Economic Evaluation of COVID-19 Immunization Strategies: A Systematic Review and Narrative Synthesis.

OBJECTIVES: This study aimed to systematically assess global economic evaluation studies on COVID-19 vaccination, offer valuable insights for future economic evaluations, and assist policymakers in making evidence-based decisions regarding the implementation of COVID-19 vaccination. METHODS: Searches were performed from January 2020 to September 2023 across seven English databases (PubMed, Web of Science, MEDLINE, EBSCO, KCL-Korean Journal Dataset, SciELO Citation Index, and Derwent Innovations Index) and three Chinese databases (Wanfang Data, China Science and Technology Journal, and CNKI). Rigorous inclusion and exclusion criteria were applied. Data were extracted from eligible studies using a standardized data collection form, with the reporting quality of these studies assessed using the Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022). RESULTS: Of the 40 studies included in the final review, the overall reporting quality was good, evidenced by a mean score of 22.6 (ranging from 10.5 to 28). Given the significant heterogeneity in fundamental aspects among the studies reviewed, a narrative synthesis was conducted. Most of these studies adopted a health system or societal perspective. They predominantly utilized a composite model, merging dynamic and static methods, within short to medium-term time horizons to simulate various vaccination strategies. The research strategies varied among studies, investigating different doses, dosages, brands, mechanisms, efficacies, vaccination coverage rates, deployment speeds, and priority target groups. Three pivotal parameters notably influenced the evaluation results: the vaccine's effectiveness, its cost, and the basic reproductive number (R0). Despite variations in model structures, baseline parameters, and assumptions utilized, all studies identified a general trend that COVID-19 vaccination is cost-effective compared to no vaccination or intervention. CONCLUSIONS: The current review confirmed that COVID-19 vaccination is a cost-effective alternative in preventing and controlling COVID-19. In addition, it highlights the profound impact of variables such as dose size, target population, vaccine efficacy, speed of vaccination, and diversity of vaccine brands and mechanisms on cost effectiveness, and also proposes practical and effective strategies for improving COVID-19 vaccination campaigns from the perspective of economic evaluation.

Cyanide-Bridged Rope-like Chains Based on Trigonal-Bipyramidal [Fe2Cu3] Subunits.

Extending a selected cyanometalate block into a higher dimensional framework continues to present intriguing challenges in the fields of chemistry and material science. Here, we prepared two rope-like chain compounds of {[(Tp*Me)Fe(CN)3]2Cu2X2(L)}·sol (1, X = Cl, L = (MeCN)0.5(H2O/MeOH)0.5, sol = 2MeCN·1.5H2O; 2, X = Br, L = MeOH, sol = 2MeCN·0.75H2O; Tp*Me = tris(3, 4, 5-trimethylpyrazole)borate) in which the cyanide-bridged trigonal-bipyramidal [Fe2Cu3] subunits were linked with the adjacent ones via two vertex Cu(II) centers, providing a new cyanometallate chain archetype. Direct current magnetic study revealed the presence of ferromagnetic couplings between Fe(III) and Cu(II) ions and uniaxial anisotropy due to a favorable alignment of the anisotropic tricyanoiron(III) units. Moreover, compound 1 exhibits single-chain magnet behavior with an appreciable energy barrier of 72 K, while 2 behaves as a metamagnet, likely caused by the subtle changes in the interchain interactions.

Music Box-Inspired Semi-Automatic Hematocrit Validation Device.

A high hematocrit (HCT) level is strongly associated with the risk of cardiovascular disease. For early diagnosis of cardiovascular disease, it is vital to regularly measure the HCT, which is typically achieved by centrifuging a blood sample to measure the percentage of red blood cells. However, the centrifugal modalities are usually bulky, expensive, and require a stable electric input, which restrict the availability. This research develops a semi-automatic and portable centrifugal device for HCT measurement. This torque-actuated semi-automatic centrifuge, which we call the tFuge, is inspired by a music box, allowing different operators to generate the same rhythm. It is electricity-free and can be controlled based on a constant torque mechanism. Repeatable test results can be received from among different users regardless of their age, sex, and activity. With the assistance of the Boycott effect on the tFuge, we proved that the HCT level is in high linearity to the length of the sedimentation of the blood cells in a tube (R2 = 0.99, sample HCT range 10-60%). The tFuge takes less than 4 min and requires no more than 10 µL of blood that can be obtained by a less-invasive finger prick to complete the testing procedure. Calibrated gradient numbers are printed onto the rotation disc for instant HCT results that can be read by the naked eye. We expect this proposed point-of-care testing device possesses the potential to replace the microhematocrit centrifuge in the regions with limited resources.

Health Technology Assessment in China's Health Care Sector: Development and Applications.

China's health system is facing severe challenges from social transition and the double burden of population aging and non-communicable diseases. Addressing the tension between the public's increasing demand for health services and the limited availability of medical resources has become a critical issue for health care policymakers and medical insurance fund administrators. In promoting its medical insurance system reform, China is actively developing health technology assessment (HTA) with principles and applications adapted to the Chinese context. This study aims to analyze the evolution of HTA in China with a focus on context, actors, process, content, and challenges encountered through applying a modified verson of Walt and Gilson's policy triangle framework. Currently, HTA plays an indispensable part in the reform of China's health care and medical insurance system, especially in the formulation and adjustment of the National Reimbursement Drug List (NRDL). While HTA is increasingly used in China, there remain challenges, such as the slow development of HTA related disciplines, lack of an independent national HTA authority, and limited scope in the use of HTA. Despite the identified challenges, HTA has the potential to support a wide range of applications in China's health care sector, building on the progress achieved over the last three decades.

