Pub Date : 2023-10-13DOI: 10.2174/18743641-v17-230822-2022-61
Andrew C.W. Robart, Abbey F. J. Alexander, Adil Al-Mehiawi, Ismael Abuallut, Nir Shoham Hazon
Background: Morquio Syndrome or Mucopolysaccharidosis Type IV (MPS IV) is a rare inherited metabolic disorder characterized by the deficiency of certain lysosomal enzymes involved in the breakdown of mucopolysaccharides. The deficiency results in proteoglycan accumulation, particularly keratan sulfate in various tissues in the body. Morquio Syndrome is classified into two subtypes: Morquio A and Morquio B, which are distinguished by the specific enzyme deficiency involved, with Morquio A being more prevalent. Morquio Syndrome commonly affects the eyes with 46.7% of diagnosed patients experiencing ocular symptoms related to the disorder. Objective: To perform a comprehensive review of the existing literature and summarize the ophthalmological manifestations of Morquio Syndrome. Methods: A methodical literature search was conducted, including papers with abstracts discussing ophthalmology or ocular pathology of “Mucopolysaccharidosis Type IV” or ” Morquio Syndrome.” Twelve relevant articles met the inclusion criteria and were included in the review. Seven of the articles consisted of case reports, collectively reporting on forty-one patients with Morquio Syndrome, primarily Morquio A. The outcome of the narrative review is an overview of the existing literature on ocular presentations of Morquio Syndrome and a summary of case report findings. Results: Forty-one different patients were identified from the included case reports, and forty patients were included as they presented with ocular pathology related to Morquio Syndrome. Corneal opacification was the most common presentation where twenty-seven patients had significant corneal opacification and seven patients had slight corneal opacification. Small, gray, spherical, dust-like opacities that dispersed among the stroma were most commonly seen in cases with corneal opacification. Other ocular presentations included decreased visual acuity, astigmatism, lens opacities, and glaucoma. Conclusion: Morquio syndrome, a rare genetic disorder, exhibits multiple ocular symptoms, with corneal opacification being the most common. While most research has concentrated on Morquio A, the more severe subtype, there's limited information on Morquio B, highlighting a need for more comparative studies. As the syndrome remains incurable, exploring new treatment avenues and understanding the reasons behind these ocular manifestations can significantly improve the quality of life for Morquio patients.
背景:Morquio综合征或粘多糖病IV型(MPS IV)是一种罕见的遗传性代谢疾病，其特征是参与粘多糖分解的某些溶酶体酶缺乏。这种缺乏会导致蛋白聚糖的积累，尤其是硫酸角朊在体内的各种组织中。Morquio综合征分为两种亚型:Morquio A和Morquio B，这两种亚型根据所涉及的特定酶缺乏症来区分，其中Morquio A更为普遍。莫基奥综合征通常影响眼睛，46.7%的确诊患者出现与该疾病相关的眼部症状。目的:对现有文献进行综合复习，总结Morquio综合征的眼科表现。方法:系统地检索文献，包括讨论“粘多糖病IV型”或“Morquio综合征”的眼科或眼部病理的论文摘要。12篇相关文章符合纳入标准，被纳入本综述。其中7篇文章由病例报告组成，共报道了41例Morquio综合征患者，主要是Morquio a .叙述性回顾的结果是对Morquio综合征眼部表现的现有文献的概述和病例报告结果的总结。结果:从纳入的病例报告中确定了41例不同的患者，其中40例患者因出现与Morquio综合征相关的眼部病理而被纳入。角膜混浊是最常见的表现，27例患者有明显的角膜混浊，7例患者有轻微的角膜混浊。小的、灰色的、球形的尘埃样混浊物分散在基质中，最常见于角膜混浊。其他眼部表现包括视力下降、散光、晶状体混浊和青光眼。结论:Morquio综合征是一种罕见的遗传性疾病，表现为多种眼部症状，以角膜混浊最为常见。虽然大多数研究都集中在更严重的亚型Morquio A上，但关于Morquio B的信息有限，这表明需要进行更多的比较研究。由于该综合征仍然无法治愈，探索新的治疗途径并了解这些眼部表现背后的原因可以显着提高Morquio患者的生活质量。
{"title":"A Narrative Review of Morquio Syndrome: Mucopolysaccharidosis (MPS) Type IV","authors":"Andrew C.W. Robart, Abbey F. J. Alexander, Adil Al-Mehiawi, Ismael Abuallut, Nir Shoham Hazon","doi":"10.2174/18743641-v17-230822-2022-61","DOIUrl":"https://doi.org/10.2174/18743641-v17-230822-2022-61","url":null,"abstract":"Background: Morquio Syndrome or Mucopolysaccharidosis Type IV (MPS IV) is a rare inherited metabolic disorder characterized by the deficiency of certain lysosomal enzymes involved in the breakdown of mucopolysaccharides. The deficiency results in proteoglycan accumulation, particularly keratan sulfate in various tissues in the body. Morquio