{"title":"Optometrists’ perspectives on speciality programme development in South Africa","authors":"Nashua Naicker, A. Munsamy","doi":"10.4102/aveh.v83i1.910","DOIUrl":"https://doi.org/10.4102/aveh.v83i1.910","url":null,"abstract":"Background: South Africa (SA) has postgraduate research-based master’s and doctorate qualifications in optometry with no clinical coursework qualifications in special interest fields. As a result, it hinders professional growth and career path for optometrists and further limits patients’ access to various care pathways from would-be upskilled optometrists.Aim: To explore optometrists’ perspectives on postgraduate programme development in special interest fields of optometry for SA.Setting: Study population of practicing optometrists registered with the Health Professions Council of South Africa (HPCSA).Methods: A quantitative cross-sectional descriptive design was employed, utilising an online questionnaire developed with the Evasys survey system v8.2. Non-probability sampling was used to access eligible participants.Results: From 424 survey responses, 83.5% had undergraduate qualifications and 95.5% worked in patient-facing environments. Participants responded positively (88%) to this need for educational expansion. Educational needs in Ocular Disease (75.6%), Paediatric Optometry (66.4%), Binocular Vision (65.1%) and sub-specialties of myopia control (41.2%) and Specialised Contact Lens Fitting (31%) were reported. With combined ‘highly important’ and ‘likely important’ responses, participants indicated that obtaining professional recognition (94.9%) and to improve patient care (98.8%) were the main drivers for pursuing additional education and training.Conclusion: A notable demand was found for coursework postgraduate programmes by the study populations from which professional recognition can be awarded in various special interest fields of optometry. The benefit of improved patient care from upskilled optometrists was expressed.Contribution: The findings would contribute towards the development of a conceptual framework for postgraduate education and training for optometrists in SA.","PeriodicalId":7694,"journal":{"name":"African Vision and Eye Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141666115","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":"Pathophysiology of dry eye disease and novel therapeutic agents","authors":"S. Mathebula, L. Mmusi-Landela","doi":"10.4102/aveh.v83i1.874","DOIUrl":"https://doi.org/10.4102/aveh.v83i1.874","url":null,"abstract":"","PeriodicalId":7694,"journal":{"name":"African Vision and Eye Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141353313","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}
M. Kwarteng, Kathutshelo P. Mashige, S. Kyei, P. Govender-Poonsamy, Daniel Sunkwa Quarcoo Dogbe
{"title":"Impact of spectacle wear on the quality of life of learners with hearing impairment in Ghana","authors":"M. Kwarteng, Kathutshelo P. Mashige, S. Kyei, P. Govender-Poonsamy, Daniel Sunkwa Quarcoo Dogbe","doi":"10.4102/aveh.v83i1.875","DOIUrl":"https://doi.org/10.4102/aveh.v83i1.875","url":null,"abstract":"Background: Visual impairment significantly affects learners with hearing impairment.Aim: To assess the impact of spectacle wear on the quality of life (QoL) of learners with hearing impairment in Ghana.Setting: Six schools for the deaf in Ghana.Methods: A prospective case-control study design was used to assess the QoL among learners with uncorrected refractive error (URE) using the quality-of-life impact of refractive correction (QIRC) questionnaire before and after the provision of spectacles.Results: A total of 138 learners were enrolled in this study, with 69 learners in both the intervention and control groups, respectively. The mean QIRC score improved significantly for the intervention group: QIRC score before = 43.89 ± 8.96 vs. after = 48.82 ± 6.71 (P 0.05 and Cohen’s d = 0.62) but not the control group: QIRC score before = 50.79 ± 11.66 and 51.77 ± 10.67 (P = 0.607). Among the learners provided with spectacles, those who did not comply with spectacle wear had significant differences (P 0.05) in mean QIRC scores before and after the intervention. Only visual acuity (VA) and the magnitude of prescription with QIRC scores after intervention had a significant relationship (P 0.05).Conclusion: Uncorrected refractive error affected the QoL of learners with hearing impairment, and spectacle correction significantly improved their QoL.Contribution: The use of spectacle lenses, VA and magnitude of prescription affected the QoL scores; however, sex and age did not influence the QoL scores.","PeriodicalId":7694,"journal":{"name":"African Vision and Eye Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141106697","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}
