Key Points Question Is the modified newborn genetic and hearing screening feasible in China? Findings In this population-based cohort study including 32 512 infants, incorporating the limited and expanded genetic screening into physiological screening was associated with identifying 31 newborns with hearing loss missed by the conventional hearing screening, providing etiologic information to 1299 participants, and targeting 517 children at risk of late-onset hearing loss to improve prevention. Meaning Large observational studies are needed to evaluate the cost-effectiveness and long-term benefits of integrated genetic and hearing screening programs.
IMPORTANCE Congenital cytomegalovirus infection (cCMVi) is one of the most common infections associated with childhood hearing loss. Prevention and mitigation of cCMVi-related hearing loss will require an increase in newborn screening, which is not yet available in China. OBJECTIVETo estimate the cost-effectiveness of newborn screening strategies for cCMVi from the perspective of the Chinese health care system. DESIGN, SETTING, AND PARTICIPANTSA decision tree for a simulated cohort population of 15 000 000 live births was developed to compare the costs and health effects of 3 mutually exclusive interventions: (1) no screening, (2) targeted screening using CMV polymerase chain reaction assay for newborns who fail a universal hearing screening, and (3) universal screening for CMV among all newborns. Markov diagrams were used to evaluate the lifetime horizon (76 years). MAIN OUTCOMES AND MEASURESCost, hearing-related health outcomes, and incremental costeffectiveness ratios (ICERs) were estimated based on a direct medical costs perspective. Costs and ICERs were reported in 2018 US dollars. RESULTSIncidence of cCMVi among newborns was reported to be approximately 0.7% in China.Targeted screening was less costly but also less effective than universal screening, identifying 41% of cases needing antiviral treatment and preventing nearly half of less severe or profound hearing loss.To avoid 1 CMV-related severe or profound hearing loss, 13 and 16 newborns need to be treated by targeted and universal screening, respectively. The ICERs of targeted and universal screening vs no screening were $79 and $2087 per quality-adjusted life-year gained, respectively, at the discounted rate of 3.5%. Both screening options were cost-effective for the Chinese health care system based on the willingness-to-pay threshold of 3 × gross domestic product per capita. The sensitivity analysis showed that the prevalence of cCMVi, as well as diagnosis and treatment costs, were key factors that may be associated with decision-making. CONCLUSIONS AND RELEVANCETo achieve cost-effectiveness and best health outcomes, universal screening could be considered for the Chinese population. While the results are specific to China, the model may easily be adapted for other countries.
We developed monodisperse ZnO nanocapsules and atmospheric N plasma was used to develop a ZnOorganic nanocomposite. To test the seal of the ZnO nanocapsule, the halide perovskite CH 3 NH 3 PbBr 3 was used as the filler. Al atoms were doped into ZnO nanorods to increase the conductivity of ZnO nanorods. A green emission peak located at 535 nm was observed in the nanocapsules with a 410 nm excitation because of the free-exciton recombination of CH 3 NH 3 PbBr 3 . The Al-doped ZnO (AZO)/ CH 3 NH 3 PbBr 3 nanocapsules was further tested under using a three-electrode photoelectrochemistry cell. AZO/ CH 3 NH 3 PbBr 3 nanocapsule arrays yield an elevated photocurrent of approximately 0.2 mA/cm 2 at 1 V versus Ag/AgCl under air mass 1.5 (AM 1.5), almost 1.5 times larger than that of the AZO nanorod arrays. The photo-current stability of AZO/ CH 3 NH 3 PbBr 3 nanocapsule arrays photoelectrode is better than that of AZO nanorod arrays under a repeated on/off light test. This confirmed that the AZO/CH 3 NH 3 PbBr 3 nanocapsules had been successfully sealed and that the degradation of CH 3 NH 3 PbNBr 3 was thus dramatically reduced. Our study yields a novel platform for nanoscale optical and optoelectronic devices or for delivery of highly toxic drugs.
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