Decomposing the differences in healthy life expectancy between migrants and natives: the ‘healthy migrant effect’ and its age variations in Australia

Whether the ‘healthy migrant effect’ exhibits different patterns in mortality and morbidity and how such patterns change during the life course have not been adequately understood in the literature. Using the datasets of the Australian Bureau of Statistics, this study presents an in-depth investigation of the healthy migrant effect and its age variations in Australia. Specifically, this study estimates life expectancy (LE) and healthy life expectancy (HLE) of the Australia-born and overseas-born populations, as well as eight Australian migrant groups, and decomposes the HLE differences into mortality and morbidity differences from three dimensions: age, gender and country of birth. The results reveal that compared with the Australia-born population, the overseas-born population enjoys a prominently longer LE; however, they suffer a similar or lower HLE after age 65 and a lower HLE/LE ratio throughout all ages. Young overseas-born adults manifest a more significant health advantage in both mortality and morbidity than early-life and older overseas-born individuals; however, the morbidity advantage of young migrants, particularly those who are female and originated from culturally different countries, declines dramatically with ageing. The results suggest that overall, migrants do not have the same advantage in morbidity as they do in mortality and that health advantages of migrants decreases with time in both dimensions of health and more rapidly for morbidity. The results suggest that pertinent policies are needed to reduce acculturation-related challenges and to mitigate the decline in migrants’ health in the post-migration environment to ensure better quality of life outcomes of migrants

Changing impact of COVID-19 on life expectancy 2019–2023 and its decomposition: Findings from 27 countries

Background: The World Health Organization declared COVID-19 no longer a global health emergency on 5th May 2023; however, the impact of COVID-19 on life expectancy throughout the pandemic period is not clear. This study aimed to quantify and decompose the changes in life expectancy during 2019–2023 and corresponding age and gender disparities in 27 countries. Methods: Data were sourced from the Human Mortality Database, the World Population Prospects 2022 and the United Kingdom's Office for National Statistics. Life expectancy was estimated using the abridged life table method, while differentials of life expectancies were decomposed using the age-decomposition algorithm. Results: There was an overall reduction in life expectancy at age 5 among the 27 countries in 2020. Life expectancy rebounded in Western, Northern and Southern Europe in 2021 but further decreased in the United States, Chile and Eastern Europe in the same year. In 2022 and after, lost life expectancy years in the United States, Chile and Eastern Europe were slowly regained; however, as of 7th May 2023, life expectancy in 22 of the 27 countries had not fully recovered to its pre-pandemic level. The reduced life expectancy in 2020 was mainly driven by reduced life expectancy at age 65+, while that in subsequent years was mainly driven by reduced life expectancy at age 45–74. Women experienced a lower reduction in life expectancy at most ages but a greater reduction at age 85+. Conclusions: The pandemic has caused substantial short-term mortality variations during 2019–2023 in the 27 countries studied. Although most of the 27 countries experienced increased life expectancy after 2022, life expectancy in 22 countries still has not entirely regained its pre-pandemic level by May 2023. Threats of COVID-19 are more prominent for older adults and men, but special attention is needed for women aged 85+ years

Active contours with local and global energy based-on fuzzy clustering and maximum a posterior probability for retinal vessel detection

The performance of active contour model is limited on retinal vessel segmentation as vessel images are usually corrupted with intensity inhomogeneity, low contrast, and weak boundary, which severely affect the segmentation results of retinal vessels. A new active contour model combining the local and global information is proposed in this paper to facilitate the vessel segmentation. In our model, the fuzzy conception is firstly introduced as fuzzy methods generally provide more accurate and robust clustering and the concept of fuzziness in fuzzy clustering, which is represented by membership, can reflect the intensity distribution of the image. Then, we define local energy based on Maximum a Posterior Probability and use spatially varying parameters, mean and stand deviation, to describe the local Gaussian distribution in order to better deal with intensity inhomogeneity. Furthermore, we combine local and global energy based on fuzzy clustering, with a weight coefficient. The coefficient is computed by a weight function according to contrast ratio of the image. Experiments on synthetic and real images and comparisons with other state-of-the-art active contour models show that the proposed model can detect objects more accurate and robust, especially for vessels on retinal angiogram

Maintenance of antiangiogenic and antitumor effects by orally active low-dose capecitabine for long-term cancer therapy.

Long-term uninterrupted therapy is essential for maximizing clinical benefits of antiangiogenic drugs (AADs) in cancer patients. Unfortunately, nearly all clinically available AADs are delivered to cancer patients using disrupted regimens. We aim to develop lifetime, nontoxic, effective, orally active, and low-cost antiangiogenic and antitumor drugs for treatment of cancer patients. Here we report our findings of long-term maintenance therapy with orally active, nontoxic, low cost antiangiogenic chemotherapeutics for effective cancer treatment. In a sequential treatment regimen, robust antiangiogenic effects in tumors were achieved with an anti-VEGF drug, followed by a low-dose chemotherapy. The nontoxic, low dose of the orally active prodrug capecitabine was able to sustain the anti-VEGF-induced vessel regression for long periods. In another experimental setting, maintenance of low-dose capecitabine produced greater antiangiogenic and antitumor effects after AAD plus chemotherapy. No obvious adverse effects were developed after more than 2-mo of consecutive treatment with a low dose of capecitabine. Together, our findings provide a rationalized concept of effective cancer therapy by long-term maintenance of AAD-triggered antiangiogenic effects with orally active, nontoxic, low-cost, clinically available chemotherapeutics

Off-tumor targets compromise antiangiogenic drug sensitivity by inducing kidney erythropoietin production.

Anti-VEGF drugs are commonly used for treatment of a variety of cancers in human patients, and they often develop resistance. The mechanisms underlying anti-VEGF resistance in human cancer patients are largely unknown. Here, we show that in mouse tumor models and in human cancer patients, the anti-VEGF drug-induced kidney hypoxia augments circulating levels of erythropoietin (EPO). Gain-of-function studies show that EPO protects tumor vessels from anti-VEGF treatment and compromises its antitumor effects. Loss of function by blocking EPO function using a pharmacological approach markedly increases antitumor activity of anti-VEGF drugs through inhibition of tumor angiogenesis. Similarly, genetic loss-of-function data shows that deletion of EpoR in nonerythroid cells significantly increases antiangiogenic and antitumor effects of anti-VEGF therapy. Finally, in a relatively large cohort study, we show that treatment of human colorectal cancer patients with bevacizumab augments circulating EPO levels. These findings uncover a mechanism of desensitizing antiangiogenic and anticancer effects by kidney-produced EPO. Our work presents conceptual advances of our understanding of mechanisms underlying antiangiogenic drug resistance