Impact of cancer diagnosis on life expectancy by area-level socioeconomic groups in New South Wales, Australia: a population-based study

Objective: Improvement in cancer survival over recent decades has not been accompanied by a narrowing of socioeconomic disparities. This study aimed to quantify the loss of life expectancy(LOLE) resulting from a cancer diagnosis and examine disparities in LOLE based on area-level socioeconomic status(SES).Methods: Data were collected for all people between 50 and 89 years of age who were diagnosed with cancer, registered in the NSW Cancer Registry between 2001 and 2019, and underwent mortality follow-up evaluations until December 2020. Flexible parametric survival models were fitted to estimate the LOLE by gender and area-level SES for 12 common cancers.Results: Of 422,680 people with cancer, 24% and 18% lived in the most and least disadvantaged areas, respectively. Patients from the most disadvantaged areas had a significantly greater average LOLE than patients from the least disadvantaged areas for cancers with high survival rates, including prostate [2.9 years(95% CI: 2.5±3.2 years) vs. 1.6 years(95% CI: 1.3±1.9 years)] and breast cancer [1.6 years(95% CI: 1.4±1.8 years) vs. 1.2 years(95% CI: 1.0±1.4 years)]. The highest average LOLE occurred in males residing in the most disadvantaged areas with pancreatic [16.5 years(95% CI: 16.1±16.8 years) vs. 16.2 years(95% CI: 15.7±16.7 years)] and liver cancer [15.5 years(95% CI: 15.0±16.0 years) vs. 14.7 years(95% CI: 14.0±15.5 years)]. Females residing in the least disadvantaged areas with thyroid cancer [0.9 years(95% CI: 0.4±1.4 years) vs. 0.6 years(95% CI: 0.2±1.0 years)] or melanoma [0.9 years(95% CI: 0.8±1.1 years) vs. 0.7 years(95% CI: 0.5±0.8 years)] had the lowest average LOLE.Conclusions: Patients from the most disadvantaged areas had the highest LOLE with SES-based differences greatest for patients diagnosed with cancer at an early stage or cancers with higher survival rates, suggesting the need to prioritise early detection and reduce treatment-related barriers and survivorship challenges to improve life expectancy.

积极英语阅读教程Life Expectations阅读课教学设计及总结——首届全国中小学英语阅读教学观摩活动

阅读教学是英语教学中的重要组成部分。2016年5月27日,旨在推动中国中小学阅读教育的科学实践以及英语课外阅读的推广和普及的全国英语阅读教学研究协作体在京主办了首届全国中小学英语阅读教学研讨会。笔者有幸在此活动中承担了一节阅读观摩课。在此次活动中,本节课为借班上课,教师在对阅读课堂教学实践进行尝试的同时,也应该对如何培养学生阅读策略和思维能力有所展示。

Dimensionality reduction model based on integer planning for the analysis of key indicators affecting life expectancy

Purpose:Exploring a dimensionality reduction model that can adeptly eliminate outliers and select the appropriate number of clusters is of profound theoretical and practical importance.Additionally,the interpretability of these models presents a persistent challenge.Design/methodology/approach:This paper proposes two innovative dimensionality reduction models based on integer programming(DRMBIP).These models assess compactness through the correlation of each indicator with its class center,while separation is evaluated by the correlation between different class centers.In contrast to DRMBIP-p,the DRMBIP-v considers the threshold parameter as a variable aiming to optimally balances both compactness and separation.Findings:This study,getting data from the Global Health Observatory(GHO),investigates 141 indicators that influence life expectancy.The findings reveal that DRMBIP-p effectively reduces the dimensionality of data,ensuring compactness.It also maintains compatibility with other models.Additionally,DRMBIP-v finds the optimal result,showing exceptional separation.Visualization of the results reveals that all classes have a high compactness.Research limitations:The DRMBIP-p requires the input of the correlation threshold parameter,which plays a pivotal role in the effectiveness of the final dimensionality reduction results.In the DRMBIP-v,modifying the threshold parameter to variable potentially emphasizes either separation or compactness.This necessitates an artificial adjustment to the overflow component within the objective function.Practical implications:The DRMBIP presented in this paper is adept at uncovering the primary geometric structures within high-dimensional indicators.Validated by life expectancy data,this paper demonstrates potential to assist data miners with the reduction of data dimensions.Originality/value:To our knowledge,this is the first time that integer programming has been used to build a dimensionality reduction model with indicator filtering.It not only has applications in life expectancy,but also has obvious advantages in data mining work that requires precise class centers.

