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【最新 #研究 揭密：為何腺病毒疫苗恐致 #血栓 ，mRNA疫苗卻不會？】🤔🤔🤔
今國內首度傳出AZ疫苗血栓個案！一名30多歲男性接種AZ疫苗後，出現微燒、持續頭痛、腹痛等不適，經就醫證實為「血栓合併 #血小板低下 症候群」。
不過，到底為什麼 #腺病毒疫苗 屢傳血栓事件， #mRNA疫苗 卻不會呢？一起來看看專家怎麼說！
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台灣出現二例「變異病毒」之後，指揮中心已經宣佈提升 #邊境管制層級。這二天，我也遇到不少鄉親表達對疫情的關切，我的答案很簡單：無須過度恐慌，保持正確的防疫觀念、落實做好各項防疫措施，就是對抗病毒最有效的方式。
以下分享 #中山醫學大學公衛系翁瑞宏教授 的分析：
B.1.1.7病毒株最早於英國在九月被採集，其官方傳染病監測系統在過去的四週觀察到此病毒株在快速增長，在其他地方也發現，表示該病毒株在擴散，甚至經由旅運而擴及其他國家，包括台灣。
此病毒株有1623個基因組，攜帶的遺傳變化量比一般的大。迄今為止，比對COVID-19大流行的全球病毒基因組數據，CoV-2病毒株以每月約1-2個突變速率在累積核苷酸突變。B.1.1.7病毒株具有較快的分子進化速率，推斷原因在於氨基酸的改變，有14個非同義突變和3個缺失，反應著涉及病毒的自我適應之分子進化過程。
為何產生B.1.1.7病毒株?這要從它具有的高突變率說起。從病例證據知曉，病毒在感染COVID-19的免疫缺陷或抑制患者中，在短時間內可產生高突變累積率，並且在2-4個月內或更長時間可檢測到SARS-CoV-2 RNA。使用恢復期血漿來治療病患，通常還會使用瑞德西韋來治療，而將這些感染的病毒基因組進行序列檢測，顯示出異常多的核苷酸變化和缺失突變，並且通常存在高比例的非同義與同義變化。當患者的病毒載量很高時，在英國經常給予恢復期血漿；也就是給予血漿治療後，患者體內病毒的遺傳多樣性就增加了。在這種情況下，病患體內的病毒種類的進化動態和選擇性壓力就不同於典型感染的病毒。首先，在免疫缺陷/抑制的患者中，從自然免疫反應中進行選擇會很困難，甚至沒有。其次，由於高抗體濃度，抗體治療的選擇可能很強。第三，如果在數週的慢性感染後進行抗體治療，那麼在施加抗體介導的選擇壓力時，病毒可能會異常龐大且具有遺傳多樣性，從而為病毒變化創造了快速又適當的環境。從這些考量，或可支撐假設，也就是B.1.1.7病毒株的異常遺傳變化可能部分是由於慢性感染個體的病毒進化所致。儘管這種感染很少見，而且從慢性感染個體再繼續傳播的可能性甚小，但鑑於正在進行的大量新感染的情境，因而爆發大流行並非不可能。
在這一年來，我們都注意到冠狀病毒的傳播關鍵在脊蛋白 (spine protein)。重要的是，B.1.1.7病毒株的多個突變點就發生在脊蛋白，病毒結構的受體結合結構域 (RBD) 中具有關鍵性的接觸殘基。實驗表明突變的N501Y可以增加ACE2受體的親和力，P681H在S1和S2之間產生弗林蛋白酶切割位點，這是在以前就被提醒和傳播有關的重要位點。在脊蛋白之外，在病毒的開放閱讀框架 (open reading frame, ORF) 突變會截短蛋白或使其失活，從而允許下游突變之產生。在疫情早期，在全球分離出多個帶有導致ORF8表現缺失的病毒株，包括在新加坡。關鍵的是，在新加坡的病毒株於三月底消失了，這應該和新加玻的管控成效有關。也就是說，這株病毒是可能可以被控制住，只要落實防疫管控。後續的工作發現，與沒有缺失的病毒相比，ORF8缺失對於人類呼吸道細胞中的病毒複製僅具有非常適度的影響。
對於從英國蔓延出的B.1.1.7病毒株，出奇意料的傳播速度應該和大量遺傳變化有關，包括在受體結合域中以及與弗林蛋白酶切割位點有關。必然地，包括台灣，世界各地實驗室必須針對此病毒株進行監測。還是要提及，新冠病毒在未來呈現像流感一樣週期性出現的可能性即可。而此病毒要生存，就不會讓宿主太容易死亡，應該還是依循中度進化，目前並未傳出對於個體產生太嚴重後果的明確證據。
至於台灣對於此變異病毒株之管控建議，國家的重點應著重在旅運，也就是嚴守邊境管制，必要時必須加嚴。近幾個月來，隨著入境旅客之增加，預期的境外個案數目也就有所增長。雖然入境旅客尚須執行居家檢疫，攜入病毒之可能依然存在。對於旅客來自疫情炙熱之國家，其邊境管控更需嚴謹，檢疫人員為國人善盡把關之責，直至航線對接國家沒有出現其本土個案達國際所接受之日數，如兩個平均潛伏期的28天。而在英國的留學生和僑民眾多，外交部、交通部、教育部、衛福部應該要提前部署，擬定接回計畫，共同合作。
