Vaccine最新文献

{"title":"Varicella zoster virus reactivation episodes and vaccination uptake in Spleen Australia registrants","authors":"Gabriela Khoury ,&nbsp;Tim Spelman ,&nbsp;Penelope Jones ,&nbsp;Nenad Macesic ,&nbsp;Denis Spelman ,&nbsp;Ian Woolley","doi":"10.1016/j.vaccine.2025.127391","DOIUrl":"10.1016/j.vaccine.2025.127391","url":null,"abstract":"<div><div>The Australian National Immunisation Program recently made the recombinant zoster vaccine (RZV), Shingrix, available to First Nations people (Aboriginal and Torres Strait Islander Peoples) aged 50+ years; others 65+ years and immunocompromised people &gt;18 years. It is unclear if people without functioning spleens have a higher risk of varicella zoster virus (VZV) reactivation (herpes zoster, HZ) and are therefore ineligible for the vaccine without meeting other criteria. Spleen Australia has supported people living with asplenia and hyposplenism through education about increased risks of bacterial infection, and advice on vaccines and chemoprophylaxis. To understand the prevalence and predictors of HZ and the uptake of the VZV and HZ vaccines in registrants in July 2023 we offered registrants an online survey. 2657/7624 (34.8 %) eligible persons completed the cross-sectional study, with 1999/2657 (75.2 %) of respondents reported a history of VZV infection and 521/2657 (19.6 %) of HZ. There were 687 self-reported cases with 113/521 (21.7 %) of respondents having &gt;1 episode. Predictors of VZV reactivation were age 61+ years old, splenectomy indication and autoimmune disease. HZ vaccine uptake in eligible age groups (especially 61–70 years old) could be improved, thus highlighting opportunities for further education on the benefits of immunisation against VZV/HZ.</div></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":"61 ","pages":"Article 127391"},"PeriodicalIF":4.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct and indirect experiences, risk perceptions, and vaccine booster intention: A mediation study in Singapore using secondary risk theory","authors":"Sonny Rosenthal ,&nbsp;Agnes S.F. Chuah ,&nbsp;Hye Kyung Kim ,&nbsp;Shirley S. Ho","doi":"10.1016/j.vaccine.2025.127435","DOIUrl":"10.1016/j.vaccine.2025.127435","url":null,"abstract":"<div><div>This study examined how direct experiences with COVID-19 infection and vaccination and indirect experience through government and media information predict individuals' intention to receive a COVID-19 booster dose. Drawing on secondary risk theory, we conducted a nationally representative door-to-door survey of 1000 adult Singapore residents in mid-2024. We used structural equation modeling to test whether risk perceptions and efficacy beliefs mediate the effects of experience and information exposure on booster intention. Booster intention was positively related to perceived susceptibility to infection, vaccine effectiveness, vaccination self-efficacy, and prior vaccination, and negatively related to perceived severity of and susceptibility to booster side effects and prior COVID-19 infection. The model explained 26 % of the variance in booster intention. Prior infection positively predicted perceived susceptibility to infection and negatively predicted perceived vaccine effectiveness. Prior vaccination positively predicted perceived vaccine effectiveness and self-efficacy, and negatively predicted concerns about side effects. Information exposure via the government and television news was positively related to perceived severity of and susceptibility to illness and vaccination self-efficacy. There were three notable mediation effects in the prediction of booster intention. The effect of prior infection was mediated by perceived vaccine effectiveness and the effect of prior vaccination was mediated by perceived vaccine effectiveness and perceived severity of vaccine side effects. These findings suggest that personal vaccination history and beliefs about vaccine effectiveness and safety may be especially important for promoting booster uptake.