ABSTRACT
Background/Aims: The global pandemic of COVID-19 has caused tremendous loss of human life since 2019. Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is one of the best policies to control the pandemic. The vaccination efficacy in Taiwanese patients with different comorbidities is elusive and to be explored. Method(s): Uninfected subjects who received 3-doses of mRNA vaccines (Moderna, BioNTech), non-replicating viral vector-based vaccines (AstraZeneca, AZ) or protein subunit vaccines (Medigen COVID-19 vaccine, MVC) were prospectively enrolled. SARSCoV2- IgG spike antibody level was determined (Abbott [SARS-CoV- 2 IgG II]) within 3 months after the last dose of vaccination. Charlson Comorbidity Index (CCI) was applied to disclose the association of vaccine titer and underlying comorbidities. Result(s): A total of 824 subjects were enrolled in the current study. The mean age was 58.9 years and males accounted for 48.7% of the population. The proportion of CCI with 0-1, 2-3 and>4 was 52.8% (n = 435), 31.3% (n = 258) and 15.9% (n = 131), respectively. The most commonly used vaccination combination was AZ-AZ-Moderna (39.2%), followed by Moderna-Moderna-Moderna (27.8%) and AZAZ- BioNTech (14.7%), respectively. The mean vaccination titer was 3.11 log BAU/mL after a median 48 days of the 3rd dose. Subjects of male gender, lower body mass index, chronic kidney disease, higher CCI, and receiving AZ-AZ based vaccination were likely to have a lower titer of antibody. There was a decreasing trend of antibody titer with the increase of CCT (trend P<0.001). Linear regression analysis revealed that AZ-AZ-based vaccination (beta: 0.341, 95% confidence intervals [CI]: 0.144, 0.21, P<0.001) and higher CCI (beta: - 0.055, CI: - 0.096, - 0.014, P = 0.009) independently correlated with low IgG spike antibody levels. Conclusion(s): Patients with more comorbidities had a poor response to 3 doses of COVID-19 vaccination. Further studies are warranted to clarify the efficacy of booster vaccination in the population. The vaccine titer did not differ between patient with or without chronic liver disease.
ABSTRACT
Background: Hepatocellular carcinoma (HCC) is the second leading cause of malignancy-related mortality and the fifth most common worldwide. Immuno-cancer microenvironment (ICME) was highlighted recently because scientists want to unlock the detailed mechanism in carcinogenesis pathway and find the novel interactions in ICME. Besides, single cell analysis could mitigate the interrupted signals between cells and tissues. On the other hand, COVID-19 angiotensin I converting enzyme (ACE) previously was reported associated with cancer. However, the robust association between COVID-19 and HCC ICME is still unaddressed. Aim(s): We plan to investigate the COVID-19 ACE relevant genes to HCC ICME regarding survival. Method(s): We used Reactome for COVID-19 ACE gene pathway mapping and explored the positive relevant gene expression. DISCO website was applied for single cell analyses using the above-collected genes from Reactome. Finally, we implanted the biomedical informatics into TIMER 2.0 for ICME survival analyses. Result(s): In Fig. 1, the gene-gene interaction mapping was shown. We collected 13 genes (CPB2, ACE2, AGT, MME, ANPEP, CPA3, ENPEP, GZMH, CTSZ, CTSD, CES1, ATP6AP2, and AOPEP) for further single cell relevant analyses, in Table 1, with detailed expression level (TPM). Among the above 13 genes, AGT, GZMH, CTSZ, CTSD, CES1, and ATP6AP2 were strongly expressed in liver tissue. We then applied the initial 13 genes to TIMER 2.0 for HCC ICME 2-year survival analyses. CPA3 and GZMH low expressions with high macrophage infiltration in HCC ICME showed significantly worse 2-year cumulative survival [hazard ratio (HR):CPA3 2.21, p-value 0.018;GZMH 2.07, p-value 0.0341]. ACE2, CPB2, AGT, MME, ANPEP, ENPEP, CTSZ, CTSD, CES1, and ATP6AP2 high expressions with high macrophage infiltration in HCC ICME revealed significantly worse 2-year cumulative survival. Conclusion(s): We demonstrate that ACE2 was strongly associated with HCC clinical survival with macrophage infiltration. However, the bidirectional translational roles about ACE2 relevant genes in HCC should be documented.
ABSTRACT
During the outbreak of the new coronavirus disease COVID-19 (Coronavirus Disease 2019) epidemic, online learning has changed the traditional learning model. The purpose of this research was to explore how the antecedent of self-directed learning approach and attitudes of online learning can affect participants’ perceptions of cognitive fatigue and immersion during online learning that reflect their perceptions of the learning ineffectiveness of online learning. Design/methodology/approach This research adopted convenience sampling to collect data. During the period of the COVID-19 epidemic, the target participants were higher education students who adopted distance learning in the lockdown area of China. A questionnaire was posted on the Tencent questionnaire system for participants to fill out. The sample data of 155 college students were validly collected and subjected to test reliability and structural equation modeling using the SmartPLS 3.0 software to verify the research model proposed in this study. Findings/results The study found that self-directed learning attitudes were negatively related to online learning cognitive fatigue, but were positively related to cognitive presence;the self-directed learning approach was negatively related to online learning cognitive fatigue, but was positively related to cognitive presence. Moreover, online learning cognitive fatigue was positively related to perceived learning ineffectiveness, whereas cognitive presence was negatively related to perceived learning ineffectiveness. Originality/value In the new learning mode under the threat of the COVID-19 epidemic, this study explored the interaction between students' selfdirected learning, focused learning, and cognitive fatigue during the online learning process. Although there is no in-depth discussion on related research that affects learners’ perception of their learning outcomes, based on TAT (Trait activation theory), this study first divided self-directed learning into two categories: approach and attitude, and found how self-directed learning traits can predict online learning mental state, such as deactivator-cognitive fatigue and activator–immersion that affected the perceived effectiveness of online learning during the COVID-19 epidemic. Suggestions/implications The results of this study divided self-directed learning into approach and attitudes and indicated that both approach and attitudes of self-directed learning should be promoted by school teachers. Moreover, to design good distance learning programs, it is necessary to stimulate students’ mental state to learn and explore actively. Teachers can design interactive prompts or a reminding service in the teaching process to promote students’ cognitive presence and reduce their Internet cognitive fatigue, and to strengthen the overall learning effect. © 2022. Contemporary Educational Research Quarterly.All Rights Reserved