Ocular Surface最新文献

{"title":"Re: Significant errors in the paper by Ballesteros-Sánchez A, Rocha-de-Lossada C and Sánchez-González J. Efficacy of eyelid warming devices as first-step treatment in meibomian gland dysfunction: A systematic review with meta-analysis. 2025; 37:33–46","authors":"Jacqueline Tan","doi":"10.1016/j.jtos.2025.04.003","DOIUrl":"10.1016/j.jtos.2025.04.003","url":null,"abstract":"","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Pages 443-444"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcriptional landscape of aniridia-associated keratopathy through single-cell RNA sequencing","authors":"Masahito Yoshihara ,&nbsp;Rei Kamuro ,&nbsp;Susumu Hara ,&nbsp;Nozomi Nishida ,&nbsp;Koji Ohmoto ,&nbsp;Yuzuru Sasamoto ,&nbsp;Satoshi Kawasaki ,&nbsp;Yoshinori Oie ,&nbsp;Kohji Nishida","doi":"10.1016/j.jtos.2025.05.008","DOIUrl":"10.1016/j.jtos.2025.05.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Aniridia-associated keratopathy (AAK) is a progressive condition characterized by conjunctivalization of the cornea, yet its molecular mechanisms remain largely unknown. This study aims to elucidate the transcriptional landscape of AAK by characterizing the gene expression profiles of corneal epithelial cells in a patient with congenital aniridia.</div></div><div><h3>Methods</h3><div>Single-cell RNA sequencing (scRNA-seq) was performed on epithelial tissues collected from the clear central corneal region and limbus of a 48-year-old female patient with congenital aniridia. The transcriptomic profiles were compared with those of healthy control samples.</div></div><div><h3>Results</h3><div>scRNA-seq analysis revealed that a subpopulation of cells from the clear central corneal region expressed the cornea-specific keratins <em>KRT3</em> and <em>KRT12</em> despite a significant reduction in <em>PAX6</em> expression. These cells exhibited corneal, conjunctival, or mixed gene signatures. Genes associated with wound healing and apoptosis were upregulated in the cornea-like cells from the aniridic cornea, indicating a chronic wound healing state. Elevated <em>KLF4</em> expression and regulon activity were observed in these cornea-like cells. Most limbal epithelial cells exhibited conjunctiva-like characteristics, reflecting a loss of limbal cell identity.</div></div><div><h3>Conclusion</h3><div>While acknowledging the limitations of a single case study, this study provides deeper insights into the transcriptional signatures associated with AAK using scRNA-seq. We identified transcriptional alterations reflecting AAK progression and highlighted potential transcription factors that may contribute to corneal identity maintenance despite PAX6 deficiency. These findings enhance our understanding of AAK and suggest potential therapeutic strategies to slow its progression.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Pages 43-52"},"PeriodicalIF":5.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pilot randomized controlled trial of topical androgen treatment in dry eye","authors":"Jay Ruzhang Jiang ,&nbsp;Rima Khankan ,&nbsp;William H. Ridder III ,&nbsp;Andrew Loc Nguyen ,&nbsp;Jerry R. Paugh","doi":"10.1016/j.jtos.2025.06.002","DOIUrl":"10.1016/j.jtos.2025.06.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the safety and efficacy of eyelid androgen gel application to treat moderate to severe dry eye disease.</div></div><div><h3>Methods</h3><div>Twenty four eyes of 24 subjects (12 eyes per arm) were randomized to either eyelid testosterone or vehicle gel. Subjects received either 17β-Hydroxyandrost-4-en-3-one) 4.5 % wt./wt. or vehicle gel, applied twice daily 12 h apart for 4 weeks. Outcome parameters were monitored at 2-, and 4-weeks during dosing, and at 4-, and 8-weeks following dosing cessation.</div></div><div><h3>Results</h3><div>Significant positive differences were found in the androgen arm only, for Schein symptom score, tear meniscus height (TMH), fluorescein tear breakup time (fTBUT) and meibum score (repeated ANOVA, all p = 0.046 or less for each arm comparison) at all follow-up visits compared to baseline. For example, fTBUT in the androgen arm at 4 weeks was 6.2 ± 1.5 s compared to baseline, 3.3 ± 0.9 secs p&lt; 0.001 (Dunnett's test, 95 % CI [1.838, 3.829]). No change was observed for either arm for staining, tear osmolarity, OSDI, non-invasive breakup time (NIBUT), serum lipid levels or hematocrit. Serum testosterone increased ∼ 9-fold in females (paired <em>t</em>-test; p = 0.006; CI [-240.2, −55.6]) in the androgen arm, but not males (paired <em>t</em>-test; p = 0.727; CI [-25.9, 31.2]).