Syndrome is classified into two subtypes: Morquio A and Morquio B, which are distinguished by the specific enzyme deficiency involved, with Morquio A being more prevalent. Morquio Syndrome commonly affects the eyes with 46.7% of diagnosed patients experiencing ocular symptoms related to the disorder. Objective: To perform a comprehensive review of the existing literature and summarize the ophthalmological manifestations of Morquio Syndrome. Methods: A methodical literature search was conducted, including papers with abstracts discussing ophthalmology or ocular pathology of “Mucopolysaccharidosis Type IV” or ” Morquio Syndrome.” Twelve relevant articles met the inclusion criteria and were included in the review. Seven of the articles consisted of case reports, collectively reporting on forty-one patients with Morquio Syndrome, primarily Morquio A. The outcome of the narrative review is an overview of the existing literature on ocular presentations of Morquio Syndrome and a summary of case report findings. Results: Forty-one different patients were identified from the included case reports, and forty patients were included as they presented with ocular pathology related to Morquio Syndrome. Corneal opacification was the most common presentation where twenty-seven patients had significant corneal opacification and seven patients had slight corneal opacification. Small, gray, spherical, dust-like opacities that dispersed among the stroma were most commonly seen in cases with corneal opacification. Other ocular presentations included decreased visual acuity, astigmatism, lens opacities, and glaucoma. Conclusion: Morquio syndrome, a rare genetic disorder, exhibits multiple ocular symptoms, with corneal opacification being the most common. While most research has concentrated on Morquio A, the more severe subtype, there's limited information on Morquio B, highlighting a need for more comparative studies. As the syndrome remains incurable, exploring new treatment avenues and understanding the reasons behind these ocular manifestations can significantly improve the quality of life for Morquio patients.","PeriodicalId":46347,"journal":{"name":"Open Ophthalmology Journal","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135923083","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}
Pub Date : 2023-10-10DOI: 10.2174/18743641-v17-231005-2023-13
Brittany J. McMurren, Michael A. Kling, Andrew Fasciani, M. Henrietta Nymark-McMahon
Background: MGD (meibomian gland dysfunction) is a chronic cause of dry eyes. Thermal expression of the meibomian glands, along with massage and debridement, is an effective treatment for MGD. Objective: We describe a multi-modal thermal device (MGrx) to manage meibomian gland dysfunction (MGD). We observed the efficacy and safety of the MGrx to manage MGD in one 15-minute in-office session. Methods: We enrolled 37 patients in a prospective, open-label trial of the novel MGrx. Patients were enrolled with a Standard Patient Evaluation for Eye Dryness (SPEED) score > 12 or a Tear Breakup Time (TBUT) of < 6 seconds in at least one eye. After screening for eligibility, one 15-minute MGrx treatment was provided to each patient. The patient assessment consisted of a SPEED score, TBUT, and a Meibomian gland score (MGS) obtained pre-treatment and at a follow-up visit 30 days after the treatment. Results: Dry eye symptoms improved in the patient population, as measured by SPEED score, MGS, and TBUT, by 40%, 341%, and 145%, respectively (p<0.05). No adverse reactions were noted among the patients. Conclusion: A single 15-minute MGrx treatment was effective at significantly improving dry eye symptoms secondary to MGD in adult patients, as measured by SPEED score. Additionally, a single MGrx treatment improved meibomian gland function and all measures of MGD in the adult patients treated. Given the relatively low risk and efficient delivery of the MGrx treatment, a single MGrx treatment should be considered as a first-line treatment for MGD.
