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Ayman Elnahry, MD, PhD

Eye Specialists

Ayman Elnahry, MD, PhD

About Ayman Elnahry, MD, PhD

Ayman Elnahry, MD, PhD is a fellowship-trained retina specialist and ocular oncologist with BayCare Clinic Eye Specialists in Green Bay, Wisconsin. 

Following in the footsteps of his parents and grandparents, Dr. Elnahry always knew he’d practice medicine. His interest in ophthalmology is rooted in his belief that the eyes are the windows to the body. Helping patients see clearly again brings Dr. Elnahry great joy. 

Dr. Elnahry is a leading figure in the fields of retinal surgery and ocular oncology, having completed seven fellowships focused on ophthalmic imaging, glaucoma, medical and surgical retina, uveitis, ocular oncology, and research in those fields. He earned his doctorate in ophthalmology from Kasr Alainy School of Medicine at Cairo University in Cairo, Egypt and he completed his internship as well as his ophthalmology residency at Kasr Alainy Hospital. Dr. Elnahry chose to further specialize in medical and surgical retina and ocular oncology through fellowship training at the National Eye Institute in Bethesda, Maryland and Bascom Palmer Eye Institute in Miami, Florida. 

Spending time with his wife and two young children is where you’ll find Dr. Elnahry when he’s not working. They enjoy traveling to visit friends, playing and watching sports together (mostly soccer), and experiencing the outdoors.

Related Medical Services

Retina and Vitreous

Locations

Education

Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt

Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt – Master’s Degree in Ophthalmology

Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt – Doctorate Degree in Ophthalmology

Internships

Kasr Alainy Hospital, Cairo University, Cairo, Egypt

Residency

Kasr Alainy Hospital, Cairo University Hospitals - Ophthalmology

Fellowships

Kasr Alainy Hospital, Cairo University Hospitals – Ophthalmic Imaging

Kasr Alainy Hospital, Cairo University Hospitals – Glaucoma

Kasr Alainy Hospital, Cairo University Hospitals – Medical and Surgical Retina

Lahey Hospital and Medical Center, Tufts University – Research Fellow in Medical and Surgical Retina

Scheie Eye Institute, University of Pennsylvania – Research Fellow in Medical and Surgical Retina

National Eye Institute, National Institutes of Health – Clinical Fellow in Medical Retina and Uveitis

Bascom Palmer Eye Institute, University of Miami – Surgical Fellow in Ocular Oncology and Retina

Additional Certifications, Training, and Achievements

Principal Investigator of several clinical trials – REBEL, FIXER, PROPER, IMPACT, DIABEDEX

Travel Grant Award for poster presentation, Association for Research in Vision and Ophthalmology (ARVO), New Orleans, LA

Travel Grant Award for paper presentation, American Uveitis Society (AUS), 25th Annual Winter Symposium, Park City, UT

Speaker at national and international ophthalmology meetings

Editorial board member of the International Journal of Neuroscience

Editorial board member of PLOS One

Professional Associations and Memberships

American Society of Retina Specialists

American Academy of Ophthalmology

Association for Research in Vision and Ophthalmology

Areas of Special Interest

Retinal diseases and ocular oncology

Liu T, Elnahry AG, Tauqeer Z, Yu Y, Ying GS, Kim BJ. Visual and Anatomic Outcomes of Suprachoroidal Hemorrhage: A Systematic Review and Meta-Analysis. Ophthalmol Retina. 2023 Jun;7(6):468-479. doi: 10.1016/j.oret.2023.02.011 

Abdel-Kader AA, Ramsey DJ, Yussuf WA, Mohalhal AA, Eldaly MA, Elnahry AG. Diabetic microaneurysms detected by fluorescein angiography spatially correlate with regions of macular ischemia delineated by optical coherence tomography angiography. Indian J Ophthalmol. 2023 Aug;71(8):3085-3090. doi: 10.4103/IJO.IJO_3155_22.  

Abu Serhan H, Irshaidat S, Abu Serhan L, Elnahry AG. Foldable capsular vitreous body indications, complications, and outcomes: a systematic review. Graefes Arch Clin Exp Ophthalmol. 2023 Aug;261(8):2103-2116. doi: 10.1007/s00417-023-05995-5. 

