Clinical ophthalmology (Auckland, N.Z.)最新文献

{"title":"Long-Term Observation of Prognostic Factors and Clinical Outcome of Vernal Keratoconjunctivitis in Childhood.","authors":"Asami Shimokawa, Aya Ikeda, Kazuhiro Harada, Rie Takahashi, Jane Huang, Tomoko Tsukahara-Kawamura, Hiroaki Ozaki, Eiichi Uchio","doi":"10.2147/OPTH.S472826","DOIUrl":"10.2147/OPTH.S472826","url":null,"abstract":"<p><strong>Purpose: </strong>Vernal keratoconjunctivitis (VKC) is a refractory ocular allergic disorder that mainly affects boys. Long-term follow-up has been rarely reported for VKC. We investigated the long-term clinical outcome of VKC to identify relevant clinical features of prognostic value based on follow-up for a median of 70 months.</p><p><strong>Methods: </strong>In total, 45 consecutive patients clinically diagnosed with VKC aged 4 to 12 years at onset at the Department of Ophthalmology of Fukuoka University Hospital were included. Patients were treated with immunosuppressive eye drops without simultaneous corticosteroid eye drops, except for the occurrence of exacerbations. Collated variables were gender, age at onset, clinical score of ocular lesions (conjunctival giant papillae, limbal edema and corneal epithelial lesions) at the first visit, and clinical score of atopic dermatitis (AD) at baseline. Cumulative cure rate was estimated using Kaplan-Meier method. A binomial logistic predictive model was used to determine the most reliable clinical predictors of VKC outcome.</p><p><strong>Results: </strong>The observation period ranged from 24 to 188 months, with median of 70 months. Among the 45 cases enrolled, all non-cured cases (14 cases) observed clinically were complicated by AD. Cumulative cure rate was 74.5% and 84.9% at eight- and ten-year follow-up, respectively. Ten-year cumulative cure rates of cases with and without AD were 50.5% and 100%, respectively, and a significant difference was found between these cumulative cure curves. Binomial regression analysis revealed that AD and gender were significantly related to worse outcome, and this binomial regression model had high sensitivity and specificity.</p><p><strong>Conclusion: </strong>This study demonstrated that th eclinical outcomeof VKC might be predicted by several factors that can beobtained in the early clinical phase. Information on the long-term prognosis of VKC patients might play an important role for precision medicine for VKC in childhood.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082883","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":"The MOSAIC Study: A Mixed-Methods Study of the Clinical, Emotional, and Financial Burden of Geographic Atrophy Among Patients and Caregivers in the US.","authors":"Sophie J Bakri, Winfried M K Amoaku, Danielle Altman, Stéphane Quéré, Jaclyn Quilantan, Julia Carpenter-Conlin, Sujata P Sarda, Daniel L Jones, Jared S Nielsen","doi":"10.2147/OPTH.S455984","DOIUrl":"10.2147/OPTH.S455984","url":null,"abstract":"<p><strong>Purpose: </strong>Geographic atrophy (GA) impacts both patients and caregivers, yet little is understood about their respective burdens. The MOSAIC study aimed to identify the clinical, emotional, and financial burden among patients with GA and caregivers.</p><p><strong>Methods: </strong>A total of 28 patients with GA and 17 caregivers from the United States (US), the United Kingdom, and Australia participated in individualized qualitative interviews followed by a cross-sectional quantitative survey of 102 patients and 102 caregivers in the US. Interview transcripts were analyzed to develop conceptual models, which were then used to guide the design of quantitative surveys. Data were described at the item level and score level when appropriate (National Eye Institute Visual Function Questionnaire [NEI VFQ]-39 and Zarit Burden Interview [ZBI]). For the patient/caregiver dyad sample, the association between the NEI VFQ-39 scores and ZBI score was explored through correlation coefficients and scatterplots.</p><p><strong>Results: </strong>GA had a substantial impact on patients' vision-related quality of life, activities of daily living, and instrumental activities of daily living. There was considerable overlap between perspectives and key concerns identified by patients and caregivers. Eighty-three percent of caregivers reported having to drive patients to appointments due to limited patient mobility, for example, and 41% reported a change in their employment status after becoming a caregiver, with 50% of them unable to work due to caregiving. The burden of patients and caregivers had a correlation ranging from -0.63 to -0.21 between NEI VFQ-39 subscale and composite scores and ZBI score.</p><p><strong>Conclusion: </strong>This study confirms the paucity of support for both patients with GA and caregivers. Both groups require expanded access to financial, social, and mental health resources.