</div></div><div><h3>Conclusions</h3><div>Eyelid androgen gel application, 4.5 % wt./wt., was effective in improving tear fTBUT, symptoms, TMH and meibomian secretion grade in dry eye patients. Future research requires a larger sample size, outcome measure variability reduction and formulation optimization for absorption, androgen type, and dosing regimen.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Pages 56-63"},"PeriodicalIF":5.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric vs adult Stevens Johnson syndrome/toxic epidermal necrolysis: Ocular outcomes and the role of amniotic membrane","authors":"","doi":"10.1016/j.jtos.2025.10.008","DOIUrl":"10.1016/j.jtos.2025.10.008","url":null,"abstract":"","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Pages 388-389"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145412015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corneal sensory nerve regulation of tear production through stimulation of transient receptor potential melastatin 8 (TRPM8) channel: A potential new approach for treating dry eye disease","authors":"Juana Gallar ,&nbsp;Stephen Pflugfelder ,&nbsp;Anat Galor ,&nbsp;Preeya K. Gupta ,&nbsp;Pedram Hamrah","doi":"10.1016/j.jtos.2025.07.003","DOIUrl":"10.1016/j.jtos.2025.07.003","url":null,"abstract":"<div><div>The lacrimal functional unit (LFU) tightly controls the secretion of all tear components, thus playing a critical role in maintaining ocular surface homeostasis. Forming an exquisitely sensitive neural network across the ocular surface, corneal sensory nerves detect environmental stimuli (e.g., temperature, chemicals, and mechanical pressure) through transient receptor potential (TRP) ion channels. Among these, TRP melastatin 8 (TRPM8) is a key regulator of basal tear production. Stimulated by the small temperature reductions and tear film osmolarity increases that arise due to evaporative cooling, TRPM8 activates the LFU, leading to increased basal tear production.</div><div>Here, we focus on reviewing the topical ocular pathways within the LFU that regulate tear production. We describe the neural signaling underlying this regulation, with a focus on TRP channels and the central role of TRPM8 in basal tear production as elucidated through preclinical as well as limited clinical evidence. Lastly, we explore how augmenting the fundamental action of TRPM8 signaling through agonist stimulation may serve as a valuable new treatment option for dry eye disease.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Pages 142-154"},"PeriodicalIF":5.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early myeloid cell infiltration and subset-specific macrophage responses in murine corneal nerve injury","authors":"Seung Hyeun Lee ,&nbsp;Soo Jin Lee ,&nbsp;Ahra Koh ,&nbsp;Yunjin Lee ,&nbsp;Seonghan Kim ,&nbsp;Suil Jeon ,&nbsp;Noseong Park ,&nbsp;Chang Ho Yoon ,&nbsp;Ki Hean Kim ,&nbsp;Kyoung Woo Kim","doi":"10.1016/j.jtos.2025.07.001","DOIUrl":"10.1016/j.jtos.2025.07.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Corneal nerve fibers and resident macrophages form a specialized microenvironment essential for tissue integrity and recovery after injury. This study aims to elucidate the early immune dynamics following corneal nerve injury, focusing on myeloid cell infiltration and resident macrophage subset shifts.</div></div><div><h3>Methods</h3><div>Using a murine circular nerve-cut model, we tracked immune responses for 21 days, with a focus on the first 12 h post-injury. Confocal imaging was used to assess corneal nerve density, while flow cytometry quantified infiltrating and resident immune cell populations. Transcriptomic profiling was performed at 3 and 6 h post-injury to analyze inflammatory gene expression, and <em>in vitro</em> experiments examined the effects of short-term nerve growth factor (NGF) exposure on macrophage polarization.</div></div><div><h3>Results</h3><div>Confocal imaging showed a rapid decrease in corneal nerve density, followed by progressive regeneration. Flow cytometry revealed a surge in Ly6C⁺ myeloid cells at 3–6 h post-injury, predominantly in the central cornea, with an early tendency toward M2-like polarization. Resident macrophages exhibited distinct responses: M2-like and undifferentiated subsets declined, while M1-like cells were proportionally maintained, indicating divergent but complementary roles during the initial inflammatory phase. Transcriptomic profiling showed significant upregulation of inflammatory genes along with a transient increase in <em>Ngf</em> and compensatory anti-inflammatory signaling. <em>In vitro</em>, short-term NGF exposure enhanced both M1-and M2-like polarization, mirroring <em>in vivo</em> activation patterns.</div></div><div><h3>Conclusion</h3><div>Early myeloid cell infiltration and macrophage subset dynamics contribute to the initial neuroinflammatory response and may influence subsequent repair processes, highlighting the potential for immune modulation in corneal nerve regeneration.