Nuha M. Muhjoub, Saif H. Alrasheed, Yazan Gammoh, Abdelaziz M. Elmadina
{"title":"Clinical characteristics and associated factors of diabetic retinopathy in Sudanese patients","authors":"Nuha M. Muhjoub, Saif H. Alrasheed, Yazan Gammoh, Abdelaziz M. Elmadina","doi":"10.4102/aveh.v83i1.913","DOIUrl":"https://doi.org/10.4102/aveh.v83i1.913","url":null,"abstract":"Background: Diabetic retinopathy (DR) is a leading cause of vision loss and preventable blindness, particularly in middle- and high-income countries.Aim: This study aimed to assess the characteristics and associated factors of DR in Sudanese patients with type 2 diabetes mellitus (DM).Setting: A cross-sectional hospital-based study included 119 patients with type 2 DM was conducted at EL-Walidain Eye Hospital, Khartoum, Sudan, from February 2021 to May 2021.Methods: A non-mydriatic digital fundus camera was used for fundus photography, and Scottish Diabetic Retinopathy Grading Scheme was used for the final classification of DR.Results: Females comprised 53.8% of patients, mean age of 58.8 ± 8.5 years. Uncontrolled DM was found in 37.8% with a mean duration of 10.5 ± 4.8 years. Myopia was the most common refractive error found in 57.8% of the uncontrolled group, followed by emmetropia (17.8%). Whereas in the controlled group, 47.3% were hyperopic and 39.2% were myopic. Maculopathy grade M1 was found to be 37.8% in the uncontrolled group and 18.9% in the controlled group, with no significant difference (p = 0.361). Conversely, the difference in retinopathy between the two groups was statistically significant (p = 0.043).Conclusion: Decreased vision and increased retinopathy were associated with an increase in patients’ age. More widespread diabetes awareness and screening programmes to improve diabetes management and control in Sudan and other developing countries.Contribution: This study observed maculopathy grade M1 and myopia were more common in uncontrolled DM, and vision function was inversely correlated with age (p 0.05).","PeriodicalId":7694,"journal":{"name":"African Vision and Eye Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141107927","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}
Lungile M. Buthelezi, Tsatsawani N. Hlungwani, Gcinile P. Mbuli, S’bahle S. Mthembu, Pallo Nteke, Thuli Sindane, Siyathemba A. Skam
{"title":"Refractive error accuracy and user perceptions of a smartphone home-based tester","authors":"Lungile M. Buthelezi, Tsatsawani N. Hlungwani, Gcinile P. Mbuli, S’bahle S. Mthembu, Pallo Nteke, Thuli Sindane, Siyathemba A. Skam","doi":"10.4102/aveh.v83i1.902","DOIUrl":"https://doi.org/10.4102/aveh.v83i1.902","url":null,"abstract":"Background: Uncorrected refractive error accounts for nearly half of the global burden of vision impairment. The EyeQue personal vision tracker (EPVT) was created as a convenient smartphone refractometer to be used at home and order spectacles online thereafter. However, its accuracy in diagnosing refractive error has not been fully established.Aim: This study aimed to determine the accuracy of the EPVT in measurement of refractive error and determine user perception on device use.Setting: University of KwaZulu-Natal optometry clinic, Westville campus.Methods: This was a comparative cross-sectional study using a double-blind design. Objective, non-cycloplegic refraction testing results using the EPVT were compared with gold standard ophthalmic subjective refraction (SR). Both eyes were considered for the analysis with comparisons being made between EPVT and gold subjective standard refraction for each eye. User perception was evaluated by means of a structured questionnaire.Results: The mean spherical equivalent refractive error was –0.18 ± 0.70 dioptre (D) and –1.12 ± 2.79 D for the gold