Nassar GA, Maqboul IM, El-Nahry AG, Hassan LM, Shalash AB. Macular vascular features of different types of diabetic macular edema using ocular coherence tomography angiography- a comparative study. Int J Retina Vitreous. 2023 May 18;9(1):32. doi: 10.1186/s40942-023-00469-6. 

Elnahry AG, Hassan LM, Abdelrahman W, Abd Elmohsen MN. Optical coherence tomography angiography (OCTA) findings in juvenile idiopathic arthritis, The Egyptian Rheumatologist. 2023: 45(1):105-110. doi: 10.1016/j.ejr.2022.11.010. 

Sorour OA, Levine ES, Baumal CR, Elnahry AG, Braun P, Girgis J, Waheed NK. Persistent diabetic macular edema: Definition, incidence, biomarkers and treatment methods. Surv Ophthalmol. 2022 Nov 24:S0039-6257(22)00171-0. doi: 10.1016/j.survophthal.2022.11.008. Epub ahead of print. 

Abu Serhan H, Abdelaal A, Abuawwad MT, Taha MJJ, Irshaidat S, Abu Serhan L, Abu-Ismail L, Abu Salim QF, Abdelazeem B, Elnahry AG. Ocular Vascular Events following COVID-19 Vaccines: A Systematic Review. Vaccines (Basel). 2022 Dec 14;10(12):2143. doi: 10.3390/vaccines10122143. 

Elnahry AG, Al-Nawaflh MY, Gamal Eldin AA, Solyman O, Sallam AB, Phillips PH, Elhusseiny AM. COVID-19 Vaccine-Associated Optic Neuropathy: A Systematic Review of 45 Patients. Vaccines (Basel). 2022 Oct 20;10(10):1758. doi: 10.3390/vaccines10101758. PMID: 36298623. 

Salah SH, Elsherif MA, Elnahry AG. An Unusual Cause of Choroidal Excavation. Ophthalmology. 2022 Jun;129(6):667. doi: 10.1016/j.ophtha.2021.12.008. PMID: 35598904. 

Elnahry AG, Asal ZB, Shaikh N, Dennett K, Abd Elmohsen MN, Elnahry GA, Shehab A, Vytopil M, Ghaffari L, Athappilly GK, Ramsey DJ. Optic neuropathy after COVID-19 vaccination: a report of two cases. Int J Neurosci. 2021 Dec 14:1-7. doi: 10.1080/00207454.2021.2015348. Epub ahead of print. PMID: 34906029. 

Elnahry AG, Elnahry GA. Gyrate Atrophy of the Choroid and Retina: A Review. Eur J Ophthalmol. 2022 May;32(3):1314-1323. doi: 10.1177/11206721211067333. Epub 2021 Dec 13. PMID: 34894815. 

Hamza HS, Elnahry AG. Short-term perfluorocarbon liquid tamponade in choroidal melanoma endoresection. Int J Retina Vitreous. 2022 Jul 6;8(1):46. doi: 10.1186/s40942-022-00395-z. PMID: 35794652; PMCID: PMC9258178. 

Haseeb A, Elhusseiny AM, Chauhan M, Elnahry AG. Optic neuropathy after COVID-19 vaccination: Case report and systematic review. Neuroimmunology Reports. 2022 Jan;2:100121-100121. doi: 10.1016/j.nerep.2022.100121. PMCID: PMC9314262. 

Xia T, Finkelman M, Kolomeyer A, Ying GS, Bracha P, Miller CG, Elnahry AG, Carroll R, Zhang Y, Saluadades A, Brucker AJ, Kim BJ. Utility of Ocular β-D-Glucan Testing in Patients with Fungal Endophthalmitis. Retin Cases Brief Rep. 2022 Feb 21. doi: 10.1097/ICB.0000000000001266. Epub ahead of print. PMID: 35199648. 

Elnahry AG, Noureldine AM, Abdel-Kader AA, Sorour OA, Ramsey DJ. Optical Coherence Tomography Angiography Biomarkers Predict Anatomical Response to Bevacizumab in Diabetic Macular Edema. Diabetes Metab Syndr Obes. 2022 Feb 9;15:395-405. doi: 10.2147/DMSO.S351618. PMID: 35177916; PMCID: PMC8843414. 

