{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T22:08:59Z","timestamp":1791842939717,"version":"4.3.4"},"reference-count":59,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T00:00:00Z","timestamp":1726099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The aim is to investigate induced higher-order aberrations (HOA)s and astigmatism as a result of non-toric ortho-k lens decentration and utilise artificial intelligence (AI) to predict its magnitude and direction. Methods: Medmont E300 Video topographer was used to scan 249 corneas before and after ortho-k wear. Custom-built MATLAB codes extracted topography data and determined lens decentration from the boundary and midpoint of the central flattened treatment zone (TZ). An evaluation was carried out by conducting Zernike polynomial fittings via a computer-coded digital signal processing procedure. Finally, an AI-based machine learning neural network algorithm was developed to predict the direction and magnitude of TZ decentration. Results: Analysis of the first 21 Zernike polynomial coefficients indicate that the four low-order and four higher-order aberration terms were changed significantly by ortho-k wear. While baseline astigmatism was not correlated with lens decentration (R = 0.09), post-ortho-k astigmatism was moderately correlated with decentration (R = 0.38) and the difference in astigmatism (R = 0.3). Decentration was classified into three groups: \u22640.50 mm, reduced astigmatism by \u22120.9 \u00b1 1 D; 0.5~1 mm, increased astigmatism by 0.8 \u00b1 0.1 D; &gt;1 mm, increased astigmatism by 2.7 \u00b1 1.6 D and over 50% of lenses were decentred &gt;0.5 mm. For lenses decentred &gt;1 mm, 29.8% of right and 42.7% of left lenses decentred temporal-inferiorly and 13.7% of right and 9.4% of left lenses decentred temporal-superiorly. AI-based prediction successfully identified the decentration direction with accuracies of 70.2% for right and 71.8% for left lenses and predicted the magnitude of decentration with root-mean-square (RMS) of 0.31 mm and 0.25 mm for right and left eyes, respectively. Conclusions: Ortho-k lens decentration is common when fitting non-toric ortho-k lenses, resulting in induced HOAs and astigmatism, with the magnitude being related to the amount of decentration. AI-based algorithms can effectively predict decentration, potentially allowing for better control over ortho-k fitting and, thus, preferred clinical outcomes.<\/jats:p>","DOI":"10.3390\/jcm13185420","type":"journal-article","created":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T11:04:33Z","timestamp":1726139073000},"page":"5420","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Can AI Predict the Magnitude and Direction of Ortho-K Contact Lens Decentration to Limit Induced HOAs and Astigmatism?"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9592-2020","authenticated-orcid":false,"given":"Wen-Pin","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Optometry, University of Kang Ning, Taipei 11485, Taiwan"},{"name":"Research and Development Centre, Brighten Optix Corporation, Taipei 111, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lo-Yu","family":"Wu","sequence":"additional","affiliation":[{"name":"Research and Development Centre, Brighten Optix Corporation, Taipei 111, Taiwan"},{"name":"Department of Optometry, Mackay Medical College, New Taipei 252, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Kai","family":"Li","sequence":"additional","affiliation":[{"name":"Research and Development Centre, Brighten Optix Corporation, Taipei 111, Taiwan"},{"name":"Department of Power Mechanical Engineering, Nation Tsing Hua University, Hsinchu 300, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9124-9131","authenticated-orcid":false,"given":"Wei-Ren","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Optometry, University of Kang Ning, Taipei 11485, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Wu","sequence":"additional","affiliation":[{"name":"Research and Development Centre, Brighten Optix Corporation, Taipei 111, Taiwan"},{"name":"College of Optometry, Pacific University, Forest Grove, OR 97116, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6524-5071","authenticated-orcid":false,"given":"Lynn","family":"White","sequence":"additional","affiliation":[{"name":"Research and Development Department, LWVision, Leicester LE18 1DF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rowan","family":"Abass","sequence":"additional","affiliation":[{"name":"Wirral Grammar School for Girls, Bebington CH63 3AF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rami","family":"Alanazi","sequence":"additional","affiliation":[{"name":"Department of Materials, Design and Manufacturing Engineering, School of Engineering, University of Liverpool, Liverpool L69 3GH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2412-5679","authenticated-orcid":false,"given":"Joseph","family":"Towler","sequence":"additional","affiliation":[{"name":"Department of Materials, Design and Manufacturing Engineering, School of Engineering, University of Liverpool, Liverpool L69 3GH, UK"},{"name":"Department of Eye and Vision, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7637-7054","authenticated-orcid":false,"given":"Jay","family":"Davies","sequence":"additional","affiliation":[{"name":"Department of Materials, Design and Manufacturing Engineering, School of Engineering, University of Liverpool, Liverpool L69 3GH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8622-4632","authenticated-orcid":false,"given":"Ahmed","family":"Abass","sequence":"additional","affiliation":[{"name":"Department of Materials, Design and Manufacturing Engineering, School of Engineering, University of Liverpool, Liverpool L69 3GH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,12]]},"reference":[{"key":"ref_1","first-page":"58","article-title":"Corneal molding; the easy way","volume":"4","author":"Wlodyga","year":"1989","journal-title":"Contact Lens Spectr."