Impact of Cardiovascular Disease Deaths on Life Expectancy in Chinese Population

Objective We aimed to analyze the impact of cardiovascular disease （CVD） deaths on life expectancy （LE） in Chinese population and estimate the percentage reduction in CVD mortality needed to increase LE by 1 year from the current level, a national target of health improvement. Methods We used life tables, cause-elimination life tables, and age decomposition of LE with corrected mortality data from the National Disease Surveillance System in 2010. Results LE at birth of Chinese people was 73.24 years in 2010. Women had a longer LE than men, and urban population had a longer LE than rural population. CVD deaths resulted in a 4.79-year LE loss and premature deaths in people aged 25 to 64 years were responsible for a substantial part of LE loss from CVD. Death from ischemic heart disease and cerebrovascular diseases accounted for 69.2% of LE loss from CVD deaths and death from cerebrovascular diseases was the largest contributor. In rural men, 51.1% LE loss from CVD deaths was caused by cerebrovascular diseases. If there were no changes in mortality rates for all other diseases, a 27.4% reduction in CVD mortality would increase LE by i year in Chinese population. Conclusion There is a considerable impact of CVD deaths on LE. A 1-year LE increase in the future requires at least a 27.4% reduction in CVD mortality from the current level. Targeting the rural population and tackling cerebrovascular diseases are important for reaching the national goal of health improvement.

Evaluation of Impact of Major Causes of Death on Life Expectancy Changes in China,1990-2005

Objective To evaluate the impact of major causes of death on changes of life expectancy in China. Methods Life expectancy was calculated by standard life table techniques using mortality data from the national censuses in 1990 and 2000 and the 1% National Population Sampling Surveys in 1995 and 2005, Mortality data about the major causes of death from VR-MOH were used as reference values to estimate their death proportions of the specific age groups by sex and regions, as well as all-cause mortality and age-specific mortality rates of major causes of death. Decomposition method was used to quantitatively evaluate the impact. Results Three key findings were identified in our study. First, China's health challenge was shifted from diseases related to living conditions to those related to behavior and lifestyle, with rural areas relatively lagged behind urban areas, Second, the impacts of cardiovascular diseases and neoplasm on the middle aged and elderly population were stressed. Third, compared to the urban population, the rural population tended to have increasing mortality of neoplasm and cardiovascular diseases, especially in adults at the age of 15-39 years. Conclusion Further efforts should be made to reduce the incidence of neoplasm and cardiovascular diseases, especially in rural areas, by promoting healthy behavior and lifestyle and providing appropriate therapies for all patients in need.

Impact of Cerebrovascular Disease Mortality on Life Expectancy in China

Objective To evaluate the impact of cerebrovascular disease mortality on life expectancy （LE） in China in 2010 compared with 2005, and to identify the high-risk population （age, sex, and region） where cerebrovascular disease mortality has had a major impact on LE. Methods LE and cause-eliminated LE were calculated by using standard life tables which used adjusted mortality data from the Death Surveillance Data Sets in 2005 and 2010 from the National Disease Surveillance System. Decomposition was used to quantitate the impact of cerebrovascular disease in different age groups. Results LE in China was 73.24 years in 2010, which was higher in women and urban residents compared with men and rural residents. The loss of LE caused by cerebrovascular disease mortality was 2.26 years, which was higher in men and rural residents compared with women and urban residents. More than 30% of the loss of LE were attributed to premature death from cerebrovascular disease in people aged 〈65 years. Compared with 2005, LE in 2010 increased by 0.92 years. The reduction of cerebrovascular disease mortality in urban residents contributed 0.45 years to the increase of LE, but the increase of cerebrovascular disease mortality caused a 0.12-year loss