Elhusseiny AM, Haseeb A, Elnahry AG. Regression of treatment-resistant gyrate atrophy-associated intraretinal cystic spaces using long-term diet restriction: A case report. Eur J Ophthalmol. 2022 Mar 4:11206721221085868. doi: 10.1177/11206721221085868. Epub ahead of print. PMID: 35243906. 

Talbet JH, Elnahry AG. OnabotulinumtoxinA for the treatment of headache: an updated review. J Integr Neurosci. 2022 Jan 28;21(1):37. doi: 10.31083/j.jin2101037. PMID: 35164473. 

Elnahry AG, Yussuf WA. Comment on: Disentangling the association between retinal non-perfusion and anti-VEGF agents in diabetic retinopathy. Eye (Lond). 2022 Aug;36(8):1705. doi: 10.1038/s41433-021-01800-x. Epub 2021 Oct 6. PMID: 34616003; PMCID: PMC9307818. 

Sorour OA, Elsheikh M, Chen S, Elnahry AG, Baumal CR, Pramil V, Abdelhalim TI, Nassar E, Moult EM, Witkin AJ, Duker JS, Waheed NK. Mean macular intercapillary area in eyes with diabetic macular oedema after anti-vascular endothelial growth factor therapy and its association with treatment response. Clin Exp Ophthalmol. 2021 Sep;49(7):714-723. doi: 10.1111/ceo.13966. Epub 2021 Aug 1. PMID: 34189816. 

Elnahry AG, Elnahry GA. Optical Coherence Tomography Angiography of Macular Perfusion Changes after Anti-VEGF Therapy for Diabetic Macular Edema: A Systematic Review. Journal of Diabetes Research. 2021; 2021:6634637. 

Elnahry AG, Talbet JH, Elnahry GA. Methotrexate monotherapy for unilateral moderately active thyroid-related eye disease. Clinical Case Reports. 2021 Jul 9;9(7):e04559. doi: 10.1002/ccr3.4559. 

Elnahry AG, Talbet JH, El Mahgoub IR, Elnahry GA. Optic Nerve Sheath Fenestration for Papilledema Due to Cerebral Venous Sinus Thrombosis Associated with Antiphospholipid Syndrome: A Case Report. The American Journal of Case Reports. 2021; 22:e930497. 

Elnahry AG, Ramsey DJ. Automated Image Alignment for Comparing Microvascular Changes Detected by Fluorescein Angiography and Optical Coherence Tomography Angiography in Diabetic Retinopathy. Semin Ophthalmol. 2021 Nov 17;36(8):757-764. doi: 10.1080/08820538.2021.1901122. Epub 2021 Mar 30. PMID: 33784213. 

Elnahry AG. Comment on: Imaging in inherited retinal disorders. Eur J Ophthalmol. 2022 Jan;32(1):NP329. doi: 10.1177/11206721211008022. Epub 2021 Apr 5. PMID: 33818172. 

Liu T, Elnahry AG, Kim BJ. A 47-Year-Old Woman Urgently Referred for Proliferative Diabetic Retinopathy Management. JAMA Ophthalmol. 2021 Apr 1;139(4):482-483. doi: 10.1001/jamaophthalmol.2020.4670. PMID: 33507219. 

Elnahry AG, Farag AA, Abdel-Kader AA, Bowen RC, Sharma S. Diagnostic and Therapeutic Challenges. Retina. 2021 Nov 1;41(11):2407-2411. doi: 10.1097/IAE.0000000000003084. PMID: 33394968. 

Mansour AM, Elnahry AG, Tripathy K, Foster RE, Mehanna C, Vishal R, Çavdarlı C, Arrigo A, Parodi MB. Analysis of optical coherence angiography in cystoid macular oedema associated with gyrate atrophy. Eye. 2021; 35(6):1766-1774. doi: 10.1038/s41433-020-01166-6. 

Elnahry GA, Elemary AM, Badr Eldin N, Nossair AA, Barrada OA, Elnahry AG. Peripapillary microperimetry for the diagnosis and follow-up of papilledema in cases treated for idiopathic intracranial hypertension. Neurological Research. 2020. doi: 10.1080/01616412.2020.1820811. 

Habib AE, Abdel-Kader AA, Elnahry AG. Chandelier-Assisted Pneumatic Retinopexy for Rhegmatogenous Retinal Detachment Repair in Young Adults. Indian Journal of Ophthalmology. 2021; 69(4):979-981. 

