British Journal of Ophthalmology最新文献

{"title":"Microbiological sampling has limited value in managing acute postoperative bacterial endophthalmitis: a multicentre study in the UK","authors":"Ariel Yuhan Ong, Boon Lin Teh, Alice Milligan, Alice Thomas, Blanca Flores-Sánchez, Vy Hoang, Jacob M Fingret, Ankur Mehta, Andrew J Lotery, Jonathan Smith, Raquel Garcia-Cabrera, Carlos Pavesio, David H Steel, Peter Charbel Issa","doi":"10.1136/bjo-2025-327543","DOIUrl":"https://doi.org/10.1136/bjo-2025-327543","url":null,"abstract":"Aims To determine whether microbiological testing impacts clinical management in acute postoperative endophthalmitis. Methods Multicentre retrospective cohort study encompassing five tertiary centres in the UK. Patients presenting with acute postoperative endophthalmitis with at least 4 weeks follow-up were included. The main outcome was the proportion with a change in management (defined as further intravitreal antibiotic therapy and/or further surgical intervention within 4 weeks of the initial treatment) and the rationale for this change. Results 190 eyes of 189 patients were included. Patients presented at a median of 5 days postoperatively (IQR 3–10). Sampling was predominantly obtained via vitreous tap alone (80/190, 42%) or with both vitreous and anterior chamber tap (84/190, 44%). Over half were culture-positive (107/190, 56%), and only bacterial pathogens were isolated. Culture-positive cases with available antibiotic sensitivity data demonstrated in vitro sensitivity to at least one of the empirical intravitreal antibiotics administered. Seventy-six eyes (40%) had a change in management within 4 weeks of the initial treatment. These additional procedures took place within 48 hours of initial treatment in 46% (35/76) of patients. The main reasons were a lack of clinical improvement (46/76, 61%) or clinical deterioration (18/76, 24%); none of these changes were prompted or guided by culture or sensitivity results. Conclusions Microbiological sampling was of limited clinical utility in this series. In patients presenting with suspected acute bacterial endophthalmitis, if microbiological sampling might pose any delays to treatment, consideration should be given to immediate intravitreal antibiotic treatment without sampling to optimise visual outcomes. Data are available upon reasonable request.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"4 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594157","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":"3D facial reconstruction refines 60-4 visual field assessment","authors":"Armin Garmany, Sepideh Jamali Dogahe, Seyedmostafa Sadegh Mousavi, Tyler M Kaplan, Cheryl L Khanna","doi":"10.1136/bjo-2024-326457","DOIUrl":"https://doi.org/10.1136/bjo-2024-326457","url":null,"abstract":"Background This study aimed to provide methodology to create a facial contour-informed normative 60-4 visual field and to apply the reference field to a glaucoma cohort to derive facial contour-informed 60-4 global indices. Methods Participant recruitment was completed at a tertiary medical centre. 60 eyes from 30 participants with no ocular pathology by clinical exam or optical coherence tomography were recruited for the healthy cohort. For the glaucoma cohort, 86 eyes from 43 patients diagnosed with glaucoma by clinical exam were recruited, with 30-2 visual field mean deviation used to stratify glaucoma severity. Results The median (range) age of the healthy participants was 33 (24–61) years old. A facial contour-informed 60-4 visual field reference field was developed. 43 glaucoma patients were recruited with a resulting median (range) age of 65 (30–84). Three algorithms compensating for facial contour were used for the derivation of 60-4 mean deviation and pattern SD. All mean deviation algorithms correlated with 30-2 mean deviation severity (ρ≤−0.62, p<0.0001) and retinal nerve fibre layer thickness (ρ≥0.36, p<0.05). For pattern SD, consideration of inferior nasal defects allowed correlation with both 30-2 mean deviation severity (ρ≥0.49, p<0.001) and retinal nerve fibre layer thickness (ρ≤−0.47, p<0.01). Conclusion This study provides methodology for deriving a facial contour-informed 60-4 reference field and illustrates the feasibility of applying facial contour information to refine global indices of the 60-4 visual field. Obtained metrics compensated for facial contour and correlated with functional and structural disease metrics. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"33 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586590","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":"Efficacy comparison of atropine, orthokeratology and repeated low-level red-light therapy for myopia control in children: a systematic review and network meta-analysis.","authors":"Zetong Zheng, Xue Jiang, Rongxin Chen, Li Dong","doi":"10.1136/bjo-2025-327366","DOIUrl":"10.1136/bjo-2025-327366","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to compare the efficacy of different interventions for myopia control in children, including 0.01% atropine (AP), orthokeratology (Ortho-k), and repeated low-level red-light therapy (RLRL), and their combinations by conducting a network meta-analysis.