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Pages 117-131"},"PeriodicalIF":5.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144613297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to letter to the editor regarding “Simple limbal epithelial transplantation versus cultivated limbal epithelial transplantation in ocular burns”","authors":"Namrata Sharma,&nbsp;Renu Venugopal,&nbsp;Sujata Mohanty,&nbsp;Kamalakannan Priyadarshini,&nbsp;Ritu Nagpal,&nbsp;Deepali Singhal,&nbsp;Aafreen Bari,&nbsp;Tanuj Dada,&nbsp;Prafulla Kumar Maharana,&nbsp;Tushar Agarwal,&nbsp;Ashish Dutt Upadhyay","doi":"10.1016/j.jtos.2025.07.007","DOIUrl":"10.1016/j.jtos.2025.07.007","url":null,"abstract":"","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Pages 447-448"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topical pharmacologic treatments for dry eye disease: A systematic review","authors":"Louis Tong ,&nbsp;Zuguo Liu ,&nbsp;Afsun Şahin ,&nbsp;Koray Gümüş ,&nbsp;Elisabeth M. Messmer ,&nbsp;José M. Benítez-del-Castillo ,&nbsp;Marc Labetoulle ,&nbsp;Clara C. Chan ,&nbsp;Laura M. Periman","doi":"10.1016/j.jtos.2025.07.010","DOIUrl":"10.1016/j.jtos.2025.07.010","url":null,"abstract":"<div><h3>Background</h3><div>Topical pharmacologic treatments for dry eye disease (DED) address different aspects of tear film deficiency by decreasing ocular surface inflammation, stimulating mucin secretion, increasing tear production, or reducing excessive evaporation. This systematic review evaluated randomized controlled trials (RCTs) and prospective observational studies of topical ophthalmic medications for DED.</div></div><div><h3>Methods</h3><div>PubMed and Embase were searched from 1980 to February 2024. For studies meeting inclusion criteria, efficacy outcomes (signs and symptoms of DED) and adverse event data were extracted.</div></div><div><h3>Results</h3><div>A total of 107 publications covering topical prescription medications (anti-inflammatory agents cyclosporine and lifitegrast; mucin secretagogues diquafosol and rebamipide; tear evaporation inhibitor perfluorohexyloctane; tear production stimulator nasal spray varenicline), other commercially available products, and novel agents in development were identified. In RCTs, significant improvements relative to a control group were demonstrated more often for sign endpoints (e.g., corneal staining, Schirmer score) than for symptom endpoints (e.g., eye dryness, ocular discomfort). The evaluated treatments were well tolerated; instillation site reactions were the most commonly reported adverse events. Year-long safety extension studies demonstrated maintenance of efficacy, with no new safety signals identified. Studies differed in design, methodology, control group, and outcomes assessment, making it difficult to compare across products, and head-to-head studies were rare. Several new products are in late-stage development, which will likely lead to additional treatment options.</div></div><div><h3>Conclusions</h3><div>Current topical pharmacologic eye products improved signs, and sometimes symptoms, of DED and were well tolerated. Treatment selection should use a shared decision-making approach that takes DED etiology and patient preferences into account.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Pages 302-317"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasonography assessments of meibomian gland as a noninvasive method of detecting changes in morphology","authors":"Liyun Wang ,&nbsp;Hongbo Yin ,&nbsp;Yujia Yang ,&nbsp;Li Qiu","doi":"10.1016/j.jtos.2025.06.006","DOIUrl":"10.1016/j.jtos.2025.06.006","url":null,"abstract":"<div><h3>Purpose</h3><div>We employed 24 MHz ultrasonography to evaluate the morphological features of meibomian glands (MGs) and compared the ultrasonic differences in morphology between healthy volunteers and meibomian gland dysfunction (MGD) patients.</div></div><div><h3>Methods</h3><div>24 MHz ultrasound examinations on both the upper and lower eyelids of healthy volunteers and patients with MGD, using transverse and longitudinal sections. The reproducibility of ultrasonographic findings for the MG was evaluated, and a comparison of morphological characteristics at different examination sites between the two groups was made.