Binary Host-induced Exciplex Enabled High Color-Rendering Index of 94 for Carbon Quantum Dot-Based White Light-Emitting Diodes.

White light-emitting diodes (WLEDs) with high color-rendering index (CRI, >90) are important for backlight displays and solid-state lighting applications. Although the well-developed colloidal quantum dots (QDs) based on heavy metals such as cadmium and lead are promising candidates for WLEDs, the low CRI still remains a significant limitation. In addition, the severe toxicity of heavy metals greatly limits their widespread use. Herein, the study demonstrates low-cost and environmentally friendly carbon quantum dots (CQDs)-based WLEDs that exhibit a high CRI of 94.33, surpassing that of conventional cadmium/lead-containing QD-based WLEDs. This achievement is attained through the employment of a binary host-induced exciplex strategy. The high hole/electron mobility and suitable energy levels of the donor and acceptor give rise to a broadband orange-yellow emission stemming from the exciplex. As the host, the binary exciplex is capable of contributing blue and orange-yellow emission components while efficiently mitigating the aggregation-induced quenching of CQDs. Meanwhile, CQDs effectively address the deep-red emission gap, enabling the realization of CQDs-based WLEDs with high CRI. These WLEDs also exhibit a remarkably low turn-on voltage of 2.8 V, a maximum luminance exceeding 2000 cd m- 2, a correlated color temperature of 4976 K, and Commission Internationale de l'Eclairage coordinates of (0.34, 0.32).

A Novel PiGF@Diamond Color Converter with a Record Thermal Conductivity for Laser-Driven Projection Display.

High-brightness laser lighting is confronted with crucial challenges in developing laser-excitable color converting materials with effective heat dissipation and super optical performance. Herein, a novel composite of phosphor-in-glass film on transparent diamond (PiGF@diamond) is designed and fabricated via a facile low-temperature co-sintering strategy. The as-prepared La3Si6N11:Ce3+ (LSN:Ce) PiGF@diamond with well-retained optical properties of raw phosphor shows a record thermal conductivity of ≈599 W m-1 K-1, which is about 60 times higher than that of currently well-used PiGF@sapphire (≈10 W m-1 K-1). As a consequence, this color converter can bear laser power density up to 40.24 W mm-2 and a maximum luminance flux of 5602 lm without luminescence saturation due to efficient inhibition of laser-induced heat accumulation. By further supplementing red spectral component of CaAlSiN3:Eu2+ (CASN:Eu), the PiGF@diamond based white laser diode is successfully constructed, which can yield warm white light with a high color rendering index of 89.3 and find practical LD-driven applications. The findings will pave the way for realizing the commercial application of PiGF composite in laser lighting and display.

Crystal-Site Engineering of Novel Na3KMg7(PO4)6-x(BO3)x:Eu2+ Phosphors for Full-Spectrum Lighting.

The "cyan gap" is the bottleneck problem in violet-driven full-spectrum white-light-emitting diodes (wLEDs) in healthy lighting. Accordingly, we develop a novel broadband-blue-cyan emission Na3KMg7(PO4)6-x(BO3)x:Eu2+ (NKMPB:Eu2+) phosphor via crystal-site engineering. This phosphor is derived from the Na3KMg7(PO4)6:Eu2+ phosphor, which shows desired abundant cyan emissive components. A comparative study is conducted to reveal the microstructure-property relationship and the key influential factors to its spectrum distribution. It can be found that the introduced (BO3)3- units can manipulate the site-selective occupation of Eu2+ activators, asymmetrically broadening the emission spectrum in NKMPB:Eu2+. Considering detailed luminescence performance analysis and the density functional theory calculations, a new substitution pathway of Eu2+ is created by substituting (PO4)3- with (BO3)3- units, making partial Eu2+ ions enter the Mg2+ (CN = 5, CN = 6) crystallographic sites, and yielding an extra emission band at 600 nm (16667 cm-1) and especially 501 nm (19960 cm-1). Meanwhile, a high-color-quality full-spectrum-emitting wLEDs was fabricated, upon 100 mA forward-bias current driven. Due to the achieved extra cyan emissive components of NKMPB:Eu2+, the constructed NKMPB:Eu2+-based wLEDs show better color rendering ability (∼90.9) than that of Na3KMg7(PO4)6:Eu2+-based wLEDs (∼86.3), and also demonstrate its great potential in full-spectrum healthy lighting.

