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.btn-small:hover,[data-thm=cardi] .btn:hover{color:#981b1e}[data-thm=cardi] .btn-alt,[data-thm=cardi] .btn-small-alt{color:#981b1e}[data-thm=cardi] .btn-alt:hover,[data-thm=cardi] .btn-small-alt:hover{background:#981b1e}[data-thm=cardi] .tab-nav-trigger.target-tab-active{color:#981b1e}[data-thm=cardi] .tab-nav-trigger.target-tab-active:hover{color:#981b1e}[data-thm=cardi] .tab-nav-trigger.target-tab-active:before{color:#981b1e}[data-thm=cardi].pg_abstract .full-text-link{background:#981b1e;border-right:3px solid #be1e32}[data-thm=cardi].pg_abstract .full-text-link:hover{background:#be1e32}[data-thm=cardi] .widget-MagazineView .decorated-hed:after,[data-thm=cardi].pg_abstract .decorated-hed:after{border-bottom:1px solid #be1e32}[data-thm=cardi] .widget-MagazineView .decorated-hed .heading-text,[data-thm=cardi].pg_abstract .decorated-hed .heading-text{border-bottom:5px solid #c9132a}[data-thm=cardi] .themed-hed{border-top:1px solid #be1e32}[data-thm=cardi] 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.comment-form-item input::-moz-placeholder,[data-thm=derm] .comment-form-item textarea::-moz-placeholder{color:#006f3b}[data-thm=derm] .comment-form-item input::placeholder,[data-thm=derm] .comment-form-item textarea::placeholder{color:#006f3b}[data-thm=derm] .comment-form-item input[type=radio]:checked+.radio-label:before{background-color:#3b923f}[data-thm=derm] .comment-form-item .radio-label:before{border:#3b923f}[data-thm=derm] .thm-learning{color:#4978bc}[data-thm=derm] .thm-learning:hover{color:#4978bc}[data-thm=derm] .thm-col-lt{color:#80b79d}[data-thm=derm] .thm-col-lt:hover{color:#80b79d}[data-thm=derm] .ymal--leader .featured-list--contents{display:flex}[data-thm=derm] .ymal--leader .featured-list--contents li.article.ymal--item{border-bottom:1px solid #006f3b}[data-thm=derm] .ymal--leader .featured-list--contents li.article.ymal--item:nth-of-type(even){border-left:1px solid #006f3b}[data-thm=derm] .ymal--leader .featured-list--contents 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.underlined-header{border-bottom:1px solid #006f3b}[data-thm=derm] .underlined-header span{color:#006f3b;border-bottom:5px solid #006f3b}[data-thm=derm] .header-wrap{border-bottom:5px solid #006f3b}[data-thm=derm] .nav-journal-level{border-left:8px solid #006f3b}.ama-composer-class .cms-fullwidth-view .unauth_wrap [data-thm=derm] .institutional-login-link,.ama-composer-class .cms-module-content_wrap [data-thm=derm] .toggle-left-col,.ama-composer-class .cms-module-view .unauth_wrap [data-thm=derm] .institutional-login-link,[data-thm=derm] .ama-composer-class .cms-fullwidth-view .unauth_wrap .institutional-login-link,[data-thm=derm] .ama-composer-class .cms-module-content_wrap .toggle-left-col,[data-thm=derm] .ama-composer-class .cms-module-view .unauth_wrap .institutional-login-link,[data-thm=derm] .btn,[data-thm=derm] .btn-small{background:#3b923f;border:2px solid #3b923f}.ama-composer-class .cms-fullwidth-view .unauth_wrap [data-thm=derm] 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.btn:hover{color:#981b1e}[data-thm=faci] .btn-alt,[data-thm=faci] .btn-small-alt{color:#981b1e}[data-thm=faci] .btn-alt:hover,[data-thm=faci] .btn-small-alt:hover{background:#981b1e}[data-thm=faci] .tab-nav-trigger.target-tab-active{color:#981b1e}[data-thm=faci] .tab-nav-trigger.target-tab-active:hover{color:#981b1e}[data-thm=faci] .tab-nav-trigger.target-tab-active:before{color:#981b1e}[data-thm=faci].pg_abstract .full-text-link{background:#981b1e;border-right:3px solid #ed1c24}[data-thm=faci].pg_abstract .full-text-link:hover{background:#ed1c24}[data-thm=faci] .widget-MagazineView .decorated-hed:after,[data-thm=faci].pg_abstract .decorated-hed:after{border-bottom:1px solid #ed1c24}[data-thm=faci] .widget-MagazineView .decorated-hed .heading-text,[data-thm=faci].pg_abstract .decorated-hed .heading-text{border-bottom:5px solid #f91019}[data-thm=faci] .themed-hed{border-top:1px solid #ed1c24}[data-thm=faci] .themed-hed:before{background:#f91019}[data-thm=faci] 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h6:hover{color:#006e96}[data-thm=intem] .comment-form-item input::-moz-placeholder,[data-thm=intem] .comment-form-item textarea::-moz-placeholder{color:#006e96}[data-thm=intem] .comment-form-item input::placeholder,[data-thm=intem] .comment-form-item textarea::placeholder{color:#006e96}[data-thm=intem] .comment-form-item input[type=radio]:checked+.radio-label:before{background-color:#005276}[data-thm=intem] .comment-form-item .radio-label:before{border:#005276}[data-thm=intem] .thm-learning{color:#4978bc}[data-thm=intem] .thm-learning:hover{color:#4978bc}[data-thm=intem] .thm-col-lt{color:#80b7cb}[data-thm=intem] .thm-col-lt:hover{color:#80b7cb}[data-thm=intem] .ymal--leader .featured-list--contents{display:flex}[data-thm=intem] .ymal--leader .featured-list--contents li.article.ymal--item{border-bottom:1px solid #006e96}[data-thm=intem] .ymal--leader .featured-list--contents li.article.ymal--item:nth-of-type(even){border-left:1px solid #006e96}[data-thm=intem] .ymal--leader 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#006e96}[data-thm=intem] .underlined-header{border-bottom:1px solid #006e96}[data-thm=intem] .underlined-header span{color:#006e96;border-bottom:5px solid #006e96}[data-thm=intem] .header-wrap{border-bottom:5px solid #006e96}[data-thm=intem] .nav-journal-level{border-left:8px solid #006e96}.ama-composer-class .cms-fullwidth-view .unauth_wrap [data-thm=intem] .institutional-login-link,.ama-composer-class .cms-module-content_wrap [data-thm=intem] .toggle-left-col,.ama-composer-class .cms-module-view .unauth_wrap [data-thm=intem] .institutional-login-link,[data-thm=intem] .ama-composer-class .cms-fullwidth-view .unauth_wrap .institutional-login-link,[data-thm=intem] .ama-composer-class .cms-module-content_wrap .toggle-left-col,[data-thm=intem] .ama-composer-class .cms-module-view .unauth_wrap .institutional-login-link,[data-thm=intem] .btn,[data-thm=intem] .btn-small{background:#005276;border:2px solid #005276}.ama-composer-class .cms-fullwidth-view .unauth_wrap [data-thm=intem] .institutional-login-link:hover,.ama-composer-class .cms-module-content_wrap [data-thm=intem] .toggle-left-col:hover,.ama-composer-class .cms-module-view .unauth_wrap [data-thm=intem] .institutional-login-link:hover,[data-thm=intem] .ama-composer-class .cms-fullwidth-view .unauth_wrap .institutional-login-link:hover,[data-thm=intem] .ama-composer-class .cms-module-content_wrap .toggle-left-col:hover,[data-thm=intem] .ama-composer-class .cms-module-view .unauth_wrap .institutional-login-link:hover,[data-thm=intem] .btn-small:hover,[data-thm=intem] .btn:hover{color:#005276}[data-thm=intem] .btn-alt,[data-thm=intem] .btn-small-alt{color:#005276}[data-thm=intem] .btn-alt:hover,[data-thm=intem] .btn-small-alt:hover{background:#005276}[data-thm=intem] .tab-nav-trigger.target-tab-active{color:#005276}[data-thm=intem] .tab-nav-trigger.target-tab-active:hover{color:#005276}[data-thm=intem] .tab-nav-trigger.target-tab-active:before{color:#005276}[data-thm=intem].pg_abstract .full-text-link{background:#005276;border-right:3px solid #006e96}[data-thm=intem].pg_abstract .full-text-link:hover{background:#006e96}[data-thm=intem] .widget-MagazineView .decorated-hed:after,[data-thm=intem].pg_abstract .decorated-hed:after{border-bottom:1px solid #006e96}[data-thm=intem] .widget-MagazineView .decorated-hed .heading-text,[data-thm=intem].pg_abstract .decorated-hed .heading-text{border-bottom:5px solid #006e96}[data-thm=intem] .themed-hed{border-top:1px solid #006e96}[data-thm=intem] .themed-hed:before{background:#006e96}[data-thm=intem] .auth--purchase{border-top:.0625rem solid #006e96}[data-thm=neur] .image-box .featured,[data-thm=neur] .themed-border{border-top:10px solid #d71635}[data-thm=neur] .image-box .featured:before,[data-thm=neur] .themed-border:before{background:#981b1e}[data-thm=neur] .branded-bar{background:#981b1e}[data-thm=neur] .branded-bar:after{background:#d71635}[data-thm=neur] .no-access.modal{border:none}[data-thm=neur] .modal{border-top:8px solid #981b1e}.ama-composer-class [data-thm=neur] .table .cms-module-abstract-wrap:before,.ama-composer-class [data-thm=neur] .table .cms-module-content_wrap:before,.ama-composer-class [data-thm=neur] .table .cms-post-view_wrap:before,[data-thm=neur] .h6,[data-thm=neur] .list-style-1 li:before,[data-thm=neur] .logged-in .auth--trigger:before,[data-thm=neur] .master-main .email-signup--text,[data-thm=neur] .table .ama-composer-class .cms-module-abstract-wrap:before,[data-thm=neur] .table .ama-composer-class .cms-module-content_wrap:before,[data-thm=neur] .table .ama-composer-class .cms-post-view_wrap:before,[data-thm=neur] .table .column:before,[data-thm=neur] .thm-col,[data-thm=neur] h6{color:#981b1e}.ama-composer-class [data-thm=neur] .table .cms-module-abstract-wrap:before:hover,.ama-composer-class [data-thm=neur] .table .cms-module-content_wrap:before:hover,.ama-composer-class [data-thm=neur] .table .cms-post-view_wrap:before:hover,[data-thm=neur] .h6:hover,[data-thm=neur] .list-style-1 li:before:hover,[data-thm=neur] .logged-in .auth--trigger:before:hover,[data-thm=neur] .master-main .email-signup--text:hover,[data-thm=neur] .table .ama-composer-class .cms-module-abstract-wrap:before:hover,[data-thm=neur] .table .ama-composer-class .cms-module-content_wrap:before:hover,[data-thm=neur] .table .ama-composer-class .cms-post-view_wrap:before:hover,[data-thm=neur] .table .column:before:hover,[data-thm=neur] .thm-col:hover,[data-thm=neur] h6:hover{color:#981b1e}[data-thm=neur] .comment-form-item input::-moz-placeholder,[data-thm=neur] .comment-form-item textarea::-moz-placeholder{color:#981b1e}[data-thm=neur] .comment-form-item input::placeholder,[data-thm=neur] .comment-form-item textarea::placeholder{color:#981b1e}[data-thm=neur] .comment-form-item input[type=radio]:checked+.radio-label:before{background-color:#d71635}[data-thm=neur] .comment-form-item .radio-label:before{border:#d71635}[data-thm=neur] .thm-learning{color:#4978bc}[data-thm=neur] .thm-learning:hover{color:#4978bc}[data-thm=neur] .thm-col-lt{color:#cc8d8f}[data-thm=neur] .thm-col-lt:hover{color:#cc8d8f}[data-thm=neur] .ymal--leader .featured-list--contents{display:flex}[data-thm=neur] .ymal--leader .featured-list--contents li.article.ymal--item{border-bottom:1px solid #981b1e}[data-thm=neur] .ymal--leader .featured-list--contents li.article.ymal--item:nth-of-type(even){border-left:1px solid #981b1e}[data-thm=neur] .ymal--leader .featured-list--contents li.article.ymal--item:nth-of-type(odd){border-right:1px solid #981b1e}[data-thm=neur] .thm-bg-col{background:#981b1e}[data-thm=neur] .header-logo-wrapper,[data-thm=neur] .site-links-wrap{background:#981b1e}[data-thm=neur] .thm-bg{background:#d71635}[data-thm=neur] .thm-bg-hover:hover{background:#d71635}[data-thm=neur] .thm-bg-learning{background:#4978bc}[data-thm=neur] .thm-col-sec{color:#d71635!important}[data-thm=neur] .just-published--more-text:before,[data-thm=neur] .just-published--more:hover .just-published--more-button{color:#d71635}[data-thm=neur] .tabs--link.target-tab-active{color:#d71635}[data-thm=neur] .tabs--link.target-tab-active:before{border-top:5px solid #d71635}[data-thm=neur] a{color:#d71635}[data-thm=neur] a:active,[data-thm=neur] a:hover{color:#d71635}[data-thm=neur] p.box-text{background:#d71635}[data-thm=neur] .pullquote,[data-thm=neur] .thm-bd-color{border-color:#981b1e}[data-thm=neur] .thm-bd-top{border-top:1px solid #981b1e}[data-thm=neur] .underlined-header{border-bottom:1px solid #981b1e}[data-thm=neur] .underlined-header span{color:#981b1e;border-bottom:5px solid #981b1e}[data-thm=neur] .header-wrap{border-bottom:5px solid #981b1e}[data-thm=neur] .nav-journal-level{border-left:8px solid #981b1e}.ama-composer-class .cms-fullwidth-view .unauth_wrap [data-thm=neur] .institutional-login-link,.ama-composer-class .cms-module-content_wrap [data-thm=neur] .toggle-left-col,.ama-composer-class .cms-module-view .unauth_wrap [data-thm=neur] .institutional-login-link,[data-thm=neur] .ama-composer-class .cms-fullwidth-view .unauth_wrap .institutional-login-link,[data-thm=neur] .ama-composer-class .cms-module-content_wrap .toggle-left-col,[data-thm=neur] .ama-composer-class .cms-module-view .unauth_wrap .institutional-login-link,[data-thm=neur] .btn,[data-thm=neur] .btn-small{background:#d71635;border:2px solid #d71635}.ama-composer-class .cms-fullwidth-view .unauth_wrap [data-thm=neur] .institutional-login-link:hover,.ama-composer-class .cms-module-content_wrap [data-thm=neur] .toggle-left-col:hover,.ama-composer-class .cms-module-view .unauth_wrap [data-thm=neur] .institutional-login-link:hover,[data-thm=neur] .ama-composer-class .cms-fullwidth-view .unauth_wrap .institutional-login-link:hover,[data-thm=neur] .ama-composer-class .cms-module-content_wrap .toggle-left-col:hover,[data-thm=neur] .ama-composer-class .cms-module-view .unauth_wrap .institutional-login-link:hover,[data-thm=neur] .btn-small:hover,[data-thm=neur] .btn:hover{color:#d71635}[data-thm=neur] .btn-alt,[data-thm=neur] .btn-small-alt{color:#d71635}[data-thm=neur] .btn-alt:hover,[data-thm=neur] .btn-small-alt:hover{background:#d71635}[data-thm=neur] .tab-nav-trigger.target-tab-active{color:#d71635}[data-thm=neur] .tab-nav-trigger.target-tab-active:hover{color:#d71635}[data-thm=neur] .tab-nav-trigger.target-tab-active:before{color:#d71635}[data-thm=neur].pg_abstract .full-text-link{background:#d71635;border-right:3px solid #981b1e}[data-thm=neur].pg_abstract .full-text-link:hover{background:#981b1e}[data-thm=neur] .widget-MagazineView .decorated-hed:after,[data-thm=neur].pg_abstract .decorated-hed:after{border-bottom:1px solid #981b1e}[data-thm=neur] .widget-MagazineView .decorated-hed .heading-text,[data-thm=neur].pg_abstract .decorated-hed .heading-text{border-bottom:5px solid #a11215}[data-thm=neur] .themed-hed{border-top:1px solid #981b1e}[data-thm=neur] .themed-hed:before{background:#a11215}[data-thm=neur] .auth--purchase{border-top:.0625rem solid #981b1e}[data-thm=oncol] .image-box .featured,[data-thm=oncol] .themed-border{border-top:10px solid #006f3b}[data-thm=oncol] .image-box .featured:before,[data-thm=oncol] .themed-border:before{background:#3b923f}[data-thm=oncol] .branded-bar{background:#3b923f}[data-thm=oncol] .branded-bar:after{background:#006f3b}[data-thm=oncol] .no-access.modal{border:none}[data-thm=oncol] .modal{border-top:8px solid #3b923f}.ama-composer-class [data-thm=oncol] .table .cms-module-abstract-wrap:before,.ama-composer-class [data-thm=oncol] .table .cms-module-content_wrap:before,.ama-composer-class [data-thm=oncol] .table .cms-post-view_wrap:before,[data-thm=oncol] .h6,[data-thm=oncol] .list-style-1 li:before,[data-thm=oncol] .logged-in .auth--trigger:before,[data-thm=oncol] .master-main .email-signup--text,[data-thm=oncol] .table .ama-composer-class .cms-module-abstract-wrap:before,[data-thm=oncol] .table .ama-composer-class .cms-module-content_wrap:before,[data-thm=oncol] .table .ama-composer-class .cms-post-view_wrap:before,[data-thm=oncol] .table .column:before,[data-thm=oncol] .thm-col,[data-thm=oncol] h6{color:#3b923f}.ama-composer-class [data-thm=oncol] .table .cms-module-abstract-wrap:before:hover,.ama-composer-class [data-thm=oncol] .table .cms-module-content_wrap:before:hover,.ama-composer-class [data-thm=oncol] .table .cms-post-view_wrap:before:hover,[data-thm=oncol] .h6:hover,[data-thm=oncol] .list-style-1 li:before:hover,[data-thm=oncol] .logged-in .auth--trigger:before:hover,[data-thm=oncol] .master-main .email-signup--text:hover,[data-thm=oncol] .table .ama-composer-class .cms-module-abstract-wrap:before:hover,[data-thm=oncol] .table .ama-composer-class .cms-module-content_wrap:before:hover,[data-thm=oncol] .table .ama-composer-class .cms-post-view_wrap:before:hover,[data-thm=oncol] .table .column:before:hover,[data-thm=oncol] .thm-col:hover,[data-thm=oncol] h6:hover{color:#3b923f}[data-thm=oncol] .comment-form-item input::-moz-placeholder,[data-thm=oncol] .comment-form-item textarea::-moz-placeholder{color:#3b923f}[data-thm=oncol] .comment-form-item input::placeholder,[data-thm=oncol] .comment-form-item textarea::placeholder{color:#3b923f}[data-thm=oncol] .comment-form-item input[type=radio]:checked+.radio-label:before{background-color:#006f3b}[data-thm=oncol] .comment-form-item .radio-label:before{border:#006f3b}[data-thm=oncol] .thm-learning{color:#4978bc}[data-thm=oncol] .thm-learning:hover{color:#4978bc}[data-thm=oncol] .thm-col-lt{color:#9dc99f}[data-thm=oncol] .thm-col-lt:hover{color:#9dc99f}[data-thm=oncol] .ymal--leader .featured-list--contents{display:flex}[data-thm=oncol] .ymal--leader .featured-list--contents li.article.ymal--item{border-bottom:1px solid #3b923f}[data-thm=oncol] .ymal--leader .featured-list--contents li.article.ymal--item:nth-of-type(even){border-left:1px solid #3b923f}[data-thm=oncol] .ymal--leader .featured-list--contents li.article.ymal--item:nth-of-type(odd){border-right:1px solid #3b923f}[data-thm=oncol] .thm-bg-col{background:#3b923f}[data-thm=oncol] .header-logo-wrapper,[data-thm=oncol] .site-links-wrap{background:#3b923f}[data-thm=oncol] .thm-bg{background:#006f3b}[data-thm=oncol] .thm-bg-hover:hover{background:#006f3b}[data-thm=oncol] .thm-bg-learning{background:#4978bc}[data-thm=oncol] .thm-col-sec{color:#006f3b!important}[data-thm=oncol] .just-published--more-text:before,[data-thm=oncol] .just-published--more:hover .just-published--more-button{color:#006f3b}[data-thm=oncol] .tabs--link.target-tab-active{color:#006f3b}[data-thm=oncol] .tabs--link.target-tab-active:before{border-top:5px solid #006f3b}[data-thm=oncol] a{color:#006f3b}[data-thm=oncol] a:active,[data-thm=oncol] a:hover{color:#006f3b}[data-thm=oncol] p.box-text{background:#006f3b}[data-thm=oncol] .pullquote,[data-thm=oncol] .thm-bd-color{border-color:#3b923f}[data-thm=oncol] .thm-bd-top{border-top:1px solid #3b923f}[data-thm=oncol] .underlined-header{border-bottom:1px solid #3b923f}[data-thm=oncol] .underlined-header span{color:#3b923f;border-bottom:5px solid #3b923f}[data-thm=oncol] .header-wrap{border-bottom:5px solid #3b923f}[data-thm=oncol] .nav-journal-level{border-left:8px solid #3b923f}.ama-composer-class .cms-fullwidth-view .unauth_wrap [data-thm=oncol] .institutional-login-link,.ama-composer-class .cms-module-content_wrap [data-thm=oncol] .toggle-left-col,.ama-composer-class .cms-module-view .unauth_wrap [data-thm=oncol] .institutional-login-link,[data-thm=oncol] .ama-composer-class .cms-fullwidth-view .unauth_wrap .institutional-login-link,[data-thm=oncol] .ama-composer-class .cms-module-content_wrap .toggle-left-col,[data-thm=oncol] .ama-composer-class .cms-module-view .unauth_wrap .institutional-login-link,[data-thm=oncol] .btn,[data-thm=oncol] .btn-small{background:#006f3b;border:2px solid #006f3b}.ama-composer-class .cms-fullwidth-view .unauth_wrap [data-thm=oncol] .institutional-login-link:hover,.ama-composer-class .cms-module-content_wrap [data-thm=oncol] .toggle-left-col:hover,.ama-composer-class .cms-module-view .unauth_wrap [data-thm=oncol] .institutional-login-link:hover,[data-thm=oncol] .ama-composer-class .cms-fullwidth-view .unauth_wrap .institutional-login-link:hover,[data-thm=oncol] .ama-composer-class .cms-module-content_wrap .toggle-left-col:hover,[data-thm=oncol] .ama-composer-class .cms-module-view .unauth_wrap .institutional-login-link:hover,[data-thm=oncol] .btn-small:hover,[data-thm=oncol] .btn:hover{color:#006f3b}[data-thm=oncol] .btn-alt,[data-thm=oncol] .btn-small-alt{color:#006f3b}[data-thm=oncol] .btn-alt:hover,[data-thm=oncol] .btn-small-alt:hover{background:#006f3b}[data-thm=oncol] .tab-nav-trigger.target-tab-active{color:#006f3b}[data-thm=oncol] .tab-nav-trigger.target-tab-active:hover{color:#006f3b}[data-thm=oncol] .tab-nav-trigger.target-tab-active:before{color:#006f3b}[data-thm=oncol].pg_abstract .full-text-link{background:#006f3b;border-right:3px solid #3b923f}[data-thm=oncol].pg_abstract .full-text-link:hover{background:#3b923f}[data-thm=oncol] .widget-MagazineView .decorated-hed:after,[data-thm=oncol].pg_abstract .decorated-hed:after{border-bottom:1px solid #3b923f}[data-thm=oncol] .widget-MagazineView .decorated-hed .heading-text,[data-thm=oncol].pg_abstract .decorated-hed .heading-text{border-bottom:5px solid #319c36}[data-thm=oncol] .themed-hed{border-top:1px solid #3b923f}[data-thm=oncol] .themed-hed:before{background:#319c36}[data-thm=oncol] .auth--purchase{border-top:.0625rem solid #3b923f}[data-thm=ophth] .image-box .featured,[data-thm=ophth] .themed-border{border-top:10px solid #006f3b}[data-thm=ophth] .image-box .featured:before,[data-thm=ophth] .themed-border:before{background:#66bc29}[data-thm=ophth] .branded-bar{background:#66bc29}[data-thm=ophth] .branded-bar:after{background:#006f3b}[data-thm=ophth] .no-access.modal{border:none}[data-thm=ophth] .modal{border-top:8px solid #66bc29}.ama-composer-class [data-thm=ophth] .table .cms-module-abstract-wrap:before,.ama-composer-class [data-thm=ophth] .table .cms-module-content_wrap:before,.ama-composer-class [data-thm=ophth] .table .cms-post-view_wrap:before,[data-thm=ophth] .h6,[data-thm=ophth] .list-style-1 li:before,[data-thm=ophth] .logged-in .auth--trigger:before,[data-thm=ophth] .master-main .email-signup--text,[data-thm=ophth] .table .ama-composer-class .cms-module-abstract-wrap:before,[data-thm=ophth] .table .ama-composer-class .cms-module-content_wrap:before,[data-thm=ophth] .table .ama-composer-class .cms-post-view_wrap:before,[data-thm=ophth] .table .column:before,[data-thm=ophth] .thm-col,[data-thm=ophth] h6{color:#66bc29}.ama-composer-class [data-thm=ophth] .table .cms-module-abstract-wrap:before:hover,.ama-composer-class [data-thm=ophth] .table .cms-module-content_wrap:before:hover,.ama-composer-class [data-thm=ophth] .table 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