The survival and cost-effectiveness analysis of adjunctive Chinese medicine therapy for patients with non-small cell lung cancer: a nationwide cohort study in Taiwan.

Introduction: Cancer, particularly lung cancer, is a significant global healthcare challenge. Non-Small Cell Lung Cancer (NSCLC) constitutes 85% of cases. Patients often seek alternative therapies like Chinese medicine alongside Western treatments. This study investigates the survival outcomes and cost-effectiveness of adjunctive Chinese medicine therapy for NSCLC patients in Taiwan. Methods: We utilized the National Health Insurance Research Database in a retrospective cohort study from 2000 to 2018, focusing on NSCLC patients diagnosed between 2007 and 2013. After propensity score matching 1:5 ratio, then compared patients with and without adjunctive Chinese medicine therapy. Survival outcomes, cost-effectiveness, and sensitivity analyses were conducted. Results: The study involved 43,122 NSCLC patients with 5.76% receiving adjunctive Chinese medicine. There is no significant associated between the risk of death and adjuvant Chinese medicine therapy until 181-365 days of adjuvant treatment could reduce the risk of death (HR = 0.88, 95% CI: 0.80-0.98). Cost-effectiveness analysis showed an incremental cost-effectiveness ratio of 880,908 NT$/year. Conclusion: Adjunctive Chinese medicine therapy, particularly when administered for 181-365 days, significantly reduced the mortality risk among stage IV NSCLC patients. The cost-effectiveness aligns with willingness-to-pay thresholds, indicating economic benefit.

Comparison of the use of prenatal care services and the risk of preterm birth between pregnant women with disabilities and those without disabilities: A nationwide cohort study.

Objective: The difficulties faced by pregnant women with disabilities in accessing health care may make them less likely to receive prenatal care. The aims of this study were to compare the number of prenatal services and the risk of preterm birth between pregnant women with and without disabilities. Methods: A total of 2999 pregnant women aged ≥20 years with birth records in 2011-2014 in Taiwan were enrolled. Data were obtained from the Registration File for Physical and Mental Disabilities and the National Health Insurance Research Database. A 1:4 matching between pregnant women with disabilities and those without disabilities was performed. The logistic regression analysis with generalized estimating equations was used to analyze. Results: The median of prenatal care services used by pregnant women with disabilities was 9.00 (interquartile range, IQR: 2.00). Pregnant women with disabilities used fewer services than those without disabilities (median, 10.00; IQR: 1.00). The disabled group (8.44%) had a significantly higher proportion of preterm births than did the non-disabled group (5.40%). The disabled group was at a 1.30 times higher risk of preterm births than was the non-disabled group. Conclusions: Pregnant women with disabilities used significantly fewer prenatal care services and had a significantly higher risk of preterm birth than pregnant women without disabilities.

FIRST DETECTION OF CHICKEN ANEMIA VIRUS AND NOROVIRUS GENOGROUP II IN STOOL OF CHILDREN WITH ACUTE GASTROENTERITIS IN TAIWAN.

To date, there has been no report of co-infection of chicken anemia virus (CAV) with enteric virus in patients with acute gastroenteritis (AGE). CAV has been recently detected in various types of human samples including stool, indicating pathogenicity in gastrointestinal tract. Examination by PCR-based methods of CAV and norovivus genogroup II (NV GII) in stool of 110 children with AGE at a hospital in Taiwan revealed for the first time of co-infection in two cases. This is the first description of CAV infection in children with AGE in Taiwan. Systematic surveillance and evidence-based studies are required to determine the transmission pathways and spread of CAV in Taiwan.

DETECTION OF WU POLYOMAVIRUS AND NOROVIRUS GENOGROUP II IN STOOLS OF CHILDREN WITH ACUTE GASTROENTERITIS IN TAIWAN.

To date, there has been no report of coinfection of human WU polyomavirus (WUPyV) with norovirus (NV). WUPyV has been detected in stool indicating pathogenicity of the gastrointestinal tract. Feces from 110 children (58 males, 52 females) with acute gastroenteritis admitted to Wei-Gong Memorial Hospital, Taiwan were screened for the presence of WUPyV and NV GII by PCR and RT-qPCR, respectively revealing three males with WUPyV only and one male with both viruses, the latter being first such report. There are no significant differences in clinical symptoms between patients with and without viral infection. Phylogenetic analysis based on WUPyV VP2 sequences indicated that the four samples are closely related to strains epidemic in China.