},{"key":"ref_2","first-page":"37","article-title":"A new approach to orthokeratology","volume":"7","author":"Harris","year":"1992","journal-title":"Contact Lens Spectr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e11699","DOI":"10.1016\/j.heliyon.2022.e11699","article-title":"Investigation of the relationship between contact lens design parameters and refractive changes in Ortho-K","volume":"8","author":"Wu","year":"2022","journal-title":"Heliyon"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00006324-199811000-00019","article-title":"Corneal Response to Orthokeratology","volume":"75","author":"Swarbrick","year":"1998","journal-title":"Optom. Vis. Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1097\/00006324-200312000-00010","article-title":"Higher-Order Wavefront Aberrations in Corneal Refractive Therapy","volume":"80","author":"Joslin","year":"2003","journal-title":"Optom. Vis. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.visres.2005.03.012","article-title":"Retinal image quality, reading and myopia","volume":"46","author":"Collins","year":"2006","journal-title":"Vis. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"29","DOI":"10.3921\/joptom.2009.29","article-title":"Do Peripheral Refraction and Aberration Profiles Vary with the Type of Myopia?\u2014An Illustration Using a Ray-Tracing Approach","volume":"2","author":"Bakaraju","year":"2009","journal-title":"J. Optom."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1080\/08164622.2021.1970480","article-title":"Alterations in peripheral refraction with spectacles, soft contact lenses and orthokeratology during near viewing: Implications for myopia control","volume":"105","author":"Damani","year":"2022","journal-title":"Clin. Exp. Optom."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e03642","DOI":"10.1016\/j.heliyon.2020.e03642","article-title":"Impact of peripheral optical properties induced by orthokeratology lens use on myopia progression","volume":"6","author":"Yoo","year":"2020","journal-title":"Heliyon"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Sun, L., Li, Z.X., Chen, Y., He, Z.Q., and Song, H.X. (2022). The effect of orthokeratology treatment zone decentration on myopia progression. BMC Ophthalmol., 22.","DOI":"10.1186\/s12886-022-02310-4"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1167\/iovs.61.2.22","article-title":"Higher-Order Aberrations and Axial Elongation in Myopic Children Treated with Orthokeratology","volume":"61","author":"Lau","year":"2020","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1167\/tvst.12.10.8","article-title":"Two-Dimensional Peripheral Refraction and Higher-Order Wavefront Aberrations Induced by Orthokeratology Lenses Decentration","volume":"12","author":"Xue","year":"2023","journal-title":"Transl. Vis. Sci. Technol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1167\/iovs.06-0914","article-title":"Contrast sensitivity function and ocular higher-order aberrations following overnight orthokeratology","volume":"48","author":"Hiraoka","year":"2007","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"101867","DOI":"10.1016\/j.clae.2023.101867","article-title":"Long-term variations and influential factors of the treatment zone of wearing orthokeratology lenses","volume":"46","author":"Li","year":"2023","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1097\/ICL.0000000000000961","article-title":"Higher-Order Aberrations and Visual Performance in Myopic Children Treated with Aspheric Base Curve-Designed Orthokeratology","volume":"49","author":"Chen","year":"2023","journal-title":"Eye Contact Lens"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Lau, J.K., Vincent, S.J., Collins, M.J., Cheung, S.W., and Cho, P. (2018). Ocular higher-order aberrations and axial eye growth in young Hong Kong children. Sci. Rep., 8.","DOI":"10.1038\/s41598-018-24906-x"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Lin, W., Gu, T., Bi, H., Du, B., Zhang, B., and Wei, R. (2022). The treatment zone decentration and corneal refractive profile changes in children undergoing orthokeratology treatment. BMC Ophthalmol., 22.","DOI":"10.1186\/s12886-022-02396-w"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1097\/OPX.0000000000001109","article-title":"Prediction of orthokeratology lens decentration with corneal elevation","volume":"94","author":"Chen","year":"2017","journal-title":"Optom. Vis. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s40662-018-0100-7","article-title":"Influence of overnight orthokeratology lens fitting decentration on corneal topography reshaping","volume":"5","author":"Chen","year":"2018","journal-title":"Eye Vis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1097\/ICL.0000000000000580","article-title":"Influence of corneal topographic parameters in the decentration of orthokeratology","volume":"45","author":"Gu","year":"2019","journal-title":"Eye Contact Lens"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1111\/j.1475-1313.2007.00520.x","article-title":"The relationship between the treatment zone diameter and visual, optical and subjective performance in Corneal Refractive Therapy lens wearers","volume":"27","author":"Lu","year":"2007","journal-title":"Ophthalmic Physiol. Opt. J. Br. Coll. Ophthalmic Opt."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1029\/GL014i002p00139","article-title":"Biharmonic spline interpolation of GEOS-3 and SEASAT altimeter data","volume":"14","author":"Sandwell","year":"1987","journal-title":"Geophys. Res. Lett."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1136\/bjo.70.2.152","article-title":"On the calculation of power from curvature of the cornea","volume":"70","author":"Olsen","year":"1986","journal-title":"Br. J. Ophthalmol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.jcrs.2007.09.033","article-title":"Validity of the keratometric index: Evaluation by the Pentacam rotating Scheimpflug camera","volume":"34","author":"Ho","year":"2008","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_25","unstructured":"Smit, G., and Atchison, D.A. (1970). The Eye and Visual Optical Instruments, Cambridge University Press."},{"key":"ref_26","first-page":"41","article-title":"Gullstrand\u2019s Optical Schematic System of the Eye Modified by Vojnikovi & Tamajo","volume":"37","author":"Vojnikovi","year":"2013","journal-title":"Coll. Antropol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Fathy, A., Lopes, B.T., Ambr\u00f3sio, R., Wu, R., and Abass, A. (2021). The Efficiency of Using Mirror Imaged Topography in Fellow Eyes Analyses of Pentacam HR Data. Symmetry, 13.","DOI":"10.3390\/sym13112132"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Consejo, A., Fathy, A., Lopes, B.T., Ambr\u00f3sio, R., and Abass, A. (2021). Effect of Corneal Tilt on the Determination of Asphericity. Sensors, 21.","DOI":"10.3390\/s21227636"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/S0031-8914(34)80259-5","article-title":"Beugungstheorie des schneidenver-fahrens und seiner verbesserten form, der phasenkontrastmethode","volume":"1","author":"Zernike","year":"1934","journal-title":"Physica"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e08623","DOI":"10.1016\/j.heliyon.2021.e08623","article-title":"Performance of Zernike polynomials in reconstructing raw-elevation data captured by Pentacam HR, Medmont E300 and Eye Surface Profiler","volume":"7","author":"Wei","year":"2021","journal-title":"Heliyon"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Baraya, M., Moore, J., Lopes, B.T., Wu, R., Bao, F., Zheng, X., Consejo, A., and Abass, A. (2023). Limitations of Reconstructing Pentacam Rabbit Corneal Tomography by Zernike Polynomials. Bioengineering, 10.","DOI":"10.3390\/bioengineering10010039"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1016\/j.jacr.2018.02.026","article-title":"The Pareto Principle","volume":"15","author":"Harvey","year":"2018","journal-title":"J. Am. Coll. Radiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2205","DOI":"10.1016\/j.jcrs.2015.10.041","article-title":"Efficacy of axial and tangential corneal topography maps in detecting subclinical keratoconus","volume":"41","author":"Tummanapalli","year":"2015","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1097\/00006324-199511000-00005","article-title":"Comparison of elevation, curvature, and power descriptors for corneal topographic mapping","volume":"72","author":"Salmon","year":"1995","journal-title":"Optom. Vis. Sci."},{"key":"ref_35","first-page":"1","article-title":"Corneal topography in keratoconus: State of the art","volume":"3","year":"2016","journal-title":"Eye Vis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1080\/00031305.1998.10480559","article-title":"Violin Plots: A Box Plot-Density Trace Synergism","volume":"52","author":"Hintze","year":"1998","journal-title":"Am. Stat."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Aggarwal, C.C. (2018). Neural Networks and Deep Learning: A Textbook, Springer International Publishing.","DOI":"10.1007\/978-3-319-94463-0"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"118062","DOI":"10.1016\/j.enconman.2024.118062","article-title":"Ultra-short-term wind power probabilistic forecasting based on an evolutionary non-crossing multi-output quantile regression deep neural network","volume":"301","author":"Zhu","year":"2024","journal-title":"Energy Convers. Manag."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Subramani, S., Varshney, N., Anand, M.V., Soudagar, M.E.M., Al-Keridis, L.A., Upadhyay, T.K., Alshammari, N., Saeed, M., Subramanian, K., and Anbarasu, K. (2023). Cardiovascular diseases prediction by machine learning incorporation with deep learning. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1150933"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"116497","DOI":"10.1016\/j.oceaneng.2023.116497","article-title":"Research on the direction perception of cruising copepods by the fish lateral line using pressure difference matrix and residual neural network regression method","volume":"292","author":"Zhu","year":"2024","journal-title":"Ocean. Eng."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v008.i18","article-title":"Evaluating Kolmogorov\u2019s Distribution","volume":"8","author":"Marsaglia","year":"2003","journal-title":"J. Stat. Softw."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Everitt, B.S., and Skrondal, A. (2010). The Cambridge Dictionary of Statistics, Cambridge University Press. [4th ed.].","DOI":"10.1017\/CBO9780511779633"},{"key":"ref_43","unstructured":"Kendall, M.G., and Stuart, A. (1973). Inference and: Relationsship. The Advanced Theory of Statistics, Arnold."},{"key":"ref_44","unstructured":"Press, W.H., Teukolsky, S.A., Vetterling, W.T., and Flannery, B.P. (2007). Numerical Recipes 3rd Edition: The Art of Scientific Computing, Cambridge University Press."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Wu, L.-Y., Lin, W.-P., Wu, R., White, L., and Abass, A. (2024). FEA-Based Stress\u2013Strain Barometers as Forecasters for Corneal Refractive Power Change in Orthokeratology. Bioengineering, 11.","DOI":"10.3390\/bioengineering11020166"},{"key":"ref_46","first-page":"41","article-title":"Contemporary Orthokeratology","volume":"24","author":"Caroline","year":"2000","journal-title":"CLAE"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1111\/j.1444-0938.2008.00259.x","article-title":"Orthokeratology practice in children in a university clinic in Hong Kong","volume":"91","author":"Chan","year":"2008","journal-title":"Clin. Exp. Optom."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1097\/01.opx.0000135093.77007.18","article-title":"The Children\u2019s Overnight Orthokeratology Investigation (COOKI) pilot study","volume":"81","author":"Walline","year":"2004","journal-title":"Optom. Vis. Sci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1097\/ICL.0000000000000721","article-title":"Corneal Elevation, Power, and Astigmatism to Assess Toric Orthokeratology Lenses in Moderate-to-High Astigmats","volume":"47","author":"Tomiyama","year":"2021","journal-title":"Eye Contact Lens"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/s10792-022-02394-3","article-title":"Distribution of angle lambda and pupil offset as measured by combined Placido Scheimpflug Topography","volume":"43","author":"Gharieb","year":"2023","journal-title":"Int. Ophthalmol."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Alanazi, R., Esporcatte, L.P.G., White, L., Salom\u00e3o, M.Q., Lopes, B.T., Ambr\u00f3sio, R., and Abass, A. (2024). Investigation of How Corneal Densitometry Artefacts Affect the Imaging of Normal and Keratoconic Corneas. Bioengineering, 11.","DOI":"10.3390\/bioengineering11020148"},{"key":"ref_52","first-page":"87","article-title":"The Dartmouth College artificial intelligence conference: The next fifty years","volume":"27","author":"Moor","year":"2006","journal-title":"AI Mag."},{"key":"ref_53","unstructured":"Goodfellow, I., Bengio, Y., and Courville, A. (2016). Deep Learning, MIT Press."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1038\/nature14539","article-title":"Deep learning","volume":"521","author":"LeCun","year":"2015","journal-title":"Nature"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.1109\/TPAMI.2013.50","article-title":"Representation Learning: A Review and New Perspectives","volume":"35","author":"Bengio","year":"2013","journal-title":"IEEE Trans. Pattern Anal. Mach. Intell."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1097\/IOP.0000000000000136","article-title":"LESCs: Lateralizing Eyelid Sleep Compression Study","volume":"30","author":"Figueira","year":"2014","journal-title":"Ophthalmic Plast. Reconstr. Surg."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"3869","DOI":"10.1167\/iovs.14-16079","article-title":"Time Spent in Lateral Sleep Position and Asymmetry in Glaucoma","volume":"56","author":"Kaplowitz","year":"2015","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1080\/02713683.2018.1500609","article-title":"Positions of Ocular Geometrical and Visual Axes in Brazilian, Chinese and Italian Populations","volume":"43","author":"Abass","year":"2018","journal-title":"Curr. Eye Res."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"20200271","DOI":"10.1098\/rsif.2020.0271","article-title":"Characterisation of cone size and centre in keratoconic corneas","volume":"17","author":"Eliasy","year":"2020","journal-title":"J. R. Soc. Interface"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/18\/5420\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:55:04Z","timestamp":1760111704000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/18\/5420"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,12]]},"references-count":59,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["jcm13185420"],"URL":"https:\/\/doi.org\/10.3390\/jcm13185420","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,12]]}}}