METHODS: A retrospective approach was used to construct notional epidemic trajectories for eight Asia-Pacific countries or regions, from June to November 2021, under hypothetical scenarios of earlier resumption of international travel and selective border reopening. The numbers of local infections and deaths over the prediction window were calculated accordingly.
RESULTS: Had quarantine-free entry been permitted for all travellers from all the regions investigated, and travel volumes recovered to the 2019 levels, Australia, New Zealand, and Singapore would have been the three most severely affected regions, with at least doubled number of deaths, while infections would have increased marginally (< 5%) for Japan, Malaysia, and Thailand.
CONCLUSIONS: Earlier resumption of travel in Asia-Pacific, while maintaining a controlled degree of importation risk, could have been implemented through selective border-reopening strategies and on-arrival testing. Once countries had experienced large, localized COVID-19 outbreaks, earlier relaxation of border containment measures would not have resulted in a great increase in morbidity and mortality.
METHODS: We conducted a large-scale, data-driven analysis on vaccine acceptance and actual uptake in eight Western Pacific countries before (2021) and after (2022) the mass COVID-19 vaccine rollouts. We compared vaccine acceptance or uptake rates between different subpopulations using Bootstrap methods and further constructed a logistic model to investigate the relationship between vaccine endorsement and diverse socio-demographic or trust-related determinants at these two time points.
FINDINGS: Substantial between-country differences in vaccine acceptance and uptake were observed across the Western Pacific, with Mongolia, Vietnam, Laos, Cambodia, and Malaysia being more pro-vaccine than the other three countries (Japan, South Korea, and the Philippines). Actual vaccination rates in 2022 were all higher than predicted from the 2021 responses. Influencers for vaccine endorsement were country-specific, but generally, groups susceptible to vaccine hesitancy included females, the less-educated, and those distrusting vaccines or health care providers.
INTERPRETATION: Our findings demonstrate the successful translation of vaccine intent to actual uptake with the deployment of COVID-19 vaccination in the Western Pacific. Increasing vaccine confidence and supressing dissemination of misinformation may play an essential role in reducing vaccine hesitancy and ramping up immunisation.
FUNDING: AIR@InnoHK.
PURPOSE: To evaluate the feasibility of a novel trajectory for C7 laminar screws and to compare it with an old trajectory.
OVERVIEW OF LITERATURE: The previously reported trajectory of C7 laminar screws has a horizontal direction without a fixed target point. Our new trajectory has a cephalad direction with a fixed target point.
METHODS: Computed tomographic scans of a total of 50 male and 50 female patients were utilized. The placement of C7 laminar screws was activated employing the new and old trajectories. The success rate, the causes of failure, and the maximum allowable length of each trajectory were compared.
RESULTS: Employing the new trajectory, the success rates of the unilaminar and bilaminar screws were 93% and 83%, respectively, which were significantly better than the old trajectory (80%, p<0.0001 and 70%, p=0.0003). The most prevalent cause of failure was laminar cortical breach followed by facet joint violation. The new trajectory also offered significantly longer maximum allowable screw length in unilaminar (32.5±4.3 mm vs. 26.5±2.6 mm, p<0.001), bilaminar cephalic (29.5±3.8 mm vs. 25.9±2.6 mm, p<0.0001) and bilaminar caudal (33.1±2.6 mm vs. 25.8±3.1 mm, p<0.001) screws than the old trajectory. With the new and old trajectories, 70% vs. 6% of unilaminar, 60% vs. 2% of bilaminar caudal, and 32% vs. 4% of bilaminar cephalic screws could be protracted perfectly into the corresponding lateral mass without any laminar cortical or facet joint violation (p<0.0001).
CONCLUSIONS: The novel trajectory possesses a substantially higher success rate, longer maximum allowable screw length, and higher chance to be extended into the lateral mass (a condition known as a lamino-lateral mass screw) than the old trajectory.