Elnahry AG, Elnahry GA. Management of Idiopathic Intracranial Hypertension during the COVID-19 Pandemic. Reviews on Recent Clinical Trials. 2021;16(2):122-125. doi: 10.2174/1574887115666200917111413 

Elnahry AG, Ramsey DJ. Optical coherence tomography angiography imaging of the retinal microvasculature is unimpeded by macular xanthophyll pigment. Clinical & Experimental Ophthalmology. 2020;48(7):1012-1014. doi: 10.1111/ceo.13824. 

Elnahry AG, Aboulfotouh MR, Nassar GA. Treatment of Intraretinal Cystic Spaces Associated with Gyrate Atrophy of the Choroid and Retina with Intravitreal Bevacizumab. Journal of Pediatric Ophthalmology & Strabismus. 2020; 57(6):400-406. doi: 10.3928/01913913-20200813-01. 

Elnahry AG, El Mahgoub IR, Elnahry GA. Acute idiopathic maculopathy during the treatment of intracranial tuberculomas masquerading as malignant glioma. Acta Neurologica Belgica. 2020;120(5):1251-1253. doi: 10.1007/s13760-020-01406-2. 

Elnahry AG, Abdel-Kader AA, Habib AE, GA Elnahry, Raafat KA, Elrakhawy K. Review on Recent Trials Evaluating the Effect of Intravitreal Injections of Anti-VEGF Agents on the Macular Perfusion of Diabetic Patients with Diabetic Macular Edema. Reviews on Recent Clinical Trials. 2020;15(3):188-198. doi: 10.2174/1574887115666200519073704. 

Elnahry AG, Abdel-Kader AA, Raafat KA, Elrakhawy K. Evaluation of Changes in Macular Perfusion Detected by Optical Coherence Tomography Angiography Following 3 Intravitreal Monthly Bevacizumab Injections for Diabetic Macular Edema in the IMPACT Study. Journal of Ophthalmology. 2020; 2020:5814165. doi: 10.1155/2020/5814165. 

Shuaib MM, Helmy GM, Badr Eldin N, Elnahry AG, Elnahry GA. Optical coherence tomography of the optic nerve head before and after optic nerve sheath fenestration for idiopathic intracranial hypertension. Acta Neurologica Belgica. 2020;120(3):775-777. doi: 10.1007/s13760-020-01331-4. 

Elnahry AG, Gamal Eldin AA, Elnahry AG, Elnahry GA. Concomitant Congenital Horner and Harlequin Syndromes: Case Report and Review of Literature. Journal of Pediatric Neurology. 2020. doi: 10.1055/s-0040-1709461. 

Elnahry AG, Elnahry GA. Response to: Optic neuritis induced by 5-fluorouracil chemotherapy: case report and review of the literature. Journal of Oncology Pharmacy Practice. 2020;26(3):775. doi: 10.1177/1078155220904414 

Elnahry AG, Khafagy MM, Esmat SM, Mortada HA. Prevalence and Associations of Posterior Segment Manifestations in a Cohort of Egyptian Patients with Pathological Myopia. Current Eye Research. 2019;44(9):955-962. doi: 10.1080/02713683.2019.1606252. 

Elnahry AG, Hassan FK, Abdel-Kader AA. Bevacizumab for the Treatment of Intraretinal Cystic Spaces in a Patient with Gyrate Atrophy of the Choroid and Retina. Ophthalmic Genetics. 2018;39(6): 759-762. doi: 10.1080/13816810.2018.1536220. 

Elnahry AG, Sallam EM, Guirguis KJ, Talbet JH, Abdel-Kader AA. Vitrectomy for a secondary epiretinal membrane following treatment of adult-onset Coats’ disease. American Journal of Ophthalmology Case Reports. 2019: 100508. 

Elnahry AG, Abdel-Kader AA, Raafat KA, Elrakhawy K. Evaluation of the Effect of Repeated Intravitreal Bevacizumab Injections on the Macular Microvasculature of a Diabetic Patient Using Optical Coherence Tomography Angiography. Case Reports in Ophthalmological Medicine. 2019; 2019: 3936168. 