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082886","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":"Telemedicine at a University Ophthalmology Practice During the Beginning of the COVID-19 Pandemic.","authors":"Anthony C Oganov, Timothy Y Chou, Paris M Hanson, Azin Abazari, Preston Kung, Sarah B Weissbart, Jacqueline N Lenoci, Robert A Honkanen","doi":"10.2147/OPTH.S460454","DOIUrl":"10.2147/OPTH.S460454","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the research was to evaluate the use of teleophthalmology at a university practice during the COVID-19 pandemic, specifically examining precision, effectiveness, and patient satisfaction.</p><p><strong>Patients and methods: </strong>Telemedicine visits were offered to new and established patients requesting appointments with the Stony Brook University Department of Ophthalmology between March 30 and June 2, 2020. Records from these visits were reviewed for chief complaint, past medical and ocular history, diagnoses, treatment/management, and providers' sub-specialty. Precision was determined by comparing agreement between diagnoses of the telemedicine visit with those of the subsequent in-person visit. The decision to follow up in person was made by the physician and patient. Diagnostic precision as well as progression, improvement, or stability of patients' symptoms were determined by the physician's assessment at follow-up visits. Post-telemedicine visit satisfaction surveys were sent to all patients.</p><p><strong>Results: </strong>Telemedicine visits were offered to 783 patients, 520 (66.4%) of whom accepted. Of these 520 patients, 409 (78.7%) were established and 105 (20.2%) had in-person, follow-up visits. Overall, the diagnostic precision of the follow-up visits was 89.5%. Precision differed significantly across ophthalmologic subspecialties. Of the patients who had in-person follow-up visits, 56.8% remained stable, 32.4% improved, and 10.8% worsened. Established patients presented with more extensive ocular histories/procedures and experienced a higher percentage of worsening symptoms/disease stage compared to new patients. Oculoplastics/orbit was the most prevalent diagnostic subspecialty that worsened. Surveys were sent to all patients completing telemedicine visits, 15.0% of whom responded. Overall satisfaction was 91.9%, although only 23.0% of respondents preferred telemedicine to an in-office visit.</p><p><strong>Conclusion: </strong>Telehealth provides high levels of precision and patient satisfaction for a wide range of ophthalmologic visits, although most patients still prefer in-office examinations. Employing teleophthalmology for follow-up and emergency care may provide patients with an effective alternative during pandemic situations and beyond.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082884","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":"The Importance of HOA Reduction Measurements to Improving Refractive Surgery Result Outcomes [Response to Letter].","authors":"Anastasios John Kanellopoulos, Matthias Maus, Chandra Bala, Cody Hamilton, Sissimos Lemonis, Maria Elena Jockovich, Ramin Khoramnia","doi":"10.2147/OPTH.S491356","DOIUrl":"10.2147/OPTH.S491356","url":null,"abstract":"","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11350223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115997","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":"The Importance of HOA Reduction Measurements to Improving Refractive Surgery Result Outcomes [Letter].","authors":"Manoj Motwani","doi":"10.2147/OPTH.S488240","DOIUrl":"10.2147/OPTH.S488240","url":null,"abstract":"","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082885","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 Corneal Cross-Linking Effect on Progressive Keratoconus by Using the ABCD Grading System.","authors":"Mazen Alzahrani, Omer Alammari, Abdulelah Binyamin, Raed Alsulami, Rawan Hawsawi","doi":"10.2147/OPTH.S460464","DOIUrl":"10.2147/OPTH.S460464","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to assess changes in corneal parameters 6 months after corneal cross-linking for progressive keratoconus, using the ABCD system.</p><p><strong>Patients and methods: </strong>This retrospective study was conducted at the King Khaled Eye Specialist Hospital (Riyadh, Saudi Arabia) between January 1 and July 30, 2022. This study included 16 eyes of 16 patients with keratoconus who underwent corneal cross-linking at the same hospital and were at least 18 years old. At least one preoperative (T0) and one postoperative examination was performed for each patient. Six months after the procedure (T1), patients underwent corneal tomography. The parameters A, B, C, and D were also evaluated. Other parameters monitored included maximal keratometry (Kmax) (K1 and K2), Belin/Ambrósio Enhanced Ectasia Display, and index vertical asymmetry. The progression of ectasia was identified by a consistent change in at least two parameters: steepening of the anterior corneal surface or the posterior corneal surface, thinning or an increase in the rate at which the corneal thickness changed from the periphery to the thinnest point, where the magnitude of the change was greater than the normal noise of the testing system.