Highly Bright and Stable Lead-Free Double Perovskite White Light-Emitting Diodes.

Lead-free double perovskites (DPs) are emerging highly stable emitters with efficient broadband self-trapped exciton (STE) photoluminescence (PL), but their low electroluminescent (EL) efficiency is a critical shortcoming. This work promotes the external quantum efficiency (EQE) and luminance of DP-based white light-emitting diode (wLED) with a normal device structure to 0.76% and 2793 cd m-2 via two modifications: This work prevents the formation of adverse metallic silver, spatially confined STE, and lowers local site symmetry in Cs2 Na0.4 Ag0.6 In0.97 Bi0.03 Cl6 DP by terbium doping; and this work develops a guest-host strategy to improve film morphology, reduce defect density, and increase carrier mobility. These alterations cause substantial increase in STE radiative recombination and charge injection efficiency of perovskite layer. Finally, pure white EL with ideal color coordinates of (0.328, 0.329) and a record-breaking optoelectronic performance is achieved by introducing additional green carbon dots in LED to fill the deficient green component.

Gallic Acid Treats Hypertrophic Scar in Rabbit Ears via the TGF-ß/Smad and TRPC3 Signaling Pathways.

Hypertrophic scars (HSs) develop due to excessive collagen deposition and abnormal fibroblast proliferation during wound healing, significantly impacting patient quality of life. Three dosages of GA ointments were administered to rabbit ear HS models to investigate the potential efficacy and mechanism of gallic acid (GA) on HS. Daily application of ointment was performed on the matrix group, the GA ointment groups, and the silicone gel group for 28 days. (No drug treatment was performed on the skin and model groups as a blank group and vehicle group, and silicone gel ointment was topically administered to the silicone gel group as a positive control group.) Scar specimens were collected for histopathology analysis, RNA sequencing analysis, real-time quantitative polymerase chain reaction, and Western blot analysis at the first, second, and fourth weeks after the treatment. Low-dose and medium-dose GA effectively suppressed HS formation and markedly decreased fibroblast infiltration levels and scar thickness. Moreover, decreased expression of TRPC3 mRNA and TGF-ß1, p-Smad2/3, and Smad2/3 protein was observed in the low- and medium-dose GA groups and the silicone gel group. This study provides evidence for the efficacy of GA in treating HS and sheds light on its potential underlying pharmacological mechanisms.

Ultra-Narrow-Bandwidth Deep-Red Electroluminescence Based on Green Plant-Derived Carbon Dots.

Deep-red light-emitting diodes (DR-LEDs, >660 nm) with high color-purity and narrow-bandwidth emission are promising for full-color displays and solid-state lighting applications. Currently, the DR-LEDs are mainly based on conventional emitters such as organic materials and heavy-metal based quantum dots (QDs) and perovskites. However, the organic materials always suffer from the complicated synthesis, inferior color purity with full-width at half-maximum (FWHM) more than 40 nm, and the QDs and perovskites still suffer from serious problems related to toxicity. Herein, this work reports the synthesis of efficient and high color-purity deep-red carbon dots (CDs) with a record narrow FWHM of 21 nm and a high quantum yield of more than 50% from readily available green plants. Moreover, an exciplex host is further established using a polymer and small molecular blend, which has been shown to be an efficient strategy for producing high color-purity monochrome emission from deep-red CDs via Förster energy transfer (FET). The deep-red CD-LEDs display high color-purity with Commission Internationale de l'Eclairage (CIE) coordinates of (0.692, 0.307). To the best of the knowledge, this is the first report of high color-purity CD-LEDs in the deep-red region, opening the door for the application of CDs in the development of high-resolution light-emitting display technologies.