Elnahry AG, Elnahry GA. Computed Tomography Angiography of Bilateral Intracavernous Internal Carotid Artery Aneurysms. Neuroophthalmology. 2018: 42(6): 404-405. doi: 10.1080/01658107.2018.1433690 

Elnahry AG, Elnahry GA. Oculomotor Nerve Palsy Associated with Duplication of Middle Cerebral Artery, Anterior Communicating Artery Aneurysm, and Parietal Meningioma. Neuroophthalmology. 2019; 43(1): 53-55. doi: 10.1080/01658107.2018.1451902 

Elnahry AG, Elnahry GA. Abdominal Sarcoidosis Presenting as Bilateral Simultaneous Optic Disc Granulomas. Neuroophthalmology. 2019; 43(2): 91-94. doi: 10.1080/01658107.2018.1467935 

Elnahry AG, Elnahry GA. Unilateral papilledema revealing an intracanalicular optic nerve sheath meningioma. Neuroophthalmology. 2019; 43(2): 123-125. doi: 10.1080/01658107.2018.1482359 

Elnahry AG, Elnahry GA. Clinical and Imaging Findings One Year Following Traumatic Chiasm Transection. Neuroophthalmology. doi: 10.1080/01658107.2018.1521842 

Arfeen SA, Elnahry AG, Albadawi MA, El-Din DH. Orbital and Subcutaneous Encephalocele 10 Days Following an Orbital Roof Fracture in a Child. Ophthalmic Plastic & Reconstructive Surgery. 2019. doi: 10.1097/IOP.0000000000001431 

Elnahry AG, Elnahry GA. Reversible Neurotrophic Keratopathy Associated with Rosuvastatin Therapy: A Case Report. Journal of Population Therapeutics and Clinical Pharmacology. 2019; 26(2):e38-42. 

Elnahry AG, Habib MM. Needle aspiration for orbital venolymphatic malformation presenting with intralesional hemorrhage in adulthood. Orbit. 2019. doi: 10.1080/01676830.2019.1582073. 

Elnahry AG, Elnahry GA. Treatment of acquired Brown syndrome in a child with a single intramuscular systemic depot steroid injection. JAAPOS. 2019. doi: 10.1016/j.jaapos.2019.05.003. 

Elnahry AG, Khafagy MM, Esmat SM, Mortada HA. Prevalence of pathological myopia among patients in a large tertiary care center in Egypt. New Frontiers in Ophthalmology. 2018; 4(5): 1-4. doi: 10.15761/NFO.1000216 

Elnahry AG. Letter to the editor regarding: “cystoid macular edema secondary to gyrate atrophy in a child treated with sub-tenon injection of triamcinolone acetonide”. Romanian Journal of Ophthalmology. 2018; 62(4): 317-318. doi: 10.22336/rjo.2018.50 

Elnahry AG, Talbet JH. Posterior Segment Manifestations of Pathological Myopia: A Review. JOJ Ophthalmology. 2019; 7(2): 555709. doi: 10.19080/JOJO.2019.07.555709. 

Elnahry AG. Anterior ischemic optic neuropathy in a patient with optic disc Drusen while on FOLFOX Chemotherapy for colon cancer: the value of Occam’s Razor and Hickam’s dictum. Romanian Journal of Ophthalmology. 2019; 63(2):174-7.

Helmy YAH, Elnahry AG, Zein OE, Charbaji S, Yonekawa Y, Mansour HA, Serhan HA, Al-Nawaflh M, Parodi MB, Williams BK, Mansour AM. Pediatric and Adolescent Traumatic Macular Hole: A Systematic Review. Am J Ophthalmol. 2024 May 6;265: 165-175. doi: 10.1016/j.ajo.2024.05.001.

Younes AM, Hamza HS, Omar HA, Abdel-Kader AA, Abdelbaki AM, Elnahry AG. Intravitreal Infliximab for the Treatment of Proliferative Vitreoretinopathy (FIXER): A Randomized Controlled Phase II Trial. Ophthalmol Retina. 2024 May 31: S2468-6530(24)00265-3. doi: 10.1016/j.oret.2024.05.016.

Menean M, Elnahry AG, Williams BK Jr. Bifocal Circumscribed Choroidal Hemangioma. Ophthalmol Retina. 2024 Jul 29: S2468-6530(24)00324-5. doi: 10.1016/j.oret.2024.07.001.

