Impact of work-related cancers in Taiwan-Estimation with QALY (quality-adjusted life year) and healthcare costs

Anti-cancer bioprospecting on medicinal plants from Indonesia: A review

The Indonesian archipelago is home to the second largest biodiversity in the world and is inhabited by more than 300 ethnic groups with a total population of more than 270 million. The indigenous population still rely on traditional medicine practices, especially the use of plant-based remedies. Although modern science-based exploration on Indonesian medicinal plants started with the European settlement in the archipelago in the 16th century, it was not until the 1970's that the phytochemistry of Indonesian medicinal plants was recognized for its potency. The need for new cancer cures to increase the quality of human life has led to the bioprospecting of medicinal plants including those of Indonesian origin. Despite published reports on the anticancer potency of Indonesian medicinal plants, to date there has been no comprehensive review on this topic. In this manuscript, we review the phytochemical and pharmacological studies on medicinal plants from Indonesia related to cancer therapy. Established databases (GARUDA, SciFinder, and PubMed) were used to collate data from 1990 to 2022, resulting in the description of 134 medicinal plants and their phytochemical and pharmacological properties including examples containing potent agents against breast, leukaemia, cervix, lung, and colon cancer cell lines based on in vitro bioassays and in vivo evaluation. These findings provide valuable insights into the bioprospecting of Indonesian medicinal plant providing directions for future studies, including the development of new therapeutics, both as botanicals or by using conventional dosage.

Global Mapping of Interventions to Improve Quality of Life of Patients with Cancer: A Protocol for Literature Mining and Meta-Analysis

Cancer led to nearly 10 million deaths in 2020, as reported by the World Health Organization (WHO). Consequently, both biomedical therapeutics and psychological interventions have been implemented to decrease the burden of this non-communicable disease. However, the research conducted so far has only described some aspects of these interventions, which may increase the health-related quality of life of cancer patients. Therefore, a systematic review is necessary to depict an overall picture of the cancer interventions globally. Then, the impact of these interventions on the preference-based health-related quality of life of cancer patients may be synthesized. The protocol is developed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Web of Science database is used to retrieve the literature using four keyword terms: quality of life (QoL), cancer, interventions, and health utility. Then, we draw the global mapping diagram and conduct the meta-analysis for this research. Additionally, longitudinal measurements are used to estimate the changes in the health utility of patients during the interventions. Thus, this systematic review can provide insight into the impact of interventions on increasing the health-related quality of life (HRQL) of cancer patients.

Opioid agonist treatment reduces losses in quality of life and quality-adjusted life expectancy in heroin users: Evidence from real world data

BACKGROUND

This study estimated the long-term changes of opioid agonist treatment (OAT) in quality of life (QOL) and quantified the quality-adjusted life years (QALY) from the loss of quality-adjusted life expectancy (QALE) in heroin users.

METHODS

A total of 1283 heroin users stratified by OAT were linked to the National Mortality Registry for 8 years (2006-2014) to obtain survival functions, which were extrapolated to lifetime by applying a rolling extrapolation algorithm to survival ratio between the sub-cohorts and age- and sex-matched referents simulated from vital statistics of Taiwan. We performed cross-sectional measurement of EQ-5D on 349 participants, including those with a valid state of OAT or non-OAT plus newly recruited consecutive patients, during 2015-2017 for utility values, while the QOL of referents were abstracted from the 2009 National Health Interview Survey. The QALE was calculated by summing the products of the mean QOL and survival rate throughout life. The QALE difference between the cohort and corresponding referents was the loss-of-QALE.

RESULTS

QOL of the OAT group was significantly better than that of the non-OAT group in every domain of the EQ-5D, which was quantified to be 0.23 for utility after controlling for other variables. After extrapolation to 70 years, the estimated QALE and loss-of-QALE were 17.8 and 18.2 QALY for OAT subjects, respectively, while those of the non-OAT group were 9.2 and 27.9 QALY.

CONCLUSIONS

Receiving OAT could reduce QALE lost by 9.7 QALYs compared with non-OAT after accounting for QOL differences along time and different age and sex distributions.

A global perspective on coal-fired power plants and burden of lung cancer

BACKGROUND

Exposure to ambient particulate matter generated from coal-fired power plants induces long-term health consequences. However, epidemiologic studies have not yet focused on attributing these health burdens specifically to energy consumption, impeding targeted intervention policies. We hypothesize that the generating capacity of coal-fired power plants may be associated with lung cancer incidence at the national level.

METHODS

Age- and sex-adjusted lung cancer incidence from every country with electrical plants using coal as primary energy supply were followed from 2000 to 2016. We applied a Poisson regression longitudinal model, fitted using generalized estimating equations, to estimate the association between lung cancer incidence and per capita coal capacity, adjusting for various behavioral and demographic determinants and lag periods.

RESULTS

The average coal capacity increased by 1.43 times from 16.01 gigawatts (GW) (2000~2004) to 22.82 GW (2010~2016). With 1 kW (KW) increase of coal capacity per person in a country, the relative risk of lung cancer increases by a factor of 59% (95% CI = 7.0%~ 135%) among males and 85% (95% CI = 22%~ 182%) among females. Based on the model, we estimate a total of 1.37 (range = 1.34 ~ 1.40) million standardized incident cases from lung cancer will be associated with coal-fired power plants in 2025.

CONCLUSIONS

These analyses suggest an association between lung cancer incidence and increased reliance on coal for energy generation. Such data may be helpful in addressing a key policy question about the externality costs and estimates of the global disease burden from preventable lung cancer attributable to coal-fired power plants at the national level.

A Global Perspective on Sulfur Oxide Controls in Coal-Fired Power Plants and Cardiovascular Disease

Sulfur oxides (SO_x), particularly SO₂ emitted by coal-fired power plants, produce long-term risks for cardiovascular disease (CVD). We estimated the relative risks of CVD and ischemic heart disease (IHD) attributable to SO_x emission globally. National SO_x reduction achieved by emissions control systems was defined as the average SO_x reduction percentage weighted by generating capacities of individual plants in a country. We analyzed the relative risk of CVD incidence associated with national SO_x reduction for 13,581 coal-fired power-generating units in 79 countries. A 10% decrease in SO_x emission was associated with 0.28% (males; 95%CI = −0.39%~0.95%) and 1.69% (females; 95%CI = 0.99%~2.38%) lower CVD risk. The effects on IHD were > 2 times stronger among males than females (2.78%, 95%CI = 1.99%~3.57% vs. 1.18%, 95%CI = 0.19%~2.17%). Further, 1.43% (males) and 8.00% (females) of CVD cases were attributable to suboptimal SOx reduction. Thus, enhancing regulations on SO_x emission control represents a target for national and international intervention to prevent CVD.