</p><p><strong>Results: </strong>Among the patients, 68.8% were men. The patients' average age was 25.8±5 years. Throughout the 6-month postoperative follow-up, parameters A, B, and C exhibited substantial changes (P = 0.000 for parameters A, B, and C). Parameter A increased 6 months after surgery, whereas parameters B and C decreased. Preoperatively and 6 months after surgery, Kmax, K1, and Belin/Ambrosio-enhanced ectasia demonstrated substantial differences. However, parameter D, K2, and the average pachymetric progression index did not change significantly.</p><p><strong>Conclusion: </strong>Anterior and posterior corneal curvatures and corneal thickness profiles can be useful for monitoring the progression of keratoconus and the success of the corneal cross-linking operation.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074812","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":"Factors Affecting Outcomes of Stereoacuity in Partially Refractive Accommodative Esotropia with Motor Success Treated by Preoperative Prism Correction and Surgery.","authors":"Teiji Yagasaki, Yoshimi Yokoyama, Ayaka Yagasaki, Kenta Hozumi, Sho Ichikawa","doi":"10.2147/OPTH.S470504","DOIUrl":"10.2147/OPTH.S470504","url":null,"abstract":"<p><strong>Purpose: </strong>Favorable stereoacuity does not develop in all patients with partially refractive accommodative esotropia (PRAET) successfully aligned, and there have been few previous reports on the factors influencing stereoacuity outcomes in patients with PRAET treated with prismatic correction (PPC) and/or surgery. This study aimed to analyze factors affecting stereoacuity outcomes in patients of PRAET treated with PPC and surgery.</p><p><strong>Study design: </strong>Retrospective study.</p><p><strong>Methods: </strong>Sixty-six patients with alignment within 10 prism diopters at final visit with PPC and surgery were included. According to the final stereoacuity, patients were grouped into the fine group (≤60 arcsec (\")), the coarse group (60 \"<, 3000\" ≤), and absent stereoacuity group. Preoperative patient characteristics were compared among three groups using analysis of variance. Comparison of final stereoacuity among three groups based on age at onset (very early: ≤6 months; early: >6 months, ≤2 years; late: >2 years) was carried out with the Kruskal-Wallis test.</p><p><strong>Results: </strong>There were no differences in ages at initial PPC, at surgery, at final visit, durations of misalignment, of PPC, or after surgery; however, significant differences in ages at onset and initial visit were found. Age at onset in the absent group was significantly earlier than those of the fine and the coarse groups (p < 0.001 and p < 0.001, respectively). Moreover, of the 25 patients with age at onset >2 years, 18 patients (72%) showed fine or coarse stereoacuity (p < 0.001).</p><p><strong>Conclusion: </strong>Although stereoacuity outcomes in patients with early onset were poor despite of the finally successful alignments obtained with PPC and surgery, fine stereoacuity and coarse stereoacuity were obtained in 24% and 44% of patients with age at onset >2 years.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11345015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057600","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":"Safety and Effectiveness of Smooth Incision Lenticular Keratomileusis (SILK™) Using the ELITA™ Femtosecond Laser System for Correction of Myopic and Astigmatic Refractive Errors [Response to Letter].","authors":"Mahipal S Sachdev, Rohit Shetty, Pooja Khamar, Raghav Malik, Brian L Schwam, Ying Wang, Hong Fu, Andrew P Voorhees, Michal Laron","doi":"10.2147/OPTH.S488267","DOIUrl":"10.2147/OPTH.S488267","url":null,"abstract":"","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11345012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057601","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":"Correlation of Macular Ganglion Cell Layer + Inner Plexiform Layer (GCL + IPL) and Circumpapillary Retinal Nerve Fiber Layer (cRNFL) Thickness in Glaucoma Suspects and Glaucomatous Eyes.","authors":"Marie Jeremy B San Pedro, George Michael N Sosuan, Maria Imelda R Yap-Veloso","doi":"10.2147/OPTH.S439501","DOIUrl":"10.2147/OPTH.S439501","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to correlate macular ganglion cell layer + inner plexiform layer (GCL + IPL) thickness and circumpapillary retinal nerve fiber layer (cRNFL) thickness and to determine the validity of GCL + IPL in the evaluation of glaucoma across different stages using the area under the curve (AUC) analysis in comparison to cRNFL.