standard ophthalmic SR and EPVT, respectively, with significant differences in visual acuities yielded by the two methods (p = 0.000). Participants preferred gold standard refraction testing over the EPVT.Conclusion: The EPVT was not accurate in measuring refractive error; therefore, the resultant prescription from EPVT alone should not be used to order spectacles. However, this digital tool presents promise as an autorefractor for screening refractive error rather than as a diagnostic device.Contribution: This study offered valuable insights into the prospective utility of home-based, self-administered smartphone refractive error testers as a tool for screening of refractive error. The study also provided cautions to the EPVTs limitations related to accuracy and limited ocular health assessment, which have broader implications for visual health and quality.","PeriodicalId":7694,"journal":{"name":"African Vision and Eye Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140991897","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}
Rio Rhendy, Tri Rahayu, L. Edwar, Mohamad Sadikin, A. Kekalih
{"title":"Evaluation of mucin changes between daily and extended wear silicone hydrogel contact lenses","authors":"Rio Rhendy, Tri Rahayu, L. Edwar, Mohamad Sadikin, A. Kekalih","doi":"10.4102/aveh.v83i1.884","DOIUrl":"https://doi.org/10.4102/aveh.v83i1.884","url":null,"abstract":"Background: Initially, contact lenses were recommended only for daily wear because of infection and discomfort concerns. With rising demand, particularly for overnight use, extended wear lenses have gained significance. Despite concerns, intensive development of materials like Lotrafilcon B aims to meet this demand, focusing on comfort and safety.Aim: This study aimed to evaluate the mucin quantity and quality changes between daily and extended wear (Lotrafilcon B), impacting eye health and comfort.Setting: The study was conducted at Kirana Eye Center, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.Methods: This study was a single-blinded randomised clinical trial with two parallel groups. Forty (40) eligible subjects willingly participated. Mucin 5AC (MUC5AC) and Ferning-type tests were conducted. The 40 subjects with moderate myopia were then divided into a daily wear and an extended wear group. The MUC5AC test was performed at pre-fitting and at 4 weeks, whereas the Ferning-type tests were taken at pre-fitting and 1st and 4th weeks.Results: For both groups, there was a significant increase in MUC5AC levels from pre-fitting to week four, but with no significant difference between them in final MUC5AC levels. Additionally, the comparison of eyes with normal and abnormal Ferning-types between the two groups showed no significant differences at pre-fitting, 1st and 4th weeks.Conclusion: There is no significant difference in MUC5AC levels with the use of daily or extended wear (with Lotrafilcon B).Contribution: This study compares the impact of daily and extended wear Lotrafilcon B contact lenses on eye health and comfort in moderate myopia patients.","PeriodicalId":7694,"journal":{"name":"African Vision and Eye Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140696297","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":"Evaluation of convergence, accommodation and fusional vergence in pre-presbyopes with asthenopia","authors":"S. Alrasheed, Saeed Aljohani","doi":"10.4102/aveh.v83i1.863","DOIUrl":"https://doi.org/10.4102/aveh.v83i1.863","url":null,"abstract":"Background: Pre-presbyopes may suffer from ocular symptoms such as asthenopia of near work.Aim: This study aimed to evaluate near points of convergence, amplitudes of accommodation, and fusional vergence among pre-presbyopes with asthenopia symptoms.Setting: The study was conducted at El-Walidain Eye Hospital, Khartoum, Sudan in 2022.Methods: The study was a hospital-based prospective, including 107 pre-presbyopes aged 35–40 years who complained of asthenopia symptoms. Clinical examinations included an assessment of amplitude of accommodation, near point of convergence and fusional vergence.Results: The findings showed receded in near points of convergence and a decrease in the accommodation was highly significantly associated with increased age among emerging presbyopes with asthenopia