{"title":"MGrx - A Novel Multi-modal Thermal Device for Treating Moderate to Severe Meibomian Gland Dysfunction and Dry Eye","authors":"Brittany J. McMurren, Michael A. Kling, Andrew Fasciani, M. Henrietta Nymark-McMahon","doi":"10.2174/18743641-v17-231005-2023-13","DOIUrl":"https://doi.org/10.2174/18743641-v17-231005-2023-13","url":null,"abstract":"Background: MGD (meibomian gland dysfunction) is a chronic cause of dry eyes. Thermal expression of the meibomian glands, along with massage and debridement, is an effective treatment for MGD. Objective: We describe a multi-modal thermal device (MGrx) to manage meibomian gland dysfunction (MGD). We observed the efficacy and safety of the MGrx to manage MGD in one 15-minute in-office session. Methods: We enrolled 37 patients in a prospective, open-label trial of the novel MGrx. Patients were enrolled with a Standard Patient Evaluation for Eye Dryness (SPEED) score > 12 or a Tear Breakup Time (TBUT) of < 6 seconds in at least one eye. After screening for eligibility, one 15-minute MGrx treatment was provided to each patient. The patient assessment consisted of a SPEED score, TBUT, and a Meibomian gland score (MGS) obtained pre-treatment and at a follow-up visit 30 days after the treatment. Results: Dry eye symptoms improved in the patient population, as measured by SPEED score, MGS, and TBUT, by 40%, 341%, and 145%, respectively (p<0.05). No adverse reactions were noted among the patients. Conclusion: A single 15-minute MGrx treatment was effective at significantly improving dry eye symptoms secondary to MGD in adult patients, as measured by SPEED score. Additionally, a single MGrx treatment improved meibomian gland function and all measures of MGD in the adult patients treated. Given the relatively low risk and efficient delivery of the MGrx treatment, a single MGrx treatment should be considered as a first-line treatment for MGD.","PeriodicalId":46347,"journal":{"name":"Open Ophthalmology Journal","volume":"93 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136360965","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}
Pub Date : 2023-10-04DOI: 10.2174/18743641-v17-e230925-2023-7
Ayoob Lone, Fahad Abdullah Saeed AlWadani, Abdulrahman Alnaim
Objective: The risk factors for vision problems in youngsters are relatively unknown in Saudi Arabia. The purpose of this study was to examine the determinants of refractive errors among school-going children attending the ophthalmic clinic of AlMoosa Hospital in Saudi Arabia. Methodology: A sample of 161 school-going children were recruited voluntarily to complete a set of measures examining the determinants of refractive errors. The binary logistic regression model was applied to determine the relationship between independent and dependent variables. Results: Refractive errors were common among Saudi school-going children, with myopia being the most common type of refractive error. About 96 (59.6%) samples had myopia, 28 (17.4%) children had hyperopia and 27 (16.8%) children did not have any refractive error. Genetic traits and machine dependence were found to be significant predictors of refractive error. Conclusion: The preschool eye test and routine vision investigation should be performed on children to detect refractive errors early.
{"title":"Determinants of Refractive Errors on School-going Children Attending Ophthalmic Clinic of AlMoosa Hospital in Saudi Arabia","authors":"Ayoob Lone, Fahad Abdullah Saeed AlWadani, Abdulrahman Alnaim","doi":"10.2174/18743641-v17-e230925-2023-7","DOIUrl":"https://doi.org/10.2174/18743641-v17-e230925-2023-7","url":null,"abstract":"Objective: The risk factors for vision problems in youngsters are relatively unknown in Saudi Arabia. The purpose of this study was to examine the determinants of refractive errors among school-going children attending the ophthalmic clinic of AlMoosa Hospital in Saudi Arabia. Methodology: A sample of 161 school-going children were recruited voluntarily to complete a set of measures examining the determinants of refractive errors. The binary logistic regression model was applied to determine the relationship between independent and dependent variables. Results: Refractive errors were common among Saudi school-going children, with myopia being the most common type of refractive error. About 96 (59.6%) samples had myopia, 28 (17.4%) children had hyperopia and 27 (16.8%) children did not have any refractive error. Genetic traits and machine dependence were found to be significant predictors of refractive error. Conclusion: The preschool eye test and routine vision investigation should be performed on children to detect refractive errors early.","PeriodicalId":46347,"journal":{"name":"Open Ophthalmology Journal","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135647604","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}
Pub Date : 2023-08-03DOI: 10.2174/18743641-v17-20230712-2023-8
Zoelfigar Mohamed, Saif Hassan Alrasheed
Background: Convergence insufficiency (CI) is one of the most common binocular vision disorders. The condition negatively affects the quality of life through its impact on near activities, while there is a large gap in the information on its global prevalence and consensus on treatment. Objectives: The purpose of this systematic review and meta-analysis was to assess the prevalence and treatment options available for convergence insufficiency. Methods: The study was performed in 2023 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-2020) guidelines. The authors have searched Google Scholar, Research Gate, Scopus, PubMed, Index Medicus, Web of Science, and the JAMA network. This review included peer-reviewed studies published between January 2000 to January 2023 that assessed the prevalence and treatment modalities of convergence insufficiency. Results: The authors screened 13250 studies, 20 for prevalence and 15 for treatment from 12 countries that met the inclusion criteria for the study. The overall pooled prevalence of convergence insufficiency was 7.98%, and the heterogeneity between the studies was highly significant P < 0.0001. Majorities of the studies 12(80%) reported that office-based vision therapy is the most effective treatment of CI, form those studies 5(42.0%) highlighted that office-based vergence/accommodative therapy with home reinforcement is the best modality of treatment. Whereas, home-based pencil push-up therapy, vision therapy with modified refractive correction, and vision therapy with prismatic correction were reported as effective treatment options for CI. The reviewed studies showed that vision therapy is highly effective to recover from symptomatic CI in both adults and children. Conclusion: The prevalence of convergence insufficiency was high, there was highly significant heterogeneity between the reviewed studies. Office-based vergence/accommodative therapy with home reinforcement is the best modality of treatment, followed by home-based pencil push-up therapy, vision therapy with modified refractive correction, and vision therapy with prismatic correction. There is consensus among reviewed studies that vision therapy is highly effective to recover from symptomatic CI in both adults and children.