Seven-photon absorption from Na+/Bi3+-alloyed Cs2AgInCl6 perovskites.

Nonlinear multi-phonon (2-7) absorption in the Na+/Bi3+-alloyed Cs2AgInCl6 lead-free double perovskites with ∼100% photoluminescence quantum yield and superior stability is observed for the first time, which can be pumped by a femtosecond laser in a wide spectral range (800-2600 nm). First-principles calculations verify that the parity-forbidden transition from the valence band maximum and conduction band minimum (at the Γ point) is not broken by Na+/Bi3+ doping, and strong optical band-to-band absorption occurs at the L&X points. Time-resolved emission spectra evidence that single-photon and multi-photon pumping leads to the same self-trapped exciton transition and high-order nonlinear absorption will not induce a remarkable thermal effect. Finally, we demonstrate that the Cs2Na0.4Ag0.6In0.99Bi0.01Cl6 DP shows great potential for next-generation wavelength-selective and highly sensitive multiphoton imaging applications.

Traditional Chinese medicine for hypertrophic scars-A review of the therapeutic methods and potential effects.

Hypertrophic scar (HS) is a typical pathological response during skin injury, which can lead to pain, itching, and contracture in patients and even affect their physical and mental health. The complexity of the wound healing process leads to the formation of HS affected by many factors. Several treatments are available for HS, whereas some have more adverse reactions and can even cause new injuries with exacerbated scarring. Traditional Chinese Medicine (TCM) has a rich source, and most botanical drugs have few side effects, providing new ideas and methods for treating HS. This paper reviews the formation process of HS, the therapeutic strategy for HS, the research progress of TCM with its relevant mechanisms in the treatment of HS, and the related new drug delivery system of TCM, aiming to provide ideas for further research of botanical compounds in the treatment of HS, to promote the discovery of more efficient botanical candidates for the clinical treatment of HS, to accelerate the development of the new drug delivery system and the final clinical application, and at the same time, to promote the research on the anti-HS mechanism of multiherbal preparations (Fufang), to continuously improve the quality control and safety and effectiveness of anti-HS botanical drugs in clinical application.

An Analysis of Life-Year Lost Due to COVID-19 - 34 Countries, December 2019-March 2021.

What is already known about this topic?: The coronavirus disease 2019 (COVID-19) pandemic has caused severe health consequences. Though most COVID-19 deaths occurred among very old people, their life-year loss might be very large because of their life expectancy at that age. What is added by this report?: This study quantified how many years of life were lost due to COVID-19 in 34 countries. COVID-19 caused 9 to 21 years of life lost (YLL) per deceased patient. East Asia and Oceania had substantially lower per capita YLL than North America and Europe. Among all countries included, the United States had the greatest total YLL, Peru had the largest YLL per 100,000 people, and Mexico had the largest YLL per 100,000 COVID-19 patients. What are the implications for public health practice?: The YLL quantification indicated that the vulnerable population, especially the elderly, should be protected under careful public health measures to reduce their YLL. It also implied that it might be too early to lift anti-epidemic restrictions now, since the extreme disproportionate consequences (total and per-capita YLL) in different countries underscored the scrutinization over the variation in disease control strategies to optimize future disease control and prevention.

Effects of baloxavir and oseltamivir antiviral therapy on the transmission of seasonal influenza in China: A mathematical modeling analysis.

New antiviral influenza treatments can effectively alleviate illness while reducing viral shedding. However, how such effects can translate into lower population infections of seasonal influenza in China remains unknown. To shed light on the public health impacts of novel antiviral agents for influenza, we constructed a dynamic transmission model to simulate the seasonal influenza epidemics in China. Two antivirus treatments, baloxavir and oseltamivir, were evaluated by estimating their impacts on the incidences of influenza infection in a single flu season. In the base-case analysis of a 10% antiviral treatment uptake rate, 2760 and 3420 per 10 000 persons contracted influenza under the treatment of baloxavir and oseltamivir, respectively. These incidence rates amounted to an 18.90% relative risk reduction (RRR) of infection associated with baloxavir in relation to oseltamivir. The corresponding RRR was 82.16% when the antiviral treatment uptake rate was increased to 35%. In addition, the peak of the prevalence of infected individuals per 10 000 persons under the baloxavir treatment was 177 (range: 93-274) fewer than that of oseltamivir. Our analyses suggest that the baloxavir treatment strategy reduces the incidence of influenza in China compared with oseltamivir in the setting of a seasonal flu epidemic. Also, increasing the uptake rate of antiviral treatment can potentially prevent millions of infections during a single flu season.