</p><p><strong>Methods: </strong>We searched for randomised controlled trials (RCTs) in PubMed, Web of Science and Embase. The primary outcomes were the mean changes in the cycloplegic spherical equivalent (SE) and axial length (AL) at the 12-month follow-up. A Bayesian random-effects network meta-analysis was performed to estimate pooled weighted mean differences and 95% credible intervals.</p><p><strong>Results: </strong>The analysis included 41 RCTs with 6434 eyes. Compared with the control group, all interventions were found to be effective at slowing myopia progression, combining direct and indirect evidence at the 12-month follow-up: RLRL therapy (AL -0.31 (0.39, 0.24), p<0.05; SE 0.76 (0.54, 0.98), p<0.05), 0.01% atropine (AL -0.13 (-0.20, 0.07), p<0.05; SE 0.25 (0.08, 0.42), p<0.05), Ortho-k therapy (AL -0.16 (-0.26, 0.06), p<0.05; SE 0.58 (0.05, 1.13), p<0.05) and 0.01% atropine+Ortho-k therapy (AL -0.27 (-0.38, 0.16), p<0.05; SE 0.76 (0.23, 1.31), p<0.05). The cumulative probability ranking suggested that RLRL therapy was the most effective intervention in slowing AL, followed by 0.01% atropine+Ortho-k, Ortho-k and 0.01% atropine.</p><p><strong>Conclusions: </strong>This network meta-analysis provides evidence that RLRL, 0.01% atropine, Ortho-k and 0.01% atropine+Ortho-k are all effective in suppressing myopia progress. In terms of long-term treatment efficacy in slowing AL and SE procession, RLRL was the most effective intervention.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559281","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":"Effect of intravitreal injection on optic nerve in infants with retinopathy of prematurity: a long-term follow-up study","authors":"Jianbo Mao, Xinyi Deng, Yijing Chen, Shian Zhang, Hanxiao Li, Xiaoya Zhang, Ziyi Xiang, Jiajun Zhu, Yiqi Chen, Li-Jun Shen","doi":"10.1136/bjo-2024-325830","DOIUrl":"https://doi.org/10.1136/bjo-2024-325830","url":null,"abstract":"Aims To investigate the effect of intravitreal injection (IVI) on the optic nerve in infants with retinopathy of prematurity (ROP) during long-term follow-up. Methods The preterm infants included were divided into control, untreated and treated groups. The treatment group was further divided into the plus disease group and the no plus disease group. The vertical cup-to-disc ratio (C/D) was measured and compared in fundus photography at 36 weeks to 6 months of postmenstrual age (PMA) in the three groups of infants, respectively. Results A total of 381 eyes were included in this study. As the PMA passed from 36 weeks to 6 months, the C/Ds of the infants in all three groups increased to varying degrees, in which those of the treated group were significantly larger than those of the untreated group and the control group at all follow-up periods except at 36 weeks of PMA. In addition, in the treatment group, the C/D was significantly lower in the plus disease group than in the no-plus disease group, except at 6 months of PMA. Conclusions The present study found that IVI for ROP would result in an enlargement of the C/D in prematurity. The presence of plus disease was associated with an underestimation of the C/D. And the C/D in preterm infants continued to increase to varying degrees in at least 6 months of PMA. Data sharing not applicable as no datasets generated and/or analysed for this study.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"41 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568760","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":"Effectiveness of intraocular lenses designed to correct presbyopia after cataract surgery: an overview of systematic reviews","authors":"Qëndresë Daka, Christin Henein, Clarissa Ern Hui Fang, Rona Mustafa, Ergon Cocaj, Augusto Azuara-Blanco, Colin E Willoughby, Desta Bokre, Mayank A Nanavaty","doi":"10.1136/bjo-2025-327363","DOIUrl":"https://doi.org/10.1136/bjo-2025-327363","url":null,"abstract":"This is an overview of systematic reviews to evaluate the visual outcomes of different presbyopia correcting intraocular lens (IOL), spectacle independence (SI), adverse visual effects and cost-effectiveness. Reviews were included if they compared presbyopia-correcting IOLs—such as multifocal (bifocal and trifocal), extended-depth-of-focus (EDOF), and accommodative and monofocal IOLs. The AMSTAR-2 tool was used. Primary outcomes were uncorrected distance visual acuity (UDVA), intermediate visual acuity (UIVA) and near visual acuity (UNVA). Secondary outcomes were SI, halos and glare, and cost-effectiveness. Prospero registration CRD42023425283. Eight systematic reviews were included. None scored ‘Yes’ in all AMSTAR-2 tool 16 items. Primary outcomes were as follows: all IOLs reported similar UDVA. EDOF and trifocal IOLs reported better UCIVA. Trifocal diffractive, EDOF, accommodative and bifocals were better than monofocal IOL for UNVA and of these trifocal and biofocal reported better UNVA. Secondary outcomes: SI was better with trifocal, bifocals and EDOF compared with monofocal IOLs. Trifocals and bifocals reported more glare and halos. No review reported cost-effectiveness. The findings indicate that while multifocal and EDOF IOLs show comparable performance in UDVA and UIVA, multifocal performs better in UNVA but at the cost of glare and halos. EDOFs may offer superior spectacle independence but may not consistently match multifocal in near vision.