ABSTRACT
Popular courses are representative of high-quality courses on MOOC (Massive Open Online Course) platforms. However, current research on the formation mechanism of popular courses is rare. Thus, a fuzzy-set qualitative comparative analysis (fsQCA) is adopted to explore configurations of MOOC quality elements for popular courses on MOOC platforms. This study selects courses on the Coursera platform as the research object. Unique datasets of 272 observations and 261 observations before and after the outbreak of pandemic, respectively, are used to investigate for a better understanding of the role of quality elements in forming popular courses. Three key findings are revealed. First, the configurations for MOOC popular courses differ from those of nonpopular courses, suggesting an asymmetric view of causality that underpins MOOC quality. Second, parsimonious configurations emergent from complex interactions among eight MOOC quality elements which are selected from three aspects of MOOC course arrangement, MOOC teaching faculty arrangement, and MOOC learner reviews, suggesting causality of equifinality that produces a popular course both before and after the outbreak of pandemic. Notably, the role of the professional title of MOOCs teachers becomes more important for forming popular courses after COVID-19. Third, although the number of MOOC teachers appears as a peripheral element along with the number of long reviews as a core element in all configurations for popular courses, they need the presence of other quality elements to form popular courses, suggesting a conjunction between quality elements. All findings provide implications not only for MOOC providers to regard popular courses as a result of configurations of MOOCs quality elements, but also for further research on fsQCA in course quality on MOOC platforms.
ABSTRACT
Multiorgan injury has been implicated in patients with coronavirus disease 2019 (COVID-19). We aim to assess the impact of organ injury (OI) on prognosis according to the number of affected organs at admission. This is a retrospective cohort study of patients with confirmed COVID-19 in Wuhan Third Hospital & Tongren Hospital of Wuhan University from February 17 to March 22, 2020. We classified the patients according to the presence and number of damaged organs (heart, liver, and kidney). The percentage of patients with no, one, two, or three organs affected was 59.75%, 30.46%, 8.07%, and 1.72%, respectively. With the increasing number of OI, there is a tendency of gradual increase regarding the white blood cell counts, neutrophil counts, levels of C-reactive protein (CRP), lactate dehydrogenase, D-dimer, and fibrinogen as well as the incidence of most complications. In a Cox regression model, individuals with OI, old age, and an abnormal level of CRP were at a higher risk of death compared with those without. Patients with three organ injuries had the highest mortality rate (57.9%; hazard ratio [HR] with 95% confidence interval [CI] vs. patients without OI: 22.31 [10.42-47.77], those with two [23.6%; HR = 8.68, 95% CI = 4.58-16.48], one [8.6%; HR = 3.1, 95% CI = 1.7-5.7], or no OI [2.6%]; p < .001). The increasing number of OI was associated with a high risk of mortality in COVID-19 infection.
Subject(s)
COVID-19/mortality , Multiple Organ Failure/mortality , Aged , C-Reactive Protein/metabolism , COVID-19/metabolism , COVID-19/virology , Female , Fibrinogen/metabolism , Hospital Mortality , Hospitalization/statistics & numerical data , Humans , Incidence , L-Lactate Dehydrogenase/metabolism , Leukocyte Count/methods , Male , Middle Aged , Multiple Organ Failure/metabolism , Multiple Organ Failure/virology , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2/pathogenicityABSTRACT
Chinese herbal formulas including the lung-cleaning and toxicity-excluding (LCTE) soup have played an important role in treating the ongoing COVID-19 pandemic (caused by SARS-CoV-2) in China. Applying LCTE outside of China may prove challenging due to the unfamiliar rationale behind its application in terms of Traditional Chinese Medicine. To overcome this barrier, a biochemical understanding of the clinical effects of LCTE is needed. Here, we explore the chemical compounds present in the reported LCTE ingredients and the proteins targeted by these compounds via a network pharmacology analysis. Our results indicate that LCTE contains compounds with the potential to directly inhibit SARS-CoV-2 and inflammation, and that the compound targets proteins highly related to COVID-19's main symptoms. We predict the general effect of LCTE is to affect the pathways involved in viral and other microbial infections, inflammation/cytokine response, and lung diseases. Our work provides a biochemical basis for using LCTE to treat COVID-19 and its main symptoms.