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Medical technology is undergoing rapid transformations, and the classifications of medical devices have also expanded greatly; therefore, it is necessary to develop appropriate reimbursement policies and pricing mechanisms in a timely manner. This paper aims to introduce the reimbursement coverage and pricing rules for medical devices in Taiwan. In addition, this paper identifies and evaluates available health technology assessments (HTA) and literature on published websites concerning medical device decision-making processes and pricing systems in South Korea and Japan, which are near Taiwan and have similar reimbursement coverage processes. Reimbursement policy and pricing mechanisms are constantly being revised in Taiwan, Japan, and South Korea. Recently, all three countries attempted to establish new reimbursement coverage decision-making and pricing rules, adopting a differentiated approach based on the level of evidence required for the appropriated reimbursement in terms of a feasible evaluation mechanism for providing patients with more effective medical devices. This article is expected to contribute to providing references to new reimbursement coverage decision-making and pricing rules.

Purpose. This study aims to examine the prevalence rate of ocular manifestations and the positive rate for the real-time reverse transcriptase-polymerase chain reaction (RT-PCR) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in conjunctival/tear swabs among adult patients with coronavirus disease 2019 (COVID-19). Methods. PubMed and EMBASE were reviewed between December 1, 2019, and January 31, 2021, and only peer-reviewed clinical studies in our pooled analyses were included. Details regarding the patient numbers, demographics, ocular manifestations, positivity of ocular surface RT-PCR, and severity of pneumonia were recorded from each study. Primary outcomes were the occurrence of ocular manifestations and virus detection on the ocular surface. Meanwhile, secondary outcomes included frequencies of various ocular symptoms/signs (s/s), the proportion of patients with ocular manifestation as the initial symptom, and the relationship between the severity of pneumonia and the presentation of ocular manifestations. Results. In total, 35 studies with 4,432 adult COVID-19 patients were included in this analysis. The overall prevalence rate of ocular manifestations was found to be 11.3%, and the positive rate of SARS-CoV-2 in the ocular surface was 7.4%. The four most common ocular s/s were follicular conjunctivitis, redness, watering, and discharge. A proportion of 3.3% presented with ocular s/s preceding other findings. Besides, patients with higher severity of pneumonia were more likely to have ocular manifestations (odds ratio = 2.25; 95% confidence interval (CI): 1.45–3.50). Conclusion. As per our findings, it was determined that ocular transmission of SARS-CoV-2 might be possible, highlighting the importance of eye protective equipment among healthcare personnel.

Additional file 1: Figure S1. Sampling sites on the Tibetan Plateau. Figure S2. Physicochemical parameters in saline and nonsaline soil on the Tibetan Plateau. Figure S3. The difference of bacterial community functions in saline and nonsaline soil on the Tibetan Plateau. Figure S4. Normalized abundance of functional pathways of carbon fixation (a) and methane metabolism (b) of bacterial community in saline and nonsaline soil on the Tibetan Plateau. Figure S5. The ratio of sulfur cycling genes in saline and nonsaline soil on the Tibetan Plateau. Figure S6. The normalized abundance of heavy metal(loid)s resistance genes in saline and nonsaline soil on the Tibetan Plateau. Figure S7. The normalized abundance of environmental stress response genes in saline and nonsaline soil on the Tibetan Plateau. Figure S8. The correlation analysis of bacterial community composition and function with environmental factors in saline and nonsaline soil on the Tibetan Plateau. Table S1. The alpha diversity of bacterial community in saline and nonsaline soils of Tibetan Plateau. Table S2. The topology structure characteristics of network of bacteria and environmental factors. Table S3. Genera in different modules in network of genus and environmental factors.

Huan Liu,1,2 Xiao-Rong Zhang,1,2 Hong-Chang Xu,1 Yue Ma,1 Li-Ying Huang,1 Li-Ying Zhai,1 Ying Zhao2 1Division of Ocular Injuries, Department of Ophthalmology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China; 2Hebei OPO Eye Bank, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of ChinaCorrespondence: Xiao-Rong Zhang Email zxr1110@sina.comPurpose: To evaluate the effects of the vascular endothelial growth factor inhibitor conbercept (KH902) on corneal neovascularization and wound healing following penetrating keratoplasty in rabbits.Methods: Conbercept was administered to New Zealand white rabbits through topical and subconjunctival routes. Corneal neovascularization and wound healing were examined by slit-lamp photography and histological analyses. The expressions of vascular endothelial growth factor inhibitor, α-smooth muscle actin, and keratocan in the corneal grafts were measured by real-time quantitative polymerase chain reaction (RT-qPCR).Results: The anterior segment photographs demonstrated that corneal neovascularization started in the 2nd week. In the 4th week, histologically, the superficial corneal stroma layer showed disordered arrangement, and there were large numbers of dense inflammatory cells and blood vessels in the stroma layer. Vascular endothelial growth factor in the experimental groups was significantly decreased at all time points compared with the control group (both P = 0.001). Expression of α-smooth muscle actin in corneal grafts demonstrated an increase in time even it was lower in experimental groups, but the difference was not statistically significant (P equaled to 0.507 and 0.723, respectively). There were no significant differences with the expression of keratocan in all groups except that it significantly declined at the 4th week as to the second week in all groups and P values were 0.022, 0.020 and 0.014 in control (C), topical (E1), and subconjunctival (E2) group, respectively.Conclusion: The study found that conbercept inhibited the formation of corneal neovascularization without affecting keratocan-mediated corneal wound healing and there were no significant differences between topical administration of different doses of conbercept on the rabbit corneal neovascularization after penetrating keratoplasty in this study.Keywords: α-smooth muscle actin, conbercept, corneal neovascularization, keratocan, penetrating keratoplasty, vascular endothelial growth factor, VEGF

Purpose. The iStent provides a direct pathway for aqueous outflow from the anterior chamber to Schlemm’s canal in patients with open-angle glaucoma (OAG). We performed a meta-analysis to evaluate the effectiveness of iStent as a standalone operation in patients with OAG in reducing the intraocular pressure (IOP) and the number of topical glaucoma medications. Methods. We searched various databases between January 1, 2000, and September 30, 2019, and included only peer-reviewed, prospective, or retrospective clinical studies in our analyses. Details regarding the IOP and the number of medications at baseline and end point were recorded from each study. Standardized mean differences (SMDs) of IOP and medication numbers were calculated. Furthermore, the success rate (the proportion of IOP ≤18 mmHg and IOP reduction ≥20% at end point) and the complication rate were also summarized. Finally, a subgroup analysis was done based on the iStent generation (first and second), follow-up duration (≤6, 6–18, 18–36, and >36 months), and iStent number (one, two, and three). The outcome measures were aggregated SMDs computed from each study. Results. A total of 17 studies with 978 eyes were included in this analysis. All studies demonstrated a reduction in IOP after iStent implantation. Aggregated SMDs of IOP revealed a significant reduction (SMD = −2.64, 95% confidence interval (CI): −3.21 to −2.07). The success rate was significantly good, and most of the complication rates were low. The number of medications was also significantly reduced (SMD = −1.71, 95% CI: −2.18 to −1.24). The subgroup analysis revealed a reduction in IOP and medication burden in each category of iStent generation, follow-up duration of up to 42 months, and iStent numbers. Conclusion. Use of iStent as a standalone procedure does reduce the IOP and the number of glaucoma medications. The benefit of iStent lasts for at least 42 months.