</div></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":"61 ","pages":"Article 127435"},"PeriodicalIF":4.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunization with full-length TprC variants induces a broad response to surface-exposed epitopes of the Treponema pallidum repeat protein family and is partially protective in the rabbit model of syphilis","authors":"Lorenzo Giacani ,&nbsp;Emily Romeis ,&nbsp;Austin Haynes ,&nbsp;Barbara J. Molini ,&nbsp;Lauren C. Tantalo ,&nbsp;Linda H. Xu ,&nbsp;Aldo T. Trejos ,&nbsp;Jessica Keane ,&nbsp;Zakriye Mohamed ,&nbsp;Thaddeus D. Armstrong ,&nbsp;Benjamin A. Wieland ,&nbsp;Quynh Phung ,&nbsp;Dariia Vyshenska ,&nbsp;Victoria L. Campbell ,&nbsp;Charmie Godornes ,&nbsp;David M. Koelle ,&nbsp;Tara B. Reid ,&nbsp;Yang Wang ,&nbsp;Anastassia A. Vorobieva ,&nbsp;Anna Wald ,&nbsp;Alexander L. Greninger","doi":"10.1016/j.vaccine.2025.127406","DOIUrl":"10.1016/j.vaccine.2025.127406","url":null,"abstract":"<div><div>An effective vaccine against syphilis could aid current control measures to reduce the incidence of infection. Protective immunity from the syphilis agent, <em>Treponema pallidum</em> subsp. <em>pallidum</em> (<em>T. pallidum</em>), is associated with pathogen clearance by phagocytosis, supporting that immunization with an effective vaccine candidate should elicit opsonic antibodies to key epitopes at the host-pathogen interface. The <em><u>T</u>. <u>p</u>allidum</em> <u>r</u>epeat (Tpr) proteins are putative β-barrel outer membrane porins with ten predicted extracellular loops. Here, we immunized three groups of eight rabbits with either a combination of three recombinant variants of the full-length TprC antigen, the TprD₂ protein, or the conserved NH₂-terminal region of TprK, with the latter antigen already known to induce incomplete protection in immunized rabbits. Compared to unimmunized controls, rabbits immunized with the three TprC variants or the TprK fragment exhibited attenuated primary chancres, reduced treponemal burden at the challenge sites, and limited pathogen dissemination to lymph nodes. Immunization with TprD₂, alone did not produce comparable results. Strong humoral and cellular responses against TprC and TprK were elicited by immunization, and functional analyses supported the induction of opsonizing antibodies. Epitope mapping performed using TprC- and TprK-specific synthetic peptides and phage immunoprecipitation-sequencing identified a subset of highly reactive sequences and demonstrated immunity to predicted surface-exposed epitopes across multiple Tpr paralogs, which explained the significant, albeit incomplete protection measured post-challenge. These data advance TprC and TprK as syphilis vaccine candidates and highlight several correlates of their protection that deserve further examination.</div></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":"61 ","pages":"Article 127406"},"PeriodicalIF":4.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The success of toll-like receptor 4 based vaccine adjuvants","authors":"Darrick Carter ,&nbsp;Guy De La Rosa ,&nbsp;Nathalie Garçon ,&nbsp;Hyang Mi Moon ,&nbsp;Hyo Jung Nam ,&nbsp;David A.G. Skibinski","doi":"10.1016/j.vaccine.2025.127413","DOIUrl":"10.1016/j.vaccine.2025.127413","url":null,"abstract":"<div><div>Since the early 1990s, vaccinologists have worked to use adjuvants targeting toll-like receptors in the development of new vaccines. At the forefront of these efforts is the progress made with the toll-like receptor 4 agonist monophosphoryl lipid A which has now been incorporated into different adjuvant systems. These have led to the first vaccines against malaria and respiratory syncytial virus, and improved vaccines for hepatitis B, human papilloma virus, and shingles. In addition to monophosphoryl lipid A, next-generation toll-like receptor 4 adjuvants are under development with potential improvements in manufacturing, efficacy, and tolerability. This review provides a summary of the field of toll-like receptor 4 vaccine adjuvants to date, highlighting their considerable success and the new adjuvants currently under development.