While cortical injuries, such as traumatic brain injury (TBI) and neocortical stroke, acutely disrupt the neocortex, most of their consequent disabilities reflect secondary injuries that develop over time. Thalamic neuroinflammation has been proposed to be a biomarker of cortical injury and of the long‐term cognitive and neurological deficits that follow. However, the extent to which thalamic neuroinflammation depends on the type of cortical injury or its location remains unknown. Using two mouse models of focal neocortical injury that do not directly damage subcortical structures—controlled cortical impact and photothrombotic ischemic stroke—we found that chronic neuroinflammation in the thalamic region mirrors the functional connections with the injured cortex, and that sensory corticothalamic regions may be more likely to sustain long‐term damage than nonsensory circuits. Currently, heterogeneous clinical outcomes complicate treatment. Understanding how thalamic inflammation depends on the injury site can aid in predicting features of subsequent deficits and lead to more effective, customized therapies.
Purpose Abnormalities in hepatic oxygen delivery and oxygen consumption may serve as a significant indicator of hepatic cellular dysfunction and may predict treatment response. However, conventional and oxygen‐enhanced hepatic BOLD MRI can only provide semiquantitative assessment of hepatic oxygenation. Methods A hepatic quantitative BOLD (qBOLD) model was proposed for noninvasive mapping of hepatic venous blood oxygen saturation (Yv) and deoxygenated blood volume (DBV) in human subjects. The validity and the estimation bias of the proposed model were evaluated by Monte Carlo simulations. Eight healthy subjects were scanned after written consent with institutional review board approval. Results Monte Carlo simulations demonstrated that the proposed single‐compartment hepatic qBOLD model leads to significant deviation of the predicted T2* decay profile from the simulated signal due to high hepatic blood volume fraction. Small relative estimation bias for hepatic Yv and significant overestimation for hepatic DBV were observed, which can be corrected by applying the calibration curves established from simulations. After correction, the mean hepatic Yv in human subjects was 56.8 ± 6.8%, and the mean hepatic DBV was 0.190 ± 0.035, consistent with measurements from other invasive approaches. Except in regions with significant vascular contamination, the maps for hepatic Yv and DBV were relatively homogenous. Conclusions With estimation bias correction, the hepatic qBOLD approach enables noninvasive mapping of hepatic blood volume and oxygenation in human subjects. The established protocol may be used to quantitatively assess hepatic tissue hypoxia in multiple liver diseases.
Background The COVID-19 pandemic has presented new opportunities for corruption to infiltrate health and pharmaceutical sectors globally, increasing health inequities within and between countries. COVID-19 vaccine procurement and distribution are specific areas that are vulnerable to corruption due to their attraction of large amounts of public and private funding, involvement of a high number of stakeholders, and lack of centralized oversight. We conducted a descriptive, qualitative study of corruption risks and the use of anti-corruption, transparency, and accountability (ACTA) mechanisms in the international COVID-19 vaccine and distribution process.Results We identified 34 academic articles and policy documents and triangulated documentary data with 16 key informant interviews. A review of the literature identified four distinct corruption risks in the international COVID-19 vaccine procurement and distribution process: (1) a lack of transparency and accountability in the operation of the COVAX Facility; (2) a lack of transparency in the vaccine procurement process; (3) a risk of bribery; and (4) a risk of vaccine theft or the introduction of substandard and falsified vaccines at the point of distribution. Key informants further articulated concerns about a lack of transparency in vaccine pricing and vaccine contracts and the exclusion of civil society organizations from the vaccine deployment process. Reported ACTA mechanisms implemented across various levels of the international vaccine procurement and distribution chain focused primarily on transparency mechanisms, including institutional oversight processes, blockchain-based supply-chain solutions, and civil society engagements.Conclusion Emergency responses to public health crises expose institutions, such as governments and international organizations, to high risks of corruption without adequate ACTA mechanisms. Experiences during the COVID-19 vaccine deployment process demonstrate that efforts to improve transparency will be insufficient without commensurate sanctions programs in place.
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