Frontiers in ophthalmology最新文献

{"title":"Case report: Two cases of multiple evanescent white dot syndrome with transient night blindness.","authors":"Kanna Miyake, Mariko Egawa, Yoshinori Mitamura, Ryoji Yanai","doi":"10.3389/fopht.2025.1557294","DOIUrl":"10.3389/fopht.2025.1557294","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to report two cases of multiple evanescent white dot syndrome (MEWDS) with transient night blindness.</p><p><strong>Case presentation: </strong>Case 1: A 24-year-old man presented with acute visual loss and night blindness in his right eye. Examination revealed an enlarged blind spot and multiple white dots extending from the posterior pole to the peripheral retina in the right eye. Optical coherence tomography (OCT) revealed multiple disruptions of the ellipsoid zone (EZ). Full-field electroretinography (ffERG) demonstrated a more pronounced reduction in rod amplitude compared with cone amplitude in both eyes. After 3 months, the white dots, EZ disruption, and night blindness resolved spontaneously, and the ffERG amplitude normalized in the right eye. However, the enlarged blind spot persisted. Case 2: A 66-year-old woman presented with acute visual deterioration and night blindness in her right eye. The right eye exhibited an enlarged blind spot and numerous white spots widely extending from the posterior pole to the periphery. OCT revealed widespread EZ loss, and ffERG showed reduced rod and cone responses. SubTenon's triamcinolone acetonide injection was administered, and 3 months after the injection, the night blindness, ffERG abnormalities, and EZ loss had resolved, but the enlarged blind spot remained.</p><p><strong>Conclusion: </strong>MEWDS rarely causes transient night blindness due to extensive rod dysfunction. However, outer retinal layer damage is reversible, with night blindness typically resolving within a few months.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"5 ","pages":"1557294"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544795","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":"Assessment of awareness of keratoconus and its relation to eye rubbing among Saudi Arabia population.","authors":"Nuwayyir Abdullah Alqasimi, Lujain Hatim Aljohani, Renato Ambrósio, Bader Saad AlQahtani, Nasser Saleh Al Haydar, Bdour Raja Alanazi, Danah Tariq Alfurayhan, Lina Sami Hussain Saber, Fatemah Saleh Alsalem, Nawaf Abdullah Alqahtani, Jose Manuel Vargas","doi":"10.3389/fopht.2025.1545030","DOIUrl":"10.3389/fopht.2025.1545030","url":null,"abstract":"<p><strong>Background: </strong>Keratoconus (KC) is a bilateral, asymmetric, progressive thinning of the cornea that causes a decrease in optical quality due to induced myopia, irregular astigmatism, and higher order aberrations. KC affects 1.38 per 1,000 individuals globally, with a higher prevalence in Asian and Middle Eastern populations. Eye rubbing has been recognized as one of the leading risk factors for KC.</p><p><strong>Objectives: </strong>This study aimed to assess the knowledge and awareness about KC and its relation to eye rubbing among the population of the Kingdom of Saudi Arabia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in 2024 among people residing in different regions of Saudi Arabia. Data collection was carried out using an online questionnaire consisting of 21 questions, which were divided into two sections. Prior to administering the questionnaire, informed consent was obtained, and the confidentiality of the collected data was ensured.</p><p><strong>Results: </strong>This survey had a total of 2,059 respondents. The majority of the participants in the study were female, and their ages ranged from 18 to 30 years. Most of the participants held a university degree or higher. In total, 44% of respondents reported having allergic disorders, while 57.6% demonstrated a lack of knowledge regarding KC. The level of KC awareness was poor among Saudi residents, with 74.8% showing insufficient awareness. The group with acceptable awareness of KC was predominantly aged between 18 and 30 years and female, with a percentage of 30.4%.</p><p><strong>Conclusion: </strong>The study revealed that Saudi citizens are not knowledgeable about KC and the risks associated with eye rubbing. Additionally, the study identified several KC risk factors, including but not limited to eye rubbing, allergies, and family history. To alleviate the burden of KC in Saudi Arabia, it is imperative to enhance public health awareness and discourage the habit of eye rubbing.