Liu T, Elnahry AG, Tauqeer Z, Yu Y, Ying GS, Kim BJ. FACTORS ASSOCIATED WITH OUTCOMES OF SUPRACHOROIDAL HEMORRHAGE: An Individual Participant Data Systematic Review. Retina. 2024 Jul 1;44(7):1242-1250. doi: 10.1097/IAE.0000000000004081.

Abu Serhan H, Abu Suilik H, Hassan AK, AlSamhori JF, Hassan AR, Siddiq A, Ahmed N, Elnahry AG. The characteristics of white dot syndromes following COVID-19 Vaccines: a systematic review. Int Ophthalmol. 2024 Apr 23;44(1):189. doi: 10.1007/s10792-024-03119-4.

Serhan HA, Suilik HA, Hassan AK, AlSamhori JF, Hassan AR, Siddiq A, Helal RS, Metilda S, Elnahry AG. The Characteristics of White Dot Syndromes Following SARS-COV-2 Infection: A Systematic Review. Eur J Ophthalmol. 2024 May 15:11206721241255402. doi: 10.1177/11206721241255402.

Eleiwa TK, Dihan QA, Brown AD, Zaldivar AT, Abdelnaem SE, Sallam AB, Phillips PH, Elnahry AG, Elhusseiny AM. Quality, Reliability, Readability, and Accountability of Online Information on Leukocoria. J Pediatr Ophthalmol Strabismus. 2024 May 30:1-7. doi: 10.3928/01913913-20240425-02.

Fayed AE, Swaify IY, Khattab AM, Macky TA, Hassanein DH, Salah SH, Abdullatif AM, Noureldine AM, Fadel MR, Helmy YAH, Elnahry AG, Meqdad YA, Yesiltas YS, Singh AD, Hamza H. Retinal Pigment Epithelial Adenoma: Initial Treatment Outcomes following Episcleral Brachytherapy. Ocul Oncol Pathol. 2024 Apr;10(1):9-14. doi: 10.1159/000536127.

Abu Serhan H, Taha MJJ, Abuawwad MT, Abdelaal A, Irshaidat S, Abu Serhan L, Abu Salim QF, Awamleh N, Abdelazeem B, Elnahry AG. Safety and Efficacy of Brolucizumab in the Treatment of Diabetic Macular Edema and Diabetic Retinopathy: A Systematic Review and Meta-Analysis. Semin Ophthalmol. 2023 Oct 18:1-10. doi: 10.1080/08820538.2023.2271095.

Mansour AM, López-Guajardo L, Belotto S, Lima LH, Charbaji AR, Schwartz SG, Wu L, Smiddy WE, Ascaso J, Jürgens I, Foster RE, Elnahry AG, Sinawat S, Pinilla I, Pérez-Salvador García E, Suarez Leoz M, Olivier Pascual N, Zago Ribeiro L, Arroyo Castillo R, Navea A, Kadayifcilar S, Ellabban AA, Rey A, Mansour HA, Tripathy K, Kozak I, Uwaydat SH, Valero MS, Cobo-Soriano R, Díaz-Barreda MD, Monje Fernández L, González Del Valle F, López Liroz I, Vazquez Cruchaga E, Fonollosa A, Esteban Floria O, Relimpio Lopez M I, Shah G, Wingelaar MJ, Ravani R, Donate-López J, Rubio Velázquez E, Parodi M; Collaborative Postsurgical Residual Subretinal Fluid Study Group. Recovery course of persistent posterior subretinal fluid after successful repair of rhegmatogenous retinal detachment. Eur J Ophthalmol. 2023 Oct 30:11206721231210693. doi: 10.1177/11206721231210693.

Elnahry AG, Bellur S, Wiley H, Nida Sen H, Kodati S. Treatment of Intermediate Uveitis-associated Retinal Vasoproliferative Tumors: A Case Series. Retin Cases Brief Rep. 2023 Sep 19. doi: 10.1097/ICB.0000000000001494.

Shuaib A, Salem SA, Elnahry AG, Ghalwash DA, Mohalhal AA. Correlation of the macular microvasculature to the axial length in pediatric patients with high axial refractive errors. Eye (Lond). 2023 Sep 2. doi: 10.1038/s41433-023-02712-8