symptoms (p = 0.0001). Conversely, positive and negative fusional vergence amplitudes were not significantly correlated with age with p = 0.109 and p = 0.355, respectively. Positive and negative fusional amplitudes were not significantly different between males and females (p ˃ 0.05). Esophoria was more common in pre-presbyopia 62 (57.4%) and exophoria 45 (43.6) with p = 0.503.Conclusion: The pre-presbyopes presented with low accommodation amplitude and receded near point of convergence, but without significant changes in positive and negative fusional vergence amplitudes.Contribution: This study added by demonstrating how early presbyopia altered accommodation amplitude and near point of convergence significantly while having no significant impact on amplitudes of positive and negative fusional vergence.","PeriodicalId":7694,"journal":{"name":"African Vision and Eye Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140697074","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":"Loss of function of the meibomian glands among HIV and AIDS individuals undergoing antiretroviral therapy","authors":"S. Mathebula, Mologadi D. Ntsoane","doi":"10.4102/aveh.v83i1.866","DOIUrl":"https://doi.org/10.4102/aveh.v83i1.866","url":null,"abstract":"Background: Meibomian gland dysfunction (MGD) is one of the most encountered diseases in the clinical practice but appears to be underappreciated as it does not cause blindness. Meibomian gland dysfunction is a multifactorial and complex disorder of the ocular surface.Aim: This study aims to evaluate the characteristics of the meibomian glands in individuals living with HIV and AIDS undergoing antiretroviral therapy.Setting: The study was conducted at the antiretroviral (ARV) clinic, Mankweng Hospital.Methods: This was a prospective study conducted with 37 HIV and AIDS participants and 20 healthy controls. All participants were assessed using the Ocular Surface Diseases Index (OSDI) score and, tear break-up time and lid margin regularity (using the slit-lamp biomicroscopy). The loss of the meibomian glands was evaluated using the Marx’s line. For this study, this line represented a clinical parameter of meibomian function.Results: The OSDI score was significantly higher in the HIV and AIDS group than that of the control participants (39.95 ± 18.65 and 13.00 ± 9.09, respectively, P 0.05). The tear breakup time (TBUT) for the HIV and AIDS study group was lower than that of the control group (7.95 ± 3.54 and 9.90 ± 3.70, respectively, P 0.05). The HIV and AIDS participants showed greater meibomian gland loss relative to the healthy controls (9.30 ± 4.97 and 5.70 ± 2.1, P 0.05).Conclusion: The loss of eyelid meibomian glands is common in people living with HIV and AIDS in comparison with healthy controls.Contribution: Although there is a decrease in sight-threatening complications in the era of ARVs, ocular surface disorders (OSD) are still commonly found, which may reduce the quality of life of HIV and AIDS individuals.","PeriodicalId":7694,"journal":{"name":"African Vision and Eye Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140715109","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":"Heterophoria, fusional vergence, and near point of convergence in Sudanese hospital-based population","authors":"S. Alrasheed, Sulaiman Aldakhil","doi":"10.4102/aveh.v83i1.869","DOIUrl":"https://doi.org/10.4102/aveh.v83i1.869","url":null,"abstract":"Background: Fusional vergence amplitude is the amount of convergence and divergence that can be induced before fusion is lost and fusional vergence amplitude controls heterophoria.Aim: This study aimed to investigate the relationship between near heterophoria, near fusional vergence (NFV), and near point of convergence (NPC).Setting: Al-Neelain Eye Hospital Khartoum, Sudan.Methods: A hospital-based prospective study from February to October 2019, included 230 patients with age range of 15–30 years and mean age and standard deviation of 19.46 ± 3.33 years. The alternate cover test with prism was used to measure near heterophoria and a prism bar was used to measure quantity of fusional vergence. All measurements were taken at near heterophoria (0.33 m). Then the associations between near heterophoria, NFV and NPC were assessed.Results: The most common heterophoria