STAT1 Mediates the Transcription of CircIFI30 and Promotes the Progression of Triple-Negative Breast Cancer by Up-Regulating CDCA4.

Signal transducers and activators of transcription 1 (STAT1) is an important transcription factor that regulates the growth, survival, differentiation and apoptosis of various tumor cells. However, the biological roles of STAT1 and potential mechanisms in triple-negative breast cancer (TNBC) remain largely unknown. The expression levels of STAT1, CircIFI30, CDCA4, and epithelial-mesenchymal transition (EMT)-associated molecules (MM2, MMP9, E-cadherin, and N-cadherin) were evaluated using quantitative reverse transcription polymerase chain reaction (RT-qPCR). Furthermore, cell-counting kit-8 assay, Transwell assay, flow cytometry, and immunofluorescence staining were performed to investigate the biological functions of STAT1 and CircIFI30 in TNBC cells. In addition, Dual luciferase activity assay and chromatin immunoprecipitation qPCR were used to predict the interaction between STAT1 and CircIFI30 promoter. The effects of CircIFI30 on the stability of CDCA4 mRNA were also confirmed in further function study. Up-regulation of STAT1 was detected in TNBC tissues and cells, which were positively correlated with tumor metastasis, advanced clinical stage and poor survival rate. Up-regulated STAT1 could promote the proliferation, invasion, migration, EMT and inhibit the apoptosis of TNBC cells. RNA-seq indicated has_circ_0005571 (CircIFI30) was significantly down-regulated in TNBC cells after knockdown of STAT1. Moreover, STAT1 could be novel transcription factor that binds to CircIFI30 promoter to enhance its transcription. Additionally, knockdown of CirclFl30 down regulated the expression of cell division cycleassociated protein 4 (CDCA4) through reducing the stability of its mRNA. Our data revealed the STAT1/CircIFI30/CDCA4 axis could regulate the proliferation, invasion, migration, EMT and apoptosis of TNBC cells. Therefore, STAT1 may be a putative therapeutic candidate for targeted treatment of TNBC.

Compact ultrabroadband light-emitting diodes based on lanthanide-doped lead-free double perovskites.

Impurity doping is an effective approach to tuning the optoelectronic performance of host materials by imparting extrinsic electronic channels. Herein, a family of lanthanide (Ln3+) ions was successfully incorporated into a Bi:Cs2AgInCl6 lead-free double-perovskite (DP) semiconductor, expanding the spectral range from visible (Vis) to near-infrared (NIR) and improving the photoluminescence quantum yield (PLQY). After multidoping with Nd, Yb, Er and Tm, Bi/Ln:Cs2AgInCl6 yielded an ultrabroadband continuous emission spectrum with a full width at half-maximum of ~365 nm originating from intrinsic self-trapped exciton recombination and abundant 4f-4f transitions of the Ln3+ dopants. Steady-state and transient-state spectra were used to ascertain the energy transfer and emissive processes. To avoid adverse energy interactions between the various Ln3+ ions in a single DP host, a heterogeneous architecture was designed to spatially confine different Ln3+ dopants via a "DP-in-glass composite" (DiG) structure. This bottom-up strategy endowed the prepared Ln3+-doped DIG with a high PLQY of 40% (nearly three times as high as that of the multidoped DP) and superior long-term stability. Finally, a compact Vis-NIR ultrabroadband (400~2000 nm) light source was easily fabricated by coupling the DiG with a commercial UV LED chip, and this light source has promising applications in nondestructive spectroscopic analyses and multifunctional lighting.

