The reactogenicity and immunogenicity of a booster dose after the second dose of a protein subunit vaccine MVC-COV1901.

The waning antibody levels after immunization and the emergence of SARS-CoV-2 variants of concern (VoC) negatively impact the vaccine-induced neutralization of SARS-CoV-2. In this extension to the phase 1 clinical study, we report the antibody durability until 180 days after the second dose of MVC-COV1901, and examined the reactogenicity and immunogenicity followed by a booster shot MVC-COV1901 administered to 45 healthy adults from 20 to 49 years of age on day 209. Adverse reactions after the booster dose were mostly mild and comparable to that of the first two doses. Neutralizing antibodies remained detectable on day 209 at 59.4, 79.4, and 113.2 (IU/mL) for low dose (LD), middle dose (MD), and high dose (HD) groups, respectively. At four weeks after the booster dose, neutralizing titers increased to 1719.6, 818.3, and 1345.6 for LD, MD, and HD groups, respectively. Our data also showed that three doses of MVC-COV1901-induced antibodies were still effective, albeit lowered neutralizing titers, against the Omicron variant.

First-in-Human Trial of a Recombinant Stabilized Prefusion SARS-CoV-2 Spike Protein Vaccine with Adjuvant of Aluminum Hydroxide and CpG 1018

DesignThis is a phase 1, dose-escalation open-label trial to evaluate the safety and immunogenicity of MVC-COV1901, a recombinant stabilized prefusion SARS-CoV-2 spike (S-2P) protein vaccine with adjuvant of aluminum hydroxide and CpG 1018. MethodsWe enrolled 45 healthy adults from 20 to 49 years of age to be administered with two vaccinations of MVC-COV1901 in a low dose (LD), middle dose (MD), and high dose (HD) of spike protein at 28 days apart. There were 15 participants in each dose group, and all of them were followed up for 28 days after the second vaccination at the time of interim analysis. Adverse events (AEs) and laboratory data were recorded for safety evaluation. Blood samples were collected for wild-type SARS-CoV-2 and pseudovirus neutralization assays as well as SARS-CoV-2 spike-specific immunoglobulin G (IgG) at various times. Overall, the study duration will be 7 months. ResultsSolicited events were mostly mild and similar in the participants of all three dose groups. No subject experienced fever. There were no serious nor adverse events of special interest at the time point of this interim report. After the second vaccination, the SARS-CoV-2 spike specific IgG titers increased with peak geometric mean titers at 7178.245 (LD), 7746.086 (MD), and 11220.58 (HD), respectively. Serum neutralizing activity was detected by two methods in all participants of MD and HD groups, with geometric mean values generally comparable to those of a panel of control convalescent serum specimens. All of the participants in the MD and HD groups were seroconverted after the second vaccination. ConclusionsThe MVC-COV1901 vaccine is safe and elicits remarkable immune responses especially in the MD and HD groups. Trial RegistrationClinicalTrials.gov NCT 04487210

Admission policies and methods at crossroads: a review of medical school admission policies and methods in seven Asian countries / 한국의학교육

Selecting the right applicants is an important part of medical student admission. While one universally accepted selection criterion is academic capacity, there are other criteria such as communication skills and local criteria (e.g., socio-cultural values) that are no less important. This article reviews the policies and methods of selection to medical schools in seven countries with varying socio-economic conditions and healthcare systems. Senior academics involved in medical education in Indonesia, Japan, Malaysia, the Philippines, Singapore, Sri Lanka, and Taiwan completed a pre-agreed pro-forma per each country to describe the country’s admission policies and methods. The details were then compared and contrasted. This review identifies tension between many of the policies and methods used in medical school admissions, such as between the need to assess non-cognitive abilities and widen access, and between the need for more medical professionals and the requirement to set high entry standards. Finding the right balance requires careful consideration of all variables, including the country’s human resource needs; socio-economic status; graduates’ expected competencies; and the school’s vision, mission, and availability of resources.

The learning of 7th year medical students at internal medical--evaluation by logbooks

<p><b>INTRODUCTION</b>The purpose of this study was to understand the learning of internal medicine of 7th year medical students through records of the "Learning Passport".</p><p><b>MATERIALS AND METHODS</b>Between June 2005 and June 2006, data from the learning passport (a type of logbook) of 207 7th year medical students at the Department of Internal Medicine, National Taiwan University Hospital (NTUH) were collected.</p><p><b>RESULTS</b>Among the 19 symptoms/signs listed in the logbook, a large number of students did not learn well on low back pain, skin rash, oedema, oliguria and anxiety/depression; only a few students rated themselves as knowledgeable about anxiety/depression, malaise, skin rash, headache and anorexia. Among the 16 diseases listed, a large number of students did not learn well on chronic obstructive pulmonary disease, stroke, hypertension, coronary artery disease and cirrhosis; only a few students rated themselves as knowledgeable about shock, respiratory failure, consciousness disturbance, sepsis and renal failure. Among the 21 physical examination skills listed, a large number of students did not learn well on the male genitalia, eyes, cognitive status, mental state and the digital rectal examination; only a few students rated themselves as fully competent about cognitive status, mental state, eyes, neurology examination and ENT examination. Among the 11 laboratory skills and image interpretation skills listed, a large number of students did not learn well on blood smear, Gram's stain and specimen sampling; only a few students rated themselves as fully competent about the interpretation of brain computed tomographic (CT) scan, blood smear and Gram's stain. Among the 12 procedures and therapeutic skills listed, a large number of students did not learn well on observation of lumbar puncture, basic cardiopulmonary resuscitation (CPR) and aseptic procedure; only a few students rated themselves as fully competent about basic CPR and transfusion management.</p><p><b>CONCLUSIONS</b>The weak points of intern training conducted by the Department of Internal Medicine, NTUH were revealed by analysis obtained from their logbooks. Thus, we need to strengthen the learning of the interns in these specific parts and assess their performance based on the use of portfolios.</p>

Resistance to antimicrobial agents of common bacteria isolated from Taiwan.

Antimicrobial susceptibility of 11 commonly seen and/or important pathogenic bacteria isolated from the National Taiwan University Hospital in 1981 and 1992 was analysed. Oxacillin-resistance was most remarkable in Staphylococcus aureus. Its prevalence increased rapidly from 6.7% in 1981 to 49.7% in 1992. A high proportion of oxacillin-resistance was also found in coagulase-negative staphylococci, both in 1981 and in 1992. For Streptococcus pneumoniae, no penicillin-resistant nor erythromycin-resistant strain was found in 1981, but by 1992, 5.8% of the isolates were penicillin-resistant 42.3% erythromycin-resistant. Gentamicin-resistance was the most common problem in enterococci, with 70.6% resistance in 1992. As to Gram-negative bacteria, Enterobacter spp. demonstrated a high proportion of resistance to various antimicrobial agents: more than 72% susceptibility was found only for amikacin. Pseudomonas aeruginosa was also a highly resistant bacterium, with only 50 to 90% of susceptibility to various antipseudomonal agents. In Haemophilus influenzae, both ampicillin-resistance and chloramphenicol-resistance were remarkable, with 52.2% and 32.9% resistance, respectively, in 1992.