背景:会聚不全是最常见的双目视力障碍之一。这种情况通过对附近活动的影响对生活质量产生负面影响，而关于其全球流行程度的信息和对治疗的共识存在很大差距。目的:本系统综述和荟萃分析的目的是评估收敛功能不全的患病率和可用的治疗方案。方法:该研究于2023年使用系统评价和荟萃分析首选报告项目(PRISMA-2020)指南进行。作者检索了Google Scholar、Research Gate、Scopus、PubMed、Index Medicus、Web of Science和JAMA网络。本综述纳入了2000年1月至2023年1月间发表的同行评议研究，评估了趋同功能不全的患病率和治疗方式。结果:作者筛选了来自12个国家的13250项研究，其中20项是患病率研究，15项是治疗研究，符合研究的纳入标准。收敛性不全的总发生率为7.98%，各研究间异质性极显著P <0.0001. 大多数研究12(80%)报告说，以办公室为基础的视力治疗是最有效的CI治疗，而那些研究5(42.0%)强调以办公室为基础的融合/适应性治疗与家庭强化是最好的治疗方式。然而，据报道，基于家庭的铅笔俯仰疗法、改良屈光矫正视力疗法和棱镜矫正视力疗法是CI的有效治疗选择。所回顾的研究表明，视力治疗对成人和儿童症状性CI的恢复都是非常有效的。结论:收敛功能不全的患病率较高，所回顾的研究之间存在高度显著的异质性。以办公室为基础的融合/调节治疗和家庭强化治疗是最好的治疗方式，其次是以家庭为基础的铅笔俯身治疗、改良屈光矫正视力治疗和棱镜矫正视力治疗。在回顾的研究中有一个共识，即视力治疗对于成人和儿童症状性CI的恢复都是非常有效的。
{"title":"A Systematic Review and Meta-analysis of Convergence Insufficiency Prevalence and Management Options","authors":"Zoelfigar Mohamed, Saif Hassan Alrasheed","doi":"10.2174/18743641-v17-20230712-2023-8","DOIUrl":"https://doi.org/10.2174/18743641-v17-20230712-2023-8","url":null,"abstract":"Background: Convergence insufficiency (CI) is one of the most common binocular vision disorders. The condition negatively affects the quality of life through its impact on near activities, while there is a large gap in the information on its global prevalence and consensus on treatment. Objectives: The purpose of this systematic review and meta-analysis was to assess the prevalence and treatment options available for convergence insufficiency. Methods: The study was performed in 2023 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-2020) guidelines. The authors have searched Google Scholar, Research Gate, Scopus, PubMed, Index Medicus, Web of Science, and the JAMA network. This review included peer-reviewed studies published between January 2000 to January 2023 that assessed the prevalence and treatment modalities of convergence insufficiency. Results: The authors screened 13250 studies, 20 for prevalence and 15 for treatment from 12 countries that met the inclusion criteria for the study. The overall pooled prevalence of convergence insufficiency was 7.98%, and the heterogeneity between the studies was highly significant P < 0.0001. Majorities of the studies 12(80%) reported that office-based vision therapy is the most effective treatment of CI, form those studies 5(42.0%) highlighted that office-based vergence/accommodative therapy with home reinforcement is the best modality of treatment. Whereas, home-based pencil push-up therapy, vision therapy with modified refractive correction, and vision therapy with prismatic correction were reported as effective treatment options for CI. The reviewed studies showed that vision therapy is highly effective to recover from symptomatic CI in both adults and children. Conclusion: The prevalence of convergence insufficiency was high, there was highly significant heterogeneity between the reviewed studies. Office-based vergence/accommodative therapy with home reinforcement is the best modality of treatment, followed by home-based pencil push-up therapy, vision therapy with modified refractive correction, and vision therapy with prismatic correction. There is consensus among reviewed studies that vision therapy is highly effective to recover from symptomatic CI in both adults and children.","PeriodicalId":46347,"journal":{"name":"Open Ophthalmology Journal","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136381821","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}
Pub Date : 2023-03-03DOI: 10.2174/18743641-v17-e230214-2022-44
Kenneth M. Gilmour, David Young, Aaron Jamison, Monica Precup, David F. Gilmour