A single-beam NIR laser-triggered full-color upconversion tuning of a Er/Tm:CsYb2F7@glass photothermal nanocomposite for optical security.

The development of advanced luminescent materials is highly desirable for addressing the rising threat of forgery. However, it is challenging to achieve stable full-color upconversion (UC) tuning in the same matrix upon a single-beam light excitation so as to ensure that authentic items are irreproducible. Herein, hexagonal Er/Tm:CsYb2F7 nanocrystals (NCs) embedded inorganic glass via an in situ crystallization strategy is fabricated, which can emit blue, cyan, green, yellow, orange, red and near-infrared (NIR) UC emissions by simply modifying an incident 980 nm laser power. This UC tuning is attributed to the combination roles of the highly efficient laser-induced photothermal effect of the CsYb2F7 host and simultaneous emissions of Er and Tm activators. Importantly, the robust inorganic glass matrix endows Er/Tm:CsYb2F7 NCs with excellent water resistance and the ability to withstand high-power laser irradiation. Based on these unique characteristics, a proof-of-concept anti-counterfeiting experiment is designed. The results indicate that dynamic full-color UC luminescence patterns can be easily tuned by simply changing the power of the incident 980 nm laser. The present work not only confirms that the designed photothermal material can increase information security, but also provides a new idea for practical applications in the field of anti-counterfeiting.

Bright Electroluminescent White-Light-Emitting Diodes Based on Carbon Dots with Tunable Correlated Color Temperature Enabled by Aggregation.

Carbon dots (CDs) as one of the most promising carbon-based nanomaterials are inspiring extensive research in optoelectronic applications. White-light-emitting diodes (WLEDs) with tunable correlated color temperatures (CCTs) are crucial for applications in white lighting. However, the development of high-performance CDs-based electroluminescent WLEDs, especially those with adjustable CCTs, remains a challenge. Herein, white CDs-LEDs with CCTs from 2863 to 11 240 K are successfully demonstrated by utilizing aggregation-induced emission red-shifting and broadening of CDs. As a result, a series of warm white, pure white, and cold white CDs-LEDs are realized with adjustable emissions in sequence along the blackbody radiation curve. These CDs-LEDs reach maximum brightness and external quantum efficiency up to 1414-4917 cd m-2 and 0.08-0.87%, respectively, which is among the best performances of white CDs-LEDs. To the best of the authors' knowledge, this is the first time that CCT-tunable white electroluminescent CDs-LEDs are demonstrated through controlling the aggregation degrees of CDs.

Ytterbium-Doped CsPbCl3 Quantum Cutters for Near-Infrared Light-Emitting Diodes.

Exploring highly efficient near-infrared (NIR) emitting materials is desirable for the advancement of next-generation smart NIR light sources. Different from most reported Cr3+-doped emitters with far-red emissions, Yb3+-activated phosphors are expected to yield pure NIR (∼1000 nm) light. Herein, a new hot-injection route using all metal-oleate salts to fabricate Yb3+-doped CsPbCl3 perovskite nanocrystals (PeNCs) is reported for the first time, which produce PeNC-sensitized Yb3+ NIR emission with photoluminescence quantum yields (PLQYs) higher than 100%. With the help of temperature-dependent PL spectra, femtosecond transient absorption spectra, and time-resolved PL spectra, it is evidenced that the in situ produced intrinsic shallow trap states in a CsPbCl3 host play a key role in facilitating the picosecond nonradiative cooperative energy transfer from PeNCs to two Yb3+ dopants simultaneously. Using the optimized Yb3+:CsPbCl3 quantum cutters, a phosphor-converted NIR light-emitting diode (pc-NIR-LED) is fabricated, exhibiting an external quantum efficiency of 2%@28 mA, a high NIR output irradiance of 112 mW/cm2@400 mA, and excellent long-term stability. Finally, the designed pc-NIR-LED is demonstrated to have great potential as an invisible night-vision light source.