</div></div><div><h3>Results</h3><div>Among 89 participants, 24 were healthy volunteers and 65 had MGD. The cross-sectional ultrasound findings showed well-organized punctate hyperechoic ducts within the tarsal plate, surrounded by hypoechoic acinar formations, which were further classified based on the extent of MG involvement into three categories: normal, ≤50 % involvement, and &gt;50 % involvement. Additionally, a typical longitudinal ultrasound appearance of a MG consisted of a thin band-like hypoechoic structure (acinar) with uniform thickness accompanied by an arc-shaped linear hyperechoic duct in its middle region. Furthermore, seven abnormal longitudinal ultrasound manifestations were categorized as distortion, ectasia, central duct truncation, cyst formation, structureless appearance, complete disappearance or other findings. The intra- and inter-observer agreement for those categories was found to be high (ICC&gt;0.6). MGD patients exhibited a higher likelihood of overall MG involvement or abnormal ultrasound findings, particularly in relation to the middle part of the upper eyelid.</div></div><div><h3>Conclusion</h3><div>The present study has developed an initial classification method to identify abnormalities in MG morphology using 24 MHz ultrasound in MGD patients.</div></div>","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Pages 72-79"},"PeriodicalIF":5.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenotypic and genotypic profiling of antimicrobial resistance genes and virulence factors in Pseudomonas aeruginosa isolates from keratitis patients","authors":"Abiye Tigabu ,&nbsp;Mark D.P. Willcox ,&nbsp;Fiona Stapleton","doi":"10.1016/j.jtos.2025.10.011","DOIUrl":"10.1016/j.jtos.2025.10.011","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;&lt;em&gt;Pseudomonas aeruginosa&lt;/em&gt; (&lt;em&gt;P. aeruginosa&lt;/em&gt;) is a major cause of ocular infections, exhibiting resistance to many antimicrobial agents and the ability to acquire further resistance through mutations and horizontal gene transfer. It employs a range of virulence factors to invade ocular tissues, leading to complications such as corneal scarring and perforation. Alarmingly, multidrug-resistant &lt;em&gt;P. aeruginosa&lt;/em&gt; isolates are increasing worldwide. For instance, a recent outbreak in the United States of America (USA) involving an extensively drug-resistant &lt;em&gt;P. aeruginosa&lt;/em&gt; PA1270 strain resulted in four deaths, four eye removals, and 14 cases of vision loss. A comprehensive understanding of the antibiotic resistance and virulence mechanisms of &lt;em&gt;P. aeruginosa&lt;/em&gt; is essential for the effective management of corneal infections.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Whole-genome sequencing data from 70 &lt;em&gt;P. aeruginosa&lt;/em&gt; isolates collected from corneal samples were retrieved from the National Center for Biotechnology Information (NCBI) database and annotated using Prokka 1.14.6. Unique genes identified in these datasets were analyzed against the Comprehensive Antibiotic Resistance Database (CARD) to determine antimicrobial resistance profiles. The presence of acquired resistance genes and virulence factors were assessed using ResFinder and the Virulence Factor Database (VFDB), respectively. Roary v3.13.0 was used for pangenome analysis, while Snippy v4.6.0 was employed for whole-genome variant analysis. Furthermore, mobile genetic elements (MGEs) and pathogenicity islands (PIs) were identified using MobileElementFinder v1.0.3 and IslandViewer 4, respectively. In parallel, phenotypic characterization, including determination of minimum inhibitory concentrations (MICs) for selected antimicrobial agents, was performed using the broth microdilution method. Additionally, a crystal violet assay was conducted to evaluate the biofilm-forming ability of &lt;em&gt;P. aeruginosa&lt;/em&gt;.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The corneal &lt;em&gt;P. aeruginosa&lt;/em&gt; harboured numerous AMR genes against various classes of antibiotics. Notably, the most prevalent acquired resistance genes across all keratitis &lt;em&gt;P. aeruginosa&lt;/em&gt; strains were β-lactams &lt;em&gt;blaPAO&lt;/em&gt;, and &lt;em&gt;blaOXA&lt;/em&gt;, aminoglycoside &lt;em&gt;aph(3′)-IIb&lt;/em&gt;, chloramphenicol &lt;em&gt;catB7&lt;/em&gt;, and fosfomycin &lt;em&gt;fosA&lt;/em&gt;. &lt;em&gt;P. aeruginosa&lt;/em&gt; keratitis isolates harbored more core and cloud genes than environmental and cystic fibrosis (CF) strains. A significant difference in ciprofloxacin resistance gene &lt;em&gt;crpP&lt;/em&gt; was observed between the keratitis and CF isolates. Additionally, a considerable number of insertion sequences (ISPa1, ISPa6, ISPa32) and transposons (Tn4661, Tn6082, Tn5563) were identified. Phenotypic characterization of antimicrobial resistance (AMR) revealed that gentamicin were the most effective antibiotics against corneal &lt;em&gt;P. aerugino","PeriodicalId":54691,"journal":{"name":"Ocular Surface","volume":"38 ","pages":"Pages 392-420"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145405030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}