雖然，台灣的防疫相當具有成效，對於病毒傳播的防範並非就此停止。特別要提出的是，群眾仍應保持社交距離，避免參與大型聚會，以減少疫情傳播的可能性；這也將為醫療衛生人員提供喘息時間，並留出足夠資源來為未來的可能疫情變化做準備。社會亦須對於重新席捲而來的疫情準備，尤其是大規模的檢驗量能與個人防護裝備，包括供應鏈與物流的建構。社會還需進行各階層的系統測試，包括學校與企業，要評估自我應對疫情的能力，以及建構未來應變的人力與程序。防疫要成功的關鍵，不是在於病毒變異與否，而是取決於各界對於防疫措施的共同實踐。
[News] COD: Black Ops Cold War จะใช้โหมด Warzone ร่วมกันกับ COD: Modern Warfare
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Activision ได้ประกาศอย่างเป็นทางการในหน้า FAQ ว่า Call of Duty: Black Ops Cold War จะใช้โหมด Warzone ร่วมกันกับ Call of Duty: Modern Warfare นั่นแปลว่า ค่าสถิติ สกิน ไอเท็มต่างๆ รวมไปถึงเนื้อหาคอนเทนต์ต่างๆ ของ Modern Warfare ที่เคยปลดล็อคได้ อาทิ Operators และ Weapon Blueprint จะสามารถใช้งานร่วมกันได้ ไม่ต้องไปเริ่มเล่นใหม่ทั้งหมด ซึ่งทาง Activision จะเปิดเผยรายละเอียดเกี่ยวกับ Black Ops Cold...
Continue Reading[News] COD: Black Ops Cold War will use Warzone mode together with COD: Modern Warfare
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Activision has officially announced on FAQ that Call of Duty: Black Ops Cold War will be using Warzone mode together with Call of Duty: Modern Warfare. That means statistics, skin items, items including contents of Modern Warfare. Unlocked, such as Operators and Weapon Blueprint will be able to work together. Not to start all over. Activision will reveal more details about Black Ops Cold War and Warzone later.
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Also, on Activision's FAQ page, there are other information about Call of Duty: Black Ops Cold War which are interesting as follows.
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- Those who buy Call of Duty: Black Ops Cold War on PS4 and XB1 will be able to upgrade to PS5 and XBSX games via digital storefront of each platform. Sheet buying case will be able to upgrade. Can be upgraded through store as well. Only for PS5 and XBSX machines with disc compartment. Sheets are required to upgrade.
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- Sheet playing case after upgrading to Call of Duty: Black Ops Cold War War and XBSX version. ′′ Still need to keep PS4 and XB1 sheet Do not leave or sell it because it has to be used to play. Too.