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"5 ","pages":"1545030"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506527","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":"Infectious scleritis: a review of etiologies, clinical features, and management strategies.","authors":"Supriya Sharma, Jay U Sheth, Somasheila I Murthy","doi":"10.3389/fopht.2025.1493831","DOIUrl":"10.3389/fopht.2025.1493831","url":null,"abstract":"<p><p>Infectious scleritis is a severe and potentially vision-threatening inflammation of the sclera caused by microbial invasion. Unlike autoimmune scleritis, infectious scleritis is less common with a prevalence of 5%-10% of all cases of scleritis. The initial clinical presentation may often resemble autoimmune scleritis, thus resulting in a delayed diagnosis and poorer outcomes. A high level of suspicion is required in such cases and risk factors such as with a history of trauma or surgery and worsening or refractory to immunosuppressive medications as these may well be infectious. While in established cases, the classical clinical features enable us to diagnose as infectious etiology without much difficulty, the management remains a challenge. Majority of these cases require an aggressive approach with a combination of antimicrobial therapy and surgical treatment. Poor prognostic factors include delayed diagnosis, fungal etiology, and the presence of keratitis or endophthalmitis. In this review, the authors have summarized the prevalence, clinical and microbiological profile, and management strategies of infectious scleritis and their outcomes.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"5 ","pages":"1493831"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484957","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":"Multi-centre comparison between device-independent web-browser perimetry (Melbourne Rapid Fields-web) and SITA-Faster for glaucoma.","authors":"Joyce Tiang, Algis J Vingrys, Sarah Lin, Selwyn M Prea, Adam Ahmed Moktar, Allan Bank, Ashish Agar, Yu Xiang George Kong","doi":"10.3389/fopht.2025.1485950","DOIUrl":"10.3389/fopht.2025.1485950","url":null,"abstract":"<p><strong>Purpose: </strong>Visual field testing is important for glaucoma diagnosis and management, but access to standard automated perimetry can be limited in some areas due to cost or access. Melbourne Rapid Fields-web (MRF-web) perimeter is designed to address these limitations by allowing perimetry testing on the flat screen of your personal computer.</p><p><strong>Methods: </strong>This study is a retrospective, cross-sectional study involving two locations in Australia, one in metropolitan Melbourne and one in rural Dubbo NSW. 232 patients with stable glaucoma, glaucoma suspect or normal eyes were tested with MRF-web and outcomes were compared to the most recent Humphrey Field Analyzer (HFA) 24-2 SITA Faster test. Outcomes were compared by Deming regressions, Intraclass Correlation Coefficients (ICC) and Bland-Altman methods.</p><p><strong>Results: </strong>Patient age ranged from 21 to 92 (average 66.3, SD 16.1). Bland-Altman found a bias of -0.50dB for Mean Deviation (MD) between the two tests, with 95% Limits of Agreement (LoA) of -6.80dB to 5.80dB. Pattern Deviation (PD) had a bias of -0.58dB with 95% LoA of -5.60dB to 4.40dB. High concordance was found for MD and PD, with ICCs of 0.87 and 0.73. No significant differences were found in false positive and fixation loss rates. Test time was approximately one minute longer for MRF-web compared to SITA-Faster. Area Under the Curve of MRF and HFA are similar indicating comparable diagnostic capacity.</p><p><strong>Conclusion: </strong>MRF-web produces outcomes comparable to HFA SITA-Faster. Its portability and cost-effectiveness suggest suitability as an alternative method for visual field testing where a standard perimeter is not easily accessible.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"5 ","pages":"1485950"},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470168","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":"Quantifying the spatial patterns of retinal ganglion cell loss and progression in optic neuropathy by applying a deep learning variational autoencoder approach to optical coherence tomography.","authors":"Jui-Kai Wang, Brett A Johnson, Zhi Chen, Honghai Zhang, David Szanto, Brian Woods, Michael Wall, Young H Kwon, Edward F Linton, Andrew Pouw, Mark J Kupersmith, Mona K Garvin, Randy H Kardon","doi":"10.3389/fopht.2024.1497848","DOIUrl":"10.3389/fopht.2024.1497848","url":null,"abstract":"<p><strong>Introduction: </strong>Glaucoma, optic neuritis (ON), and non-arteritic anterior ischemic optic neuropathy (NAION) produce distinct patterns of retinal ganglion cell (RGC) damage. We propose a booster Variational Autoencoder (bVAE) to capture spatial variations in RGC loss and generate latent space (LS) montage maps that visualize different degrees and spatial patterns of optic nerve bundle injury. Furthermore, the bVAE model is capable of tracking the spatial pattern of RGC thinning over time and classifying the underlying cause.