Economic evaluation of remdesivir for the treatment of severe COVID-19 patients in China under different scenarios.

AIMS: The present study aimed to evaluate the cost-effectiveness of the 5-day remdesivir regimen compared with standard of care among severe COVID-19 patients in China, the evidence on which is essential to inform the necessity of securing access to remdesivir. METHODS: A dynamic transmission model that extended the susceptible-exposed-infected-recovered framework by incorporating asymptomatic, presymptomatic and waiting-to-be-diagnosed patients was constructed to conduct the cost-effectiveness analysis from the healthcare system perspective. To estimate epidemic parameters, the model was first calibrated to the observed epidemic curve in Wuhan from 23 January to 19 March 2020. Following the calibration, the infected compartment was replaced by 3 severity-defined health states to reflect differential costs and quality of life associated with disease gravity. Costs and quality-adjusted life year (QALY) outcomes of 9 million simulated people were accrued across time to evaluate the incremental cost-effectiveness ratio of remdesivir. As robustness checks, an alternative modelling technique using decision tree, additional epidemic scenarios representing different epidemic intensities, and 1-way parameter variations were also analysed. RESULTS: Remdesivir treatment cost CN¥97.93 million more than standard of care. Also, the net QALY gain from 5-day remdesivir treatment was 6947 QALYs. As such, the incremental cost-effectiveness ratio was CN¥14 098/QALY, substantially lower than the gross domestic product per capita threshold. The peak daily number of severe cases was 19% lower in the remdesivir treatment strategy. Overall, results were robust in alternative scenarios and sensitivity analyses. CONCLUSION: Given the cost-effectiveness profile, access to remdesivir for severe COVID-19 patients in China should be considered.

Cost-effectiveness of dual influenza and pneumococcal vaccination among the elderly in Shenzhen, China.

OBJECTIVE: To assess the cost-effectiveness of dual influenza and pneumococcal vaccination for the elderly in Shenzhen, China. METHODS: A Markov state-transition model with a weekly cycle was developed to compare the outcomes of dual influenza and pneumococcal vaccination for the prevention of influenza and pneumococcal infections compared with no vaccination among 70-74 years old people in Shenzhen over 5 years. The model allowed seasonal variation of influenza activity. We calculated the incremental cost-effectiveness ratio (ICER) with costs and quality-adjusted life years (QALYs) discounted at 5% annually from the societal perspective. The impact of parameter uncertainty on the results was examined using one-way and probabilistic sensitivity analyses (PSA). RESULTS: In the base case, dual vaccination prevented 5042 influenza infections, 26 IPD cases, 3 disabilities, 34 deaths, and cost US$7.1 per person while resulting in a net gain of 0.0026 QALYs compared with no vaccination. Using once the Chinese gross domestic product per capita in 2019 (US$10,289) as the willingness-to-pay threshold, dual vaccination was cost-effective with an ICER of US$2699 per QALY gained. One-way sensitivity analyses showed that the ICER was relatively sensitive to changes in influenza attack rates and influenza vaccine effectiveness. Based on the results of PSA with 1000 Monte Carlo simulations, receiving both vaccines was cost-effective in 100% of the repetitions. CONCLUSION: The current study provides evidence that dual influenza and pneumococcal vaccination is a cost-effective disease prevention strategy for the elderly in Shenzhen, China.

Effectiveness of remdesivir for the treatment of hospitalized COVID-19 persons: A network meta-analysis.