at near among the participants was exophoria: 200 (87.0%). Reported complaints of asthenopia were commonly found among these exophoric patients: 106 (86.9%) (P = 0.735). Positive fusional vergence (PFV) to the break point varied according to the forms of heterophoria (P = 0.003). Esophoria had a higher PFV to break point than exophoria (30.83 ± 8.79Δ compared to 25.59 ± 10.07Δ). Negative fusional vergence at the break and recovery points were higher among those with exophoria and lower in esophoria (P ˃ 0.05). The NPC differed by the type of heterophoria (P = 0.01), with exophoria and slightly receded NPC (8.38 cm ± 3.33 cm) than for participants with esophoria (6.77 cm ± 1.52 cm).Conclusions: Exophoria was the most common type of near heterophoria, with asthenopia being the most reported complaint. Esophoria was found to be strongly associated with high PFV. Exophoria, on the contrary, is related to significant high NFV at the blur, beak, and recovery point. The NPC differed significantly by the type of near heterophoria, with exophoria having more receded NPC compared to those with esophoria.Contribution: This study provides information on the commonest type of near heterophorias among a sample of Sudanese adolescents and young adults, namely exophoria. Near point of convergence and NFV at break and recovery points were significantly different according to forms of near heterophoria.","PeriodicalId":7694,"journal":{"name":"African Vision and Eye Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139802268","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":"Heterophoria, fusional vergence, and near point of convergence in Sudanese hospital-based population","authors":"S. Alrasheed, Sulaiman Aldakhil","doi":"10.4102/aveh.v83i1.869","DOIUrl":"https://doi.org/10.4102/aveh.v83i1.869","url":null,"abstract":"Background: Fusional vergence amplitude is the amount of convergence and divergence that can be induced before fusion is lost and fusional vergence amplitude controls heterophoria.Aim: This study aimed to investigate the relationship between near heterophoria, near fusional vergence (NFV), and near point of convergence (NPC).Setting: Al-Neelain Eye Hospital Khartoum, Sudan.Methods: A hospital-based prospective study from February to October 2019, included 230 patients with age range of 15–30 years and mean age and standard deviation of 19.46 ± 3.33 years. The alternate cover test with prism was used to measure near heterophoria and a prism bar was used to measure quantity of fusional vergence. All measurements were taken at near heterophoria (0.33 m). Then the associations between near heterophoria, NFV and NPC were assessed.Results: The most common heterophoria at near among the participants was exophoria: 200 (87.0%). Reported complaints of asthenopia were commonly found among these exophoric patients: 106 (86.9%) (P = 0.735). Positive fusional vergence (PFV) to the break point varied according to the forms of heterophoria (P = 0.003). Esophoria had a higher PFV to break point than exophoria (30.83 ± 8.79Δ compared to 25.59 ± 10.07Δ). Negative fusional vergence at the break and recovery points were higher among those with exophoria and lower in esophoria (P ˃ 0.05). The NPC differed by the type of heterophoria (P = 0.01), with exophoria and slightly receded NPC (8.38 cm ± 3.33 cm) than for participants with esophoria (6.77 cm ± 1.52 cm).Conclusions: Exophoria was the most common type of near heterophoria, with asthenopia being the most reported complaint. Esophoria was found to be strongly associated with high PFV. Exophoria, on the contrary, is related to significant high NFV at the blur, beak, and recovery point. The NPC differed significantly by the type of near heterophoria, with exophoria having more receded NPC compared to those with esophoria.Contribution: This study provides information on the commonest type of near heterophorias among a sample of Sudanese adolescents and young adults, namely exophoria. Near point of convergence and NFV at break and recovery points were significantly different according to forms of near heterophoria.","PeriodicalId":7694,"journal":{"name":"African Vision and Eye Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139862336","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}