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"41 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578000","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":"AngioReport: dataset and baseline methods for fundus angiography report generation.","authors":"Pusheng Xu, Peranut Chotcomwongse, Weiyi Zhang, Xiaolan Chen, Xinyuan Wu, Florence H T Chung, Xueli Zhang, Mingguang He, Danli Shi, Paisan Ruamviboonsuk","doi":"10.1136/bjo-2024-327006","DOIUrl":"https://doi.org/10.1136/bjo-2024-327006","url":null,"abstract":"<p><strong>Purpose: </strong>To develop an annotated fundus angiographic dataset, including fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA), and establish baseline methods for automatic report generation.</p><p><strong>Methods: </strong>This retrospective study reviewed patients aged ≥18 years who underwent FFA or ICGA at Rajavithi Hospital, Thailand, between 1 January and 31 December 2019. A total of 55 361 de-identified images from 1691 patients (3179 eyes) were annotated by retinal specialists with detailed descriptions of the type, location, shape, size and pattern of abnormal fluorescence. Two baseline methods were developed: (1) a classification-based approach using ResNet101 with class-specific residual attention for multi-label lesion recognition and (2) a language-generation approach using the Bootstrapping Language-Image Pre-training framework, fine-tuned on angiographic images and structured reports. Model performances were evaluated using F1 score and BERTScore.</p><p><strong>Results: </strong>The dataset includes 24 diagnostic conditions, with macular neovascularisation (32.5%) being the most prevalent, followed by unremarkable findings (21.8%) and dry age-related macular degeneration (10.2%). Most eyes (81.8%) underwent both FFA and ICGA. Hyperfluorescence was observed in 75.6% of cases, predominantly due to leakage, while hypofluorescence was present in 28.1%. The classification-based method achieved an average score of 7.966, demonstrating superior performance in recognising choroidal neovascularisation, hyperfluorescent and hypofluorescent areas. The language-generation method achieved a comparable average score of 7.947, excelling in impression recognition and the hyperfluorescence identification.</p><p><strong>Conclusion: </strong>We present the largest annotated fundus angiographic dataset to date, along with two effective baseline methods for automatic report generation, offering a valuable foundation for advancing artificial intelligence applications in ophthalmology.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559280","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":"Predicting the therapeutic effect of photodynamic therapy on circumscribed choroidal haemangioma: a retrospective cohort study.","authors":"Jehwi Jeon, Hyeong Ju Byeon, Suk Ho Byeon, Sung Soo Kim, Christopher Seungkyu Lee","doi":"10.1136/bjo-2024-326759","DOIUrl":"https://doi.org/10.1136/bjo-2024-326759","url":null,"abstract":"<p><strong>Background/aims: </strong>Circumscribed choroidal haemangioma (CCH) can cause visual impairment, primarily managed with photodynamic therapy (PDT). This study aimed to identify predictive factors of therapeutic response in patients with CCH treated with PDT and to analyse serial anatomical outcomes, focusing on visual acuity, tumour characteristics, and inner retinal microstructures.</p><p><strong>Methods: </strong>This retrospective study included patients diagnosed with CCH at Severance Eye Hospital, Yonsei University, from January 2005 to December 2022. We reviewed patient records and multimodal imaging, assessing demographics, including post-PDT visual acuity changes, age, laterality and sex, and multimodal imaging features such as tumour location and height, presence of subfoveal subretinal fluid (SRF), enhanced reflectivity of the retinal pigment epithelium and external limiting membrane (ELM) disruption.</p><p><strong>Results: </strong>Among 114 patients with CCH (82 men, 65.6%; mean age 52.1±14.0 years), 45 (39.5%) had asymptomatic CCH, while 69 (60.5%) presented with symptomatic CCH. PDT was administered to 41 symptomatic patients (59.4%). The pretreatment LogMAR visual acuity was 0.50±0.63, which remained stable 1 year after PDT (0.53±0.64, p=0.666). However, it worsened 3 years after PDT (0.81±0.89, p=0.024), around the time tumour regrowth was observed. At 1-year post-PDT, tumour volume and height decreased by an average of 34.6% and 32.4%, respectively, accompanied by a 75.0% reduction in SRF. Patients with >75% vol reduction showed greater SRF persistence, while a higher initial SRF height was associated with complete SRF absorption following PDT. ELM disruption was identified as a significant predictor of poorer visual acuity, reduced tumour volume response and limited SRF absorption.