ABSTRACT
Most countries rolled out COVID-19 vaccination during 2021-2022. However, COVID-19 vaccine delivery cost estimates are still needed to support planning and budgeting to integrate COVID-19 vaccines into routine programs and to target high risk populations, specifically within resource-scarce contexts. Management Sciences for Health and the COVID-19 Vaccine Delivery Partnership Working Group collected country-level data through two surveys exploring global experiences with vaccine roll-out. 40 respondents from 27 countries responded to the surveys in November 2021 and May 2022. Respondents described their country's human resources needs, vaccine delivery modalities, demand generation strategies, booster uptake, cold chain capacity, supplies, and sub-population targets. The surveys highlighted unexpected trends in hiring, reliance on newer and costlier delivery and demand generation methods and significant gaps regarding HR, supplies, boosters, cold chain and reaching sub-populations. These types of opportunity assessments are useful ways of rapidly filling gaps in information needed to adequately cost alternative delivery strategies.
ABSTRACT
Surgeons need to visualize the facial nerve reliably in relation to the vestibular schwannoma (VS) in surgical planning. Diffusion tensor imaging (DTI) tractography has enabled unprecedented in vivo preoperative visualization. We collected data to measure the accuracy of DTI for an accurate location of the nerve in preoperative VS resection planning. A PubMed search for relevant studies was conducted. Inclusion criteria were gross total resection of VS, preoperative DTI identification of the facial nerve, and intraoperative cranial nerve localization by the surgeon. Exclusion criteria were tumors other than VS and unsuccessful preoperative location of the cranial nerve. Accuracy rate was calculated by comparing the intraoperative and preoperative locations detailed by DTI. The query identified 38 cases of VS that fit our inclusion criteria. Overall, 89% had surgical findings that agreed with the DTI location of the facial nerve. Of these cases, 32 patients had a postoperative House-Brackmann grade I or II. Our findings suggest that DTI is a reliable method for facial nerve imaging. Implementation of this technique may help decrease facial nerve injury during surgery. Limitations and further studies are needed to better understand what factors correlate with successful location of the facial nerve and DTI in patients with VS.