Short-Term Effects of Ambient Air Pollution on Hospitalization for Respiratory Disease in Taiyuan, China: A Time-Series Analysis.

In this study, we estimated the short-term effects of ambient air pollution on respiratory disease hospitalization in Taiyuan, China. Daily data of respiratory disease hospitalization, daily concentration of ambient air pollutants and meteorological factors from 1 October 2014 to 30 September 2017 in Taiyuan were included in our study. We conducted a time-series study design and applied a generalized additive model to evaluate the association between every 10-µg/m³ increment of air pollutants and percent increase of respiratory disease hospitalization. A total of 127,565 respiratory disease hospitalization cases were included in this study during the present period. In single-pollutant models, the effect values in multi-day lags were greater than those in single-day lags. PM2.5 at lag02 days, SO2 at lag03 days, PM10 and NO2 at lag05 days were observed to be strongly and significantly associated with respiratory disease hospitalization. No significant association was found between O3 and respiratory disease hospitalization. SO2 and NO2 were still significantly associated with hospitalization after adjusting for PM2.5 or PM10 into two-pollutant models. Females and younger population for respiratory disease were more vulnerable to air pollution than males and older groups. Therefore, some effective measures should be taken to strengthen the management of the ambient air pollutants, especially SO2 and NO2, and to enhance the protection of the high-risk population from air pollutants, thereby reducing the burden of respiratory disease caused by ambient air pollution.

Exploring New Frontiers of Microsurgery: From Anatomy to Clinical Methods.

This article presents the authors' understanding and experience concerning anatomic studies and clinical methods in microsurgical hand reconstruction. The 4 parts of this article include anatomic study of the hand for developing new flaps; application of miniflaps from the hand, including clinical experience with 8 unique flaps in the hand; anatomic and clinical considerations concerning several flaps from other parts of the human body; And our experience with vascularized free toe joint transfer.

[Application of free flap pedicled with supracarpal cutaneous branch of ulnar artery in repairing of finger replantation].

OBJECTIVE: To evaluate clinical application and clinical outcomes of free flap pedicled with supracarpal cutaneous branch of ulnar artery in repairing of finger replantation with skin defect. METHODS: From April 2007 to March 2013,25 patients affected by finger amputation with skin defect were replanted and repaired by free flap pedicled with supracarpal cutaneous branch of ulnar artery. Among them, 18 patients were male and 7 were female,with an average age of 31.5 years old (ranged 16 to 58). The time of trauma to admission ranged from 45 to 210 min (averaged 105). Fifteen patients were complete separted, and 10 patients were non-complete separated. The area of flaps ranged from 3.5 cm x 2.0 cm to 4.5 cm x 3.0 cm, and the vessels were anastomosed through end-to-end. The functional evaluation standard of finger replantation was used to evaluate the postoperative function. RESULTS: Twenty-four cases were finally survived. Two flaps occurred vascular crisisin within 48 h after operation, one of which was survived after anti-vasospasm treatment and changing dressing,another was replanted finger for failed to survive. One had infection and healed after changing dressing. Twenty-four cases were followed up from 3 to 38 months with an average of 16.5 months. The appearance and texture of flaps were satisfactory, and the superficial senses of pain and touch were recovered,and two-point discrimination was 5.5 to 11 mm (averaged 7.4 mm). According to functional evaluation standard finger replantationissued by Hand Surgery Association of Chinese Medical Association, 8 cases got excellent results, 14 good and 2 poor. CONCLUSION: The free flap pedicled with supracarpal cutaneous branch of ulnar artery can be used in complex finger replantation with skin and vessels defect, which can extend operation indications, recover function and appearance for maximum.

[Clinical application of reverse radial hypothenar flap for finger soft tissue defect].

OBJECTIVE: To investigate the therapeutic effect of reverse radial hypothenar flap for finger soft tissue defect. METHODS: From Mar. 2006 to Mar. 2010, 13 cases (14 fingers) with finger soft tissue defects were treated with reverse radial hypothenar flaps pedicled with ulnar palmar digital artery of little finger. The defects were 1.9 cm x 1.5 cm -4.0 cm x 2.0 cm in size. The flap size ranged from 1.5 cm x 2.0 cm to 4.0 cm x 2.0 cm. RESULTS: All the flaps survived completely with primary healing both in donor and recipient area. 12 cases (13 fingers) were followed up for 1-3 years. The flaps color was similar to the unaffected fingers. Cicatricial contracture happened in one case due to contracture of palmar fascia. The two-point discrimination distance on flap was 3.2-5.3mm. The active and passive movement of finger joints was evaluated as excellent in 12 fingers, good in one finger. There was no complaint about the feeling at the donor site. Two months after operation, all patients could go back to work. CONCLUSIONS: The reverse radial hypothenar flap is very suitable for finger soft tissue defect with less morbidity to donor site.