MOLECULAR DETECTION OF HUMAN BOCAVIRUS 1 AND 2 IN CHILDREN WITH ACUTE GASTROENTERITIS IN TAIWAN.

Human bocaviruses (HBoVs) have been detected in human gastrointestinal infections worldwide. Although HBoV global prevalence and strains diversity have been reported, but epidemiological data from Taiwan is largely unavailable to date. A total of 110 fecal samples from stools of diarrheic children at a general hospital, Taiwan, obtained from August 2012 to July 2013, were analyzed by nested PCR targeting a partial fragment (576 bp) of HBoV VP1/VP2 gene, which revealed 4 positive fecal samples. Clinical symptoms of HBoV-associated acute gastroenteritis (AGE) were not different from those without HBoV. HBoV infection was seen only during the fall and winter seasons. This is the first description of HBoV infection in children with AGE in Taiwan. Systematic surveillance and evidence-based studies are required to determine the transmission pathways and spread of HBoV in Taiwan.

CO-INFECTION OF ADENOVIRUS, NOROVIRUS AND TORQUE TENO VIRUS IN STOOLS OF PATIENTS WITH ACUTE GASTROENTERITIS.

Up to now, there has been no report of co-infection of torque teno virus (TTV) with other enteric viruses playing a role in the pathogenesis of viral acute gastroenteritis (AGE). We investigated the proportion, epidemiological and clinical features of concurrent infections of adenovirus (ADV), norovirus (NV) and TTV in stools of 155 patients with AGE attending Wei-Gong Memorial Hospital, Miaoli City, Taiwan. The presence of the three viruses were determined using PCR-based assays. Some 55% of the patients were infected with at least 1 enteric virus, among whom 18% were co-infected, NV and TTV being the most common (62%). Rate of co-infectious in AGE patients is correlated statistically significantly (p < 0.05) with age, fever and drinking of spring water. Furthermore, AGE children with co- infection have a higher hospitalization rate (69%). To the best of our knowledge, this is the first report of ADV, NV and TTV triple co-infection in children (2) with AGE. This study also revealed that TTV co-infection promoted the pathogenicity of other infectious agents.

Epidemiological and molecular analysis of human norovirus infections in Taiwan during 2011 and 2012.

BACKGROUND: The human norovirus (NV) circulates worldwide and is a major cause of epidemics, which have increased in Taiwan since 2002. NV in acute gastroenteritis (AGE) and non-acute gastroenteritis (asymptomatic) patients, including children and adults, have not been previously examined in Taiwan; therefore, we examined the epidemiology and phylogeny of NV in AGE and asymptomatic patients of all ages. METHODS: 253 stool samples were collected from August 2011 to July 2012 (including 155 AGE and 98 asymptomatic samples in Taiwan) and analyzed using reverse transcription-polymerase chain reaction (RT-PCR) for NV. Primers targeting the RNA-polymerase gene were used for RT-PCR to allow DNA sequencing of Taiwan NV strains and phylogenetic analyses. RESULTS: NV was detected in 24 (9.5%) of 253 stool specimens using RT-PCR. NV was isolated from all age groups (1 to 86 y) and those NV-positive samples were major identified from inpatients (79.2%, 19/24). Statistical analysis showed that the NV infectious rate of AGE patients was statistically significant (P < 0.05) for age, season and water type, respectively. Phylogenetic analyses of the RdRp region sequence showed that 24 NV isolates belonged to Genogroup II Genotype 4 (GII.4). They were closely related to the epidemic strain in Taiwan in 2006, the GII.4-2006b pandemic strain in 2006, and the GII.4-New Orleans strain in 2010. CONCLUSION: This study is the first to examine NV in sporadic AGE and asymptomatic patients in Taiwan. Furthermore, epidemic strains of isolated GII.4 were predominant in Taiwan during 2011 and 2012.