</p><p><strong>Methods: </strong>The bVAE model consists of an encoder, a display decoder, and a booster decoder. The encoder decomposes input ganglion cell layer (GCL) thickness maps into two display latent variables (dLVs) and eight booster latent variables (bLVs). The dLVs capture primary spatial patterns of RGC thinning, while the display decoder reconstructs the GCL map and creates the LS montage map. The bLVs add finer spatial details, improving reconstruction accuracy. XGBoost was used to analyze the dLVs and bLVs, estimating normal/abnormal GCL thinning and classifying diseases (glaucoma, ON, and NAION). A total of 10,701 OCT macular scans from 822 subjects were included in this study.</p><p><strong>Results: </strong>Incorporating bLVs improved reconstruction accuracy, with the image-based root-mean-square error (RMSE) between input and reconstructed GCL thickness maps decreasing from 5.55 ± 2.29 µm (two dLVs only) to 4.02 ± 1.61 µm (two dLVs and eight bLVs). However, the image-based structural similarity index (SSIM) remained similar (0.91 ± 0.04), indicating that just two dLVs effectively capture the main GCL spatial patterns. For classification, the XGBoost model achieved an AUC of 0.98 for identifying abnormal spatial patterns of GCL thinning over time using the dLVs. Disease classification yielded AUCs of 0.95 for glaucoma, 0.84 for ON, and 0.93 for NAION, with bLVs further increasing the AUCs to 0.96 for glaucoma, 0.93 for ON, and 0.99 for NAION.</p><p><strong>Conclusion: </strong>This study presents a novel approach to visualizing and quantifying GCL thinning patterns in optic neuropathies using the bVAE model. The combination of dLVs and bLVs enhances the model's ability to capture key spatial features and predict disease progression. Future work will focus on integrating additional image modalities to further refine the model's diagnostic capabilities.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"4 ","pages":"1497848"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442990","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":"Therapeutic drug monitoring and neutralizing anti-drug antibody detection to optimize TNF-alpha inhibitor treatment for uveitis.","authors":"Howard C Chen, Jenny Shunyakova, Amit K Reddy, Srujay Pandiri, Lynn Hassman","doi":"10.3389/fopht.2025.1432935","DOIUrl":"10.3389/fopht.2025.1432935","url":null,"abstract":"<p><strong>Background: </strong>Adalimumab taken every other week is an effective treatment in patients with chronic refractory uveitis. Patients who have a suboptimal response to this treatment may suffer from recurrent inflammation and vision loss. Here, we investigated the use of therapeutic drug monitoring and neutralizing anti-drug antibody detection as a strategy to optimize tumor necrosis factor (TNF)-alpha inhibitor treatment in patients who have a suboptimal response to the initial dosing of adalimumab.</p><p><strong>Method: </strong>Retrospective cohort study performed in two tertiary referral uveitis services in the United States between 2015 to 2023. Patients with non-infectious uveitis who had a suboptimal response to every two-week dosing of adalimumab and underwent serum adalimumab level with reflex to anti-drug antibody testing were followed. Patients were considered to have neutralizing drug antibodies when serum drug levels were low (less than or equal to 6 mcg/mL) and anti-adalimumab antibodies were present on reflex testing. Treatment adjustment was made by clinicians with the knowledge of serum adalimumab level and the presence or absence of neutralizing drug antibodies. Every two-week dosing of adalimumab was either escalated to weekly dosing or switched to infliximab, an alternate TNF-alpha inhibitor, based on these findings. The primary outcome was success or failure at 12 months, as determined by disease inactivity on steroid-sparing therapy.</p><p><strong>Results: </strong>32 patients with suboptimal response to the initial dosing of adalimumab were included. 31.2% (n=10) of patients were found to have neutralizing drug antibodies. All patients with neutralizing drug antibodies underwent a medication switch to infliximab with a remission rate of 40% at 12 months. Patients without neutralizing drug antibodies (n=22) underwent dose escalation (77.3%; n=17) or medication switch (22.7%; n=5) and achieved a remission rate of 68.2% at 12 months. Altogether, treatment adjustment based on therapeutic drug monitoring and neutralizing drug antibody detection, in our cohort, resulted in a remission rate of 62.5%.</p><p><strong>Conclusions: </strong>For patients with uveitis experiencing suboptimal therapeutic response to adalimumab dosed every two weeks, therapeutic drug monitoring and neutralizing drug antibody detection may help clinicians optimize TNF-alpha inhibitor treatment.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"5 ","pages":"1432935"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400698","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":"Case report: Periorbital pilomatricoma: a rare benign skin tumor misdiagnosed as cellulitis.","authors":"Rahul Kumar, Jane Z Spadaro, Alon Kahana","doi":"10.3389/fopht.2025.1503693","DOIUrl":"10.3389/fopht.2025.1503693","url":null,"abstract":"<p><strong>Purpose: </strong>We describe an unusual case of a rapidly progressive pilomatricoma along the left brow, which was initially misdiagnosed and treated as preseptal cellulitis. Although rare, pilomatricomas and other adnexal tumors should be considered in the differential diagnosis of a growing mass near the brow.