</div></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":"61 ","pages":"Article 127413"},"PeriodicalIF":4.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risks of removing the age 11–12-year meningococcal vaccine dose from the US immunization schedule","authors":"Jana Shaw ,&nbsp;Jaime E. Fergie ,&nbsp;James H. Conway ,&nbsp;Gary S. Marshall","doi":"10.1016/j.vaccine.2025.127428","DOIUrl":"10.1016/j.vaccine.2025.127428","url":null,"abstract":"","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":"61 ","pages":"Article 127428"},"PeriodicalIF":4.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refinement of a novel staphylococcal superantigen-like poly protein vaccine","authors":"Ries J. Langley,&nbsp;Fiona Clow,&nbsp;Kelly Peterken,&nbsp;Janlin Y.H. Chan,&nbsp;John D. Fraser,&nbsp;Fiona J. Radcliff","doi":"10.1016/j.vaccine.2025.127437","DOIUrl":"10.1016/j.vaccine.2025.127437","url":null,"abstract":"<div><div><em>Staphylococcus aureus</em> is a community- and hospital-associated pathogen of global significance. Despite several decades of investment there is no licenced vaccine and antimicrobial resistance is increasing, complicating effective treatment of infection. We have developed a novel fusion vaccine (PolySSL) containing mutated forms of three immune evasion factors, Staphylococcal Superantigen-Like (SSL) proteins 3, 7 and 11, that are common to all <em>S. aureus</em> isolates. Mice given the PolySSL vaccine have a robust specific serum IgG response, attenuated signs of infection, and a significantly reduced <em>S. aureus</em> tissue burden after an intra-peritoneal challenge with <em>S. aureus</em>. A comparison of six different versions of the vaccine (PolySSL 3711, 7113, 7311 and DualSSL 73, 311, 711) suggests inclusion of all three SSLs is required, the 7113 order produces the most significant reduction in bacterial liver and kidney burden, and that SSL7 is the most important component. The likely requirement for a multi-valent vaccine was examined by immunising groups of mice with six PolySSL7113 variants (adjuvanted with AdjuPhos) encompassing most <em>S. aureus</em> strains of clinical significance. SSL7 was confirmed to be the dominant antigen eliciting endpoint titres ≥10⁵ irrespective of the variant used, whereas IgG responses to SSL3 and SSL11 were lower (∼10³) and more variable. The highest inhibition of the interaction between the six wildtype variants of SSL7 and either IgA or complement C5 was typically obtained with variant-matched anti-sera. Conversely, anti-sera from these mice showed failed to stop SSL3 from blocking TLR2 signalling. An improved version of the PolySSL vaccine has been generated by altering the protein order, but these data suggest a multi-valent vaccine will be required to elicit robust inhibitory cross-variant antibody responses. A path to further improvement may be through use of a different adjuvant to broaden and enhance immunity to SSLs 3, 7 and 11.</div></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":"61 ","pages":"Article 127437"},"PeriodicalIF":4.