</p><p><strong>Conclusions: </strong>The presence of SRF predicts favourable tumour size reduction and SRF absorption post-PDT, while ELM disruption serves as an important prognostic factor for visual acuity and structural outcomes, aiding in pre-PDT treatment planning.</p>","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559282","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":"At a glance","authors":"Frank Larkin","doi":"10.1136/bjo-2025-327969","DOIUrl":"https://doi.org/10.1136/bjo-2025-327969","url":null,"abstract":"Lack of understanding of grading and management in atopic allergic conjunctivitis in young patients without pathognomonic signs of corneal involvement at the time of presentation was the rationale for a new universal grading scheme. After penetrating keratoplasty, in vivo confocal microscopy confirmed the formation of a continuous pre-Descemet monolayer of keratocyte-like cells. Neuropathic pain was found to complicate SMILE in 13.3% and LASIK in 10.5% of eyes. Preoperative risk factors include mean refractive spherical equivalent >−8.0D for SMILE and poorer corneal nerve metrics for LASIK. Postoperative NCP eyes were found to have higher tear concentrations of NGF, CGRP, FZD7, and NME3. The incidence of RD, for a follow-up period of at least 2 years …","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"14 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639766","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":"Reference values of spherical equivalent for predicting the onset and progression of myopia among children and adolescents in China","authors":"Ran Qin, Yang Liu, Hongtian Li, Ying Xiong, Fang Gu, Wei Shi, Ting Li, Huiyu Xu, Huijuan Luo, Xin Guo, Jianmeng Liu","doi":"10.1136/bjo-2024-326815","DOIUrl":"https://doi.org/10.1136/bjo-2024-326815","url":null,"abstract":"Background/aims To establish sex-specific and grade-specific reference values of cycloplegic spherical equivalent (SE) for predicting myopia onset and progression in Chinese children and adolescents. Methods Between 2020 and 2024, vision screening was conducted among 67 260 Chinese students spanning kindergarten to high school. Myopia was defined as a cycloplegic SE of ≤−0.50 diopters (D) and high myopia as ≤−6.00D. The lambda-mu-sigma method was used to estimate centiles of cycloplegic SE for −0.50D and −6.00D at each grade. Based on this, reference values for predicting future myopia and its progression to high myopia were determined for all grades. Results Among boys in grade 12 (the third year of high school), the estimated prevalence of myopia and high myopia was 82.4% and 11.6%, respectively. For boys in grades 0–11, the cycloplegic SE values at the 82.4th and 11.6th percentiles served as reference values to predict myopia and high myopia, respectively, in grade 12. For example, among senior kindergarten boys (grade 0), those with cycloplegic SE >1.54D (82.4th percentile) were predicted to remain non-myopic before grade 12, whereas those with SE >0.19D (11.6th percentile) were not expected to develop high myopia before grade 12. Conclusions Reference values for predicting myopia and high myopia among Chinese students were established, but these values may not be applicable to populations beyond China. Nevertheless, the proposed methods could be applied to settings where student myopia prevalence patterns remain relatively stable. Data are available upon reasonable request. Researchers should submit a research plan outlining the objective and any proposed analyses, and request the de-identified participant data via the following email: guoxin@chinacdc.cn or liujm@pku.edu.cn.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"27 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533102","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":"Differentiating treatment episodes from gaps in eyes with diabetic macular oedema","authors":"Yohei Hashimoto, Adrian Robert Hunt, Rufino Silva, Antonella Witmer, Wajiha Jurdi Kheir, Francesco Viola, Maite Arrazola, Mohamed Moghazy Mahgoub, Andreas Pollreisz, Zanne Harvey, Daniel Barthelmes, Mark C Gillies","doi":"10.1136/bjo-2025-327238","DOIUrl":"https://doi.org/10.1136/bjo-2025-327238","url":null,"abstract":"The treatment of diabetic macular oedema (DMO) likely involves a series of treatment episodes separated by gaps during which no vascular endothelial growth factor inhibitor injections are delivered. Our aim is to differentiate the episodes and gaps with the isolation forests algorithm using the Fight Retinal Blindness! registry. We analysed 11 786 injection intervals (12 803 injections) and found that the period between adjacent injections≥38 weeks (95% CI 34 to 43 weeks) apart could be regarded as a treatment gap. The results will allow treatment episodes to be isolated so that the treatment patterns of DMO can be characterised more accurately. No data are available.","PeriodicalId":9313,"journal":{"name":"British Journal of Ophthalmology","volume":"27 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533106","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}