</p><p><strong>Patients and methods: </strong>The charts of 260 adult glaucoma suspect and glaucoma patients having macular ganglion cell analysis, optical coherence tomography (OCT) of the cRNFL and automated visual field (AVF) were reviewed. GCL + IPL thickness (average, minimum and sectoral) and sectoral cRNFL thickness were obtained. Glaucomatous eyes were further classified into stages based on the Hodapp-Anderson-Parrish Visual Field Criteria of Glaucoma Severity. AUC analysis was used to compare GCL + IPL parameters with cRNFL in glaucoma suspects and glaucoma patients.</p><p><strong>Results: </strong>A total of 122 eyes were included in the study and were grouped into glaucoma suspects (n = 43), early or mild glaucoma (n = 40), and moderate-to-severe glaucoma (n = 39). Both GCL + IPL and cRNFL thickness parameters showed a significant decline with greater glaucoma severity. In the determination of visual field defects across all glaucoma stages, the highest AUC was obtained by minimum GCL + IPL (AUC = 0.859) with cut-off value at ≤70 µm. Average GCL + IPL had the highest AUC (0.835) in detecting progression from glaucoma suspect to mild glaucoma, while the inferior sector of the cRNFL had the highest AUC (0.937) in discerning mild from moderate-to-severe glaucoma.</p><p><strong>Conclusion: </strong>The results of this study highlight the significance of macular ganglion cell analysis in the screening, detection and staging of glaucoma. Compared to cRNFL, macular ganglion analysis may be more beneficial in glaucoma screening and detecting progression from glaucoma suspect to mild glaucoma.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11344544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057599","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":"Scheimpflug Tomography as a Predictor of Corneal Edema After Phacoemulsification in Fuchs Endothelial Corneal Dystrophy.","authors":"Taher K Eleiwa, Mona Abd El-Azim Mohammed, Ahmed Sherin M Bayoumy","doi":"10.2147/OPTH.S474788","DOIUrl":"10.2147/OPTH.S474788","url":null,"abstract":"<p><strong>Purpose: </strong>To determine if Scheimpflug tomography pachymetry map and posterior elevation map patterns can predict the occurrence of corneal edema following uneventful phacoemulsification surgery in Fuchs endothelial corneal dystrophy (FECD).</p><p><strong>Design: </strong>Observational prospective case-control study.</p><p><strong>Participants: </strong>Fifty FECD eyes (50 patients) with visually significant cataract: 25 with subclinical corneal edema (SCE) versus 25 without SCE.</p><p><strong>Methods: </strong>Preoperatively, FECD was clinically assessed, and only patients devoid of clinical corneal edema were enrolled. Utilizing the Mayo Clinic classification for subclinical corneal edema (SCE), eligible FECD eyes were stratified based on Scheimpflug imaging pachymetry map and posterior elevation map characteristics, including loss of regular isopachs, displacement of the cornea's thinnest point, and the presence of posterior surface depression, into two groups: Group A representing FECD with SCE, and Group B: FECD without SCE. One week postoperatively, clinical and tomographic evaluation was performed. Regression analysis was conducted to evaluate predictors of corneal edema after uneventful phacoemulsification surgery in both groups.</p><p><strong>Results: </strong>All patients were successfully imaged before and 1 week after surgery. Visual acuity was significantly improved in both groups (P < 0.001). No postoperative clinical edema was observed in Group B, while 23 (92%) had mild edema and 2 (8%) had moderate edema in Group A. Both groups showed a significant increase in postoperative central corneal thickness (CCT) and thinnest corneal thickness (TCT) (both P < 0.001). Compared to Group B, Group A showed a significant central flattening of the anterior corneal surface (P = 0.007 and P = 0.04 for K1 and K2 respectively), and a significant increase in the postoperative posterior surface depression. Multivariate analysis showed that 94% of postoperative corneal edema could be predicted by the presence of preoperative posterior surface depression (P = 0.04, ARR = 5.8 (1.89-35.7)).</p><p><strong>Conclusion: </strong>Scheimpflug tomography pachymetry map and posterior elevation map patterns can predict corneal edema after uneventful phacoemulsification surgery in FECD with subclinical corneal edema.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11342942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057602","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}