evaluate eye injury (e.g., evaluated all causes of blindness); only evaluated outcomes after injury; sample size < 25; conference abstracts, editorials, letters to the editor/other review articles. Critical appraisals of included texts were performed using the Joanna Briggs Institute Checklist for Analytical Cross-Sectional Studies. Results were synthesised using the International Globe and Adnexal Trauma Epidemiology Study (IGATES) as a framework.</p><p><strong>Results: </strong>In total, 30 studies were included, ranging from statewide audits to nationwide surveys. Eye injuries were commonest among young males in occupational settings and older adults experiencing falls at home. Paediatric eye injuries frequently occurred during sport or at home. Rural Australians and First Nations women were disproportionately affected by assault-related injuries, including domestic violence.</p><p><strong>Conclusions: </strong>This review highlights key demographic and contextual risk factors for eye injury in Australia and establishes a robust evidence base to inform targeted, data-driven national prevention strategies. The main limitation of this review is the heterogeneity of included studies, which emphasises the importance of using international, standardised registries such as IGATES.</p>","PeriodicalId":55253,"journal":{"name":"Clinical and Experimental Ophthalmology","volume":" ","pages":"1084-1103"},"PeriodicalIF":5.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12747473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}