Background: The prevalence of polypoidal choroidal vasculopathy (PCV) is significantly higher amongst Asian populations compared to Caucasian, and evidence regarding the clinical outcomes of Caucasian patients is limited. Objective: This retrospective study sought to investigate real-world clinical outcomes of Caucasian PCV patients treated with polypoidal verteporfin photodynamic therapy (PDT) in combination with anti-VEGF therapy up to 36 months post-treatment. Methods: Consecutive PCV patients who received PDT between 2011 and 2017 were included. Mean change in visual acuity (VA) measured by ETDRS letter score and mean change in central subfield thickness (CST) were the main outcome measures. Data were collected at baseline, 3, 12, 24 and 36 months. Regression analyses were carried out on pre-treatment clinical features to determine if there were any factors associated with a good visual outcome (better than or equal to 70 ETDRS letters at 12 months). Results: Seventy six patients (96% Caucasian) and seventy eight eyes were included in the analysis. Mean change in VA was -1, -4, and 0 ETDRS letters at 12, 24, and 36 months, respectively. CST was reduced by a mean of -51, -54, and -55 microns at 12, 24, and 36 months, respectively. Better pre-treatment VA was the only pre-treatment clinical feature associated with a good visual outcome at 12 months (OR 1.16, p<0.001). Conclusion: PDT, in combination with anti-VEGF therapy, maintains VA and may reduce the anti-VEGF therapy burden in Caucasian patients with PCV. Better pre-treatment VA is associated with a good visual outcome.
{"title":"Photodynamic and Anti-VEGF Therapy for Polypoidal Choroidal Vasculopathy - ‘Real World’ Outcomes in a Caucasian Population","authors":"Kenneth M. Gilmour, David Young, Aaron Jamison, Monica Precup, David F. Gilmour","doi":"10.2174/18743641-v17-e230214-2022-44","DOIUrl":"https://doi.org/10.2174/18743641-v17-e230214-2022-44","url":null,"abstract":"Background: The prevalence of polypoidal choroidal vasculopathy (PCV) is significantly higher amongst Asian populations compared to Caucasian, and evidence regarding the clinical outcomes of Caucasian patients is limited. Objective: This retrospective study sought to investigate real-world clinical outcomes of Caucasian PCV patients treated with polypoidal verteporfin photodynamic therapy (PDT) in combination with anti-VEGF therapy up to 36 months post-treatment. Methods: Consecutive PCV patients who received PDT between 2011 and 2017 were included. Mean change in visual acuity (VA) measured by ETDRS letter score and mean change in central subfield thickness (CST) were the main outcome measures. Data were collected at baseline, 3, 12, 24 and 36 months. Regression analyses were carried out on pre-treatment clinical features to determine if there were any factors associated with a good visual outcome (better than or equal to 70 ETDRS letters at 12 months). Results: Seventy six patients (96% Caucasian) and seventy eight eyes were included in the analysis. Mean change in VA was -1, -4, and 0 ETDRS letters at 12, 24, and 36 months, respectively. CST was reduced by a mean of -51, -54, and -55 microns at 12, 24, and 36 months, respectively. Better pre-treatment VA was the only pre-treatment clinical feature associated with a good visual outcome at 12 months (OR 1.16, p<0.001). Conclusion: PDT, in combination with anti-VEGF therapy, maintains VA and may reduce the anti-VEGF therapy burden in Caucasian patients with PCV. Better pre-treatment VA is associated with a good visual outcome.","PeriodicalId":46347,"journal":{"name":"Open Ophthalmology Journal","volume":"286 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134946413","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}
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