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- But if you buy PS5 or XBSX without a pad compartment, it can't upgrade.
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- Case not upgraded to the next generation console game, and XB1 on PS5 and XBSX version of XBSX, but will play through the Backward Compatible system that won't get any additional features on the console. Next such as higher frame rate, Ray-tracing system, faster game loading etc.
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- Call of Duty: Black Ops Cold War PC version will not be available for sale and must be purchased via BattleNet.
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- Call of Duty: Black Ops Cold War. Cross-Gen Bundles version includes and PS5, XB1 and XBSX in the package. That means if you buy Cross-Gen Bundles, you will play PS4 or XB1 in the game. The 13th of November Oh, my God. This and will be played PS5 or XBSX version immediately when the game launches for the end of the year.
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- Call of Duty: Black Ops Cold War will support Cross-play system that allows players on PS4, PS5, XB1, XBSX and PC to play all together and use Cross-progression system. That means if you play on the current console and upload. Grade to play on PS5 or XBSX. Statistics, progress, profiles will follow.
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- Those who pre-order Call of Duty: Black Ops Cold War will get the right to play Multiplayer Open Beta in advance ((will be played before other platforms), Woods Operator Packaging Sgt. Frank Woods Operator Skin, M4 Weapon Blueprint, Voice Quip, and Finishing Move that can be used in Call of Duty: Modern Warfare and Warzone ′′ when pressing digital pre-order ′′ and Confrontation Weapons which are 2 Weapon Bluebrint that will be available when games open in Feb. Oh, my God.
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- Call of Duty: Black Ops Cold War - Digital Ultimate Edition on console will receive Call of Duty: Black Ops Cold War both PS4 and PS5 or XB1 and XBSX as well as Confrontation Weapons Pack, Battle Pass 1 Seasons include 20 Tier Skips and Land / Sea / Air Pack which consist of 3 Operator Skins, 3 Weapon Blueprints, 3 Vehicle Skins
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- Battle Pass system will unlock post-game containers with the same progress of both Black Ops Cold War and Warzone which unlock weapons, decorative items and more will be from playing in-game which will be revealed. More details later on
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- Call of Duty: Black Ops Cold War post-game contents, Multiplayer, modes or in-game events will be updated entirely free.
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- Call of Duty: Black Ops Cold War. Plot campaign, Multiplayer mode and Zombies mode.
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- Multiplayer mode will be revealed on 9 July Oh, my God. Zombies will be Co-op mode together with zombies that make a name for Treyarch with Cold War weapons and devices.
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Call of Duty: Black Ops Cold War is scheduled to be available on PS4, XB1 and PC on 13 November. Oh, my God. This and on PS5 and XBSX are available through the end of the year.
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Call of Duty: Black Ops Cold War is opening for 10 % off Gamesplanet pre-orders. The following prices are available.
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https://us.gamesplanet.com/game/call-of-duty-black-ops-cold-war-standard-edition-battlenet--4727-1?ref=sheapgamer
Call of Duty: Black Ops Cold War - Standard Edition. Discount 10 % to $ 53.99 Approximate 1690 Baht (BattleNet)
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https://us.gamesplanet.com/game/call-of-duty-black-ops-cold-war-ultimate-edition-battlenet--4727-2?ref=sheapgamer
Call of Duty: Black Ops Cold War - Ultimate Edition. Discount 10 % to $ 80.99 Approximate 2530 Baht (BattleNet)
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Ultimate Edition will receive the main game with Battle Pass Bundle, Confrontation Weapons Pack and Land, Sea and Air Pack.
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Those who pre-order with Gamesplanet will get early access to Open Beta and Iconic Operator Frankwoods and assault rifle Weapon Blueprint to Call of Duty ®: Modern Warfare ® and Warzone ™ immediately.
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More details see store page
https://us.gamesplanet.com/search?query=Black+Ops+Cold+War&ref=sheapgamer
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Source: https://support.activision.com/black-ops-cold-war/articles/call-of-duty-black-ops-cold-war-editions-faq
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