</p><p><strong>Case presentation: </strong>A 29-year-old male presented to the emergency department with a progressively enlarging left brow lesion, initially noted 3 weeks prior. Exam revealed an erythematous left subbrow mass that measured 2.5 x 2 cm, with resultant mechanical ptosis. The lesion was initially misdiagnosed and treated as preseptal cellulitis, with concern for abscess. The patient ultimately underwent excisional biopsy of the lesion and pathology revealed pilomatricoma.</p><p><strong>Conclusions: </strong>Pilomatricoma has similarities to more common skin lesions. Lack of pain or tenderness are important clues against an infectious or inflammatory etiology. Complete surgical excision is therapeutic and allows for diagnostic confirmation. Histopathology is required to rule out pilomatrix carcinoma, a malignant variant.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"5 ","pages":"1503693"},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384334","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":"Diagnostic approach to limbal stem cell deficiency.","authors":"Daniella Lent-Schochet, Mizna Akbar, Joshua H Hou, Asim V Farooq","doi":"10.3389/fopht.2024.1524595","DOIUrl":"10.3389/fopht.2024.1524595","url":null,"abstract":"<p><p>Limbal stem cell deficiency (LSCD) is an important cause of visual and ocular morbidity. Effective diagnosis and management require a thoughtful and comprehensive evaluation of the ocular surface. This review describes the pathogenesis, diagnosis, and grading of LSCD, as well as characteristic findings via slit lamp examination, <i>in-vivo</i> confocal microscopy, anterior segment optical coherence tomography (AS-OCT), impression cytology, and OCT angiography.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"4 ","pages":"1524595"},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069288","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":"Tele-ophthalmology as an effective triaging tool for acute ophthalmic concerns.","authors":"Natalie A Townsend, Shalini Shah, Joshua Reyes, Justin H Townsend, Alison Bozung, Giselle Ricur, Rami J Aboumourad","doi":"10.3389/fopht.2024.1511378","DOIUrl":"10.3389/fopht.2024.1511378","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study is to determine baseline demographics and utilization trend of an on-demand, synchronous tele-ophthalmology triage program in evaluating acute ophthalmic concerns during the COVID-19 Public Health Emergency.</p><p><strong>Methods: </strong>Setting: Single-center retrospective chart review of telemedicine visits conducted by ophthalmologists and optometrists from University of Miami's Bascom Palmer Eye Institute. Patient population: 6227 patients comprised 7138 telehealth encounters. All patient encounters were included in the retrospective review without exclusions and only the primary diagnoses were categorized from October 1, 2020 to April 30, 2023. Main outcomes measures: Descriptive statistics of the telemedicine model, utilization trends, baseline patient demographics, and primary diagnoses were performed for all virtual eye care encounters during the study period.</p><p><strong>Results: </strong>Utilization of the synchronous telemedicine platform increased during the study period. The median age of patients was 51 (IQR, 36-65) years. Patients predominantly self-identified as female (63.27%), White (72.7%), and non-Hispanic/Latino (48.2%). General external adnexa (44.1%), conjunctival disorders (15.5%) and ocular surface symptoms (15.4%), made up 75.0% of the visits during the study period. Furthermore, 63.4% of patients were new to Bascom Palmer Eye Institute, 67.1% had never engaged in telemedicine, and 96.5% of encounters were successfully completed through video conferencing.</p><p><strong>Discussion: </strong>During the COVID-19 pandemic, there was significant utilization of an on-demand synchronous ocular telemedicine program to address acute concerns. This retrospective chart review demonstrates the utility of telemedicine as an important and effective tool to triage and provide care during the COVID-19 Public Health Emergency.</p>","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"4 ","pages":"1511378"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061374","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":"Editorial: Insights in glaucoma: 2023.","authors":"Claire L Peterson, Tina T Wong, Shamira Perera","doi":"10.3389/fopht.2024.1519088","DOIUrl":"10.3389/fopht.2024.1519088","url":null,"abstract":"","PeriodicalId":73096,"journal":{"name":"Frontiers in ophthalmology","volume":"4 ","pages":"1519088"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061362","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}