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the medical briefing and vaccine type on adverse events following COVID-19 vaccination: A randomized clinical trial","authors":"Nora S. Beller ,&nbsp;Moritz Beller ,&nbsp;Jürgen J. Murmann ,&nbsp;Ryan W. Crisp","doi":"10.1016/j.vaccine.2025.127392","DOIUrl":"10.1016/j.vaccine.2025.127392","url":null,"abstract":"<div><div>Adverse events (AE) of varying severity commonly occur after vaccinations, potentially related to the nocebo effect. The randomized single-center clinical trial “LIFe Study” at the Vaccination Center Lichtenfels, Germany, investigates AE based on doctor-patient interaction and administered vaccine type following COVID-19 vaccination. Vaccinees receiving first or second doses were randomized: the control group (n=1,006) received in-depth medical briefings elaborating all possible AE; the experimental group (n=937) concise medical briefings comprising only medically relevant facts to the. Nocebo effects were quantified by self-reported AE frequency and severity; then AE across vaccine types and vaccinee demographics were compared including vaccinees receiving third (booster) doses. Questionnaires allowed rating 12 listed AE from absent, mild, moderate, to severe (valued as {0,1,2,3}, respectively), and summed to yield a score ranging from 0 to 36. Most AE were mild with no significant difference in mean AE (mAE) score between control (3.95, σ = 4.70) and experimental groups (3.96, σ = 4.75), nor in the number of participants reporting drug use for symptom relief (n_control = 208, n_experimental = 192; p = 0.54), or sick leave (n_control = 82, n_experimental = 82; p = 0.32). Higher mAE were associated with follow-up doses of Spikevax compared to Comirnaty, young age (r = -0.15, 95% CI [-0.19; -0.11], p = 9×10^-12), and female gender (mAE 5.00, σ = 5.32 vs male 3.05, σ = 3.93). These findings suggest that the nocebo effect was not a significant factor in COVID-19 vaccinations and allow optimization of future vaccination strategies.</div></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":"61 ","pages":"Article 127392"},"PeriodicalIF":4.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The HBV seroprevalence and immune responses to hepatitis B vaccination among college students from four universities in China","authors":"Yarong Song ,&nbsp;Yongliang Feng ,&nbsp;Feng Jiang ,&nbsp;Xingyan Xu ,&nbsp;Peijuan Yang ,&nbsp;Minmin Liu ,&nbsp;Lili Li ,&nbsp;Chaobi Du ,&nbsp;Huangyuan Li ,&nbsp;Qiong Li ,&nbsp;Jinge Qiao ,&nbsp;Jing Shi ,&nbsp;Le Yang ,&nbsp;Tian Yao ,&nbsp;Gongyuan Zhang ,&nbsp;Jie Wang ,&nbsp;Jie Li","doi":"10.1016/j.vaccine.2025.127408","DOIUrl":"10.1016/j.vaccine.2025.127408","url":null,"abstract":"<div><h3>Background</h3><div>People without effective immunization are vulnerable to infection with hepatitis B virus (HBV). At present, there is no appropriate hepatitis B vaccination strategy for HBV-susceptible adults. We aim to assess the long-term effect of neonatal hepatitis B immunization and HBV markers among college students, so as to explore hepatitis B vaccination strategies suitable for high-risk group.</div></div><div><h3>Methods</h3><div>The enrolled freshmen from four universities were initially tested for hepatitis B screening using colloidal gold test strips. Subjects with positive hepatitis B surface antigen (HBsAg) or negative hepatitis B surface antibody (anti-HBs) were further confirmed using Abbott reagents. HBsAg and anti-HBs double negative individuals were administered hepatitis B vaccination.</div></div><div><h3>Results</h3><div>Using Abbott reagents, we confirmed that among 3242 enrolled freshmen, 1604 (49.5 %) were negative for both HBsAg and anti-HBs, and 27 (0.8 %) were HBsAg-positive. Among the double negative freshmen, 1263 received hepatitis B vaccination. After the first and second dose of hepatitis B vaccine, the protective anti-HBs seroconversion rates reached 91.4 % and 98.5 %, respectively. Only one (0.1 %) freshman was still negative for anti-HBs after the third dose of hepatitis B vaccine. In addition, 96.3 % (104/108) of the fresmen who failed to achieve protective anti-HBs seroconversion after the first dose of hepatitis B vaccine had a baseline anti-HBs level &lt; 2 mIU/mL.