ABSTRACT
E-Learning has shown to be an important resource, particularly in recent times due to the limitations in the Sars-CoV-2 pandemic. Several ways to deliver lessons through the Internet were used but both instructors and students complained about visual outputs. An evaluation of the most proficient techniques to create video-based lessons is highly relevant and critical. Seventy-eight students participated to 30 h of university online courses delivered through MS Teams, in which OBS (Open Broadcaster Software) Studio was used to create the lessons. The software allowed merging: a) MS Powerpoint slides, b) the instructor through a webcam, c) pictures of background sceneries. After the end of the courses, students filled in a questionnaire evaluating pictures taken from different e-learning sceneries. The OBS-based situation obtained the best evaluation in all measures (fruition, attention keeping and promotion of learning) and the highest rank when participants were asked to compare all the sceneries. These results confirm that students prefer reality-based sceneries, in which the most informative aspects (face, body and voice of the instructor, and the slides used for the lesson) are all present. Beside other obvious factors related to the quality of teaching, e-learning should also definitely consider visual features. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
Background: Immunosuppressive therapies may impact immune response to COVID-19 vaccines in persons with multiple sclerosis (pwMS). Accordingly, effects of vaccination in pwMS treated with disease-modifying therapies (DMTs) need further elucidation. Aim(s): To investigate COVID-19 BNT162b2 vaccine effect concerning antibody seroconversion, T cells-associated cytokines production and immunophenotype assessment in pwMS under three different DMTs: cladribine, fingolimod, ocrelizumab. Method(s): Enzyme immunoassay test was used for anti-spike IgG detection in 98 DMTs-treated pwMS completing first vaccination cycle. In a subset of patients (n=47), serum T cells-associated cytokines (GrB, IFN-gamma and TNF-alpha) were quantified using an automatic ELISA (ELLA) and blood immunophenotype was assessed by flow cytometry. ANCOVA followed by post hoc tukey's test was used to compare anti-spike IgG response in the different DMTs, Student's paired t-test was used to evaluate differences between pre- and post-vaccination in pairwise samples and Pearson's correlation was applied to evaluate association between spike-specific IgG antibody titer and lymphocytes count. Result(s): More pwMS treated with ocrelizumab (63%) lacked anti-spike IgG compared to patients treated with cladribine (14%) and fingolimod (20%) (p<0.001). When present, the anti-spike IgG titer in the ocrelizumab group was lower than in cladribine- (p<0.001) and in fingolimod-treated pwMS (p=0.003). No significant differences in lymphocytes count and T-cell associated cytokines were observed in cladribine- and in fingolimod-treated pwMS, while in pwMS on ocrelizumab a significant increase in GrB serum levels (p=0.021) and a trend of increased CD4+ T cells count were observed after vaccination. Specifically considering non-seroconverted ocrelizumab-treated pwMS, a significant increase of GrB serum levels (p=0.008) and of CD4+ T lymphocytes count (p=0.040) was foundafter vaccination and a negative correlation was observed between anti-spike IgG production and CD4+T cells count (rho=-0.452, p=0.014). Conclusion(s): Our data confirmed differences in spike-specific antibodies among different DMTs and provided evidence of T-cell immunity preservation and activations after BNT162b2 vaccination in ocrelizumab-treated pwMS, specifically in pwMS patients lacking anti-spike IgG, suggesting a protective T-cell response that might explain why the ongoing treatment with ocrelizumab is not associated with a higher risk of COVID-19 infection.