Several randomized clinical trials (RCTs) that investigated the effectiveness of remdesivir for the treatment of coronavirus disease-2019 (COVID-19) have generated inconsistent evidence. The present study aimed to synthesize available RCT evidence using network meta-analyses (NMAs). Both blinded and open-label RCTs in PubMed database from inception to 7 June 2020 that contained "remdesivir", "Covid-19", and "trial" in the abstracts conducted on hospitalized COVID-19 persons were identified and screened. The studies must have at least one remdesivir arm and evaluated one of the pre-specified outcomes. The outcomes were clinical improvement between days 10 to 15 after randomization and clinical recovery during the follow-up period. The identified literature was supplemented with relatively recent studies that were known to the researchers if not already included. Frequentist NMAs with random effects were conducted. Both 10-day and 5-day remdesivir regimens were associated with higher odds of clinical improvement (odds ratio [OR] of 10-day regimen: 1.35, 95% confidence interval [CI], 1.09-1.67); OR of 5-day regimen: 1.81, 95% CI, 1.32-2.45, and higher probabilities of clinical recovery (relative risk [RR] of 10-day regimen: 1.24, 95% CI, 1.07-1.43; RR of 5-day regimen: 1.47, 95% CI, 1.16-1.87 compared with placebo. Remdesivir may have clinical benefits among hospitalized COVID-19 persons.

Dual influenza and pneumococcal vaccination was associated with lower short-term risks of all-cause and acute respiratory hospitalizations among the elderly in Shenzhen, China: a retrospective cohort study.

The present study evaluated the real-world effectiveness of influenza and pneumococcal dual-vaccination among Chinese elderly, the evidence on which was absent. Outpatient and inpatient claims databases from Jan 1, 2015 to Apr 1, 2017 of persons at least 60 years old in Shenzhen, China were merged with electronic records of influenza vaccines and 23-valent pneumococcal polysaccharide vaccines (PPSV23) from Oct 1, 2016 - May 31, 2017. Individuals who were vaccinated with influenza between Nov 1 and Dec 31, 2016 and received PPSV23 30 days within the date of influenza vaccination were defined as the vaccinated group. A control group consisted of individuals that received neither of the vaccines was constructed by matching on year of birth, sex, and district. The two outcomes were all-cause and acute respiratory hospitalizations. Difference-in-difference (DiD) logistic regressions that were proceeded with an entropy balancing (EB) process were used to analyse the effectiveness of dual-vaccination. A total of 48,116 eligible individuals were identified in the vaccinated group, which were matched by 93,692 individuals in the control group. The EB-DiD analyses estimated that dual-vaccination was associated with lower short-term risks of all-cause (odds ratio: 0.59, CI: 0.55-0.63) and acute respiratory (odds ratio: 0.49, CI: 0.41-0.59) hospitalizations.

The cost-effectiveness of conducting three versus two reverse transcription-polymerase chain reaction tests for diagnosing and discharging people with COVID-19: evidence from the epidemic in Wuhan, China.

OBJECTIVES: The objectives were to evaluate the effectiveness of conducting three versus two reverse transcription-PCR (RT-PCR) tests for diagnosing and discharging people with COVID-19 with regard to public health and clinical impacts by incorporating asymptomatic and presymptomatic infection and to compare the medical costs associated with the two strategies. METHODS: A model that consisted of six compartments was built. The compartments were the susceptible (S), the asymptomatic infective (A), the presymptomatic infective (L), the symptomatic infective (I), the recovered (R), and the deceased (D). The A, L and I classes were infective states. To construct the model, several parameters were set as fixed using existing evidence and the rest of the parameters were estimated by fitting the model to a smoothed curve of the cumulative confirmed cases in Wuhan from 24 January 2020 to 6 March 2020. Input data about the cost-effectiveness analysis were retrieved from the literature. RESULTS: Conducting RT-PCR tests three times for diagnosing and discharging people with COVID-19 reduced the estimated total number of symptomatic cases to 45| 013 from 51 144 in the two-test strategy over 43 days. The former strategy also led to 850.1 quality-adjusted life years (QALYs) of health gain and a net healthcare expenditure saving of CN¥49.1 million. About 100.7 QALYs of the health gain were attributable to quality-adjusted life day difference between the strategies during the analytic period and 749.4 QALYs were attributable to years of life saved. CONCLUSIONS: More accurate strategies and methods of testing for the control of COVID-19 may reduce both the number of infections and the total medical costs. Increasing the number of tests should be considered in regions with relatively severe epidemics when existing tests have moderate sensitivity.