</div></div><div><h3>Conclusion</h3><div>The HBsAg prevalence among college students has been significantly reduced after the integration of hepatitis B vaccine into Expanded Program on Immunization, but the rate of seroprotective anti-HBs among these students remains low. Hepatitis B vaccination or booster dose is advised for a high-risk group who have negative anti-HBs, and two doses of hepatitis B vaccine are advised for those with anti-HBs &lt; 2 mIU/mL.</div></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":"61 ","pages":"Article 127408"},"PeriodicalIF":4.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bivalent fusion protein vaccine induces protective immunity against SARS-CoV-2 and Staphylococcus aureus","authors":"Menghan Ma ,&nbsp;Jintao Zou ,&nbsp;Xiaoqiang Zeng ,&nbsp;Xuan Hu ,&nbsp;Wei Zhang ,&nbsp;Yi Wang ,&nbsp;Xiaopeng Zhang","doi":"10.1016/j.vaccine.2025.127411","DOIUrl":"10.1016/j.vaccine.2025.127411","url":null,"abstract":"<div><div>Viral-bacterial co-infections pose significant global health challenges. Currently, there are limited vaccines that target both viral and bacterial pathogens simultaneously. In this study, we present HRBD, a novel fusion protein vaccine combining the receptor-binding domain (RBD) of SARS-CoV-2 and a detoxified α-hemolysin mutant (Hla^H35A) from <em>S</em><em>.</em> <em>aureus</em>. When tested in mice, HRBD induced robust IgG1-dominated antibody responses against both antigens, leading to neutralizing effects against SARS-CoV-2 pseudovirus (NT₅₀ ∼ 10³) and <em>S. aureus</em> hemolytic activity (NT₅₀ ∼ 10²). HRBD promoted a Th2 immune response with increased IL-4 levels, while also boosting IFN-γ production. Importantly, HRBD showed dose-sparing efficacy, achieving similar immune responses as high-dose single or mixed-antigen vaccines with half the antigen amount. Functional tests confirmed that HRBD sera could neutralize Hla-induced cell lysis and block SARS-CoV-2 entry and syncytium formation. HRBD vaccination protected hACE2 transgenic mice against the co-infection of SARS-CoV-2 pseudovirus and <em>S. aureus</em>. These results suggest that HRBD is a promising candidate for preventing SARS-CoV-2 and <em>S. aureus</em> co-infections.</div></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":"61 ","pages":"Article 127411"},"PeriodicalIF":4.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 mRNA or viral vector vaccine type and subject sex influence the SARS-CoV-2 T-cell response","authors":"Sherry Tong ,&nbsp;Sean M. Litwin ,&nbsp;Elissa S. Epel ,&nbsp;Jue Lin ,&nbsp;Stacy S. Drury ,&nbsp;Frederick M. Hecht ,&nbsp;James E. Robinson ,&nbsp;Aric A. Prather ,&nbsp;Elizabeth B. Norton","doi":"10.1016/j.vaccine.2025.127420","DOIUrl":"10.1016/j.vaccine.2025.127420","url":null,"abstract":"<div><div>Severe SARS-CoV-2 infection has been partially controlled by vaccination, though issues in duration and breadth of protection remain. Few studies investigate factors driving diversity in the cellular immune response to vaccination. Here, we evaluated T-cell immunity in 60 healthy adults and its relationship to vaccine and subject-specific variables.</div><div>CD4 and CD8 T-cells from COVID-19 vaccinated subjects expressed spike-specific activation-induced markers (AIM+) and cytokines. Overall, AIM+ CD8 T-cells correlated best with neutralizing antibodies and were more strongly expressed by females than males. Unique patterns in CD4 T-regulatory cells, cytokine profiles, and central and effector memory subsets were observed between Moderna, Pfizer, and Janssen vaccinees and by subject-specific factors. Sex differences outweighed differences in BMI and age.</div><div>Thus, COVID-19 vaccine type and subject sex impacted the magnitude and quality of the spike-specific T-cell response. These results help explain differences in durability and memory between mRNA and adenovirus vector based COVID-19 vaccines and suggest targets for improved vaccine design.</div></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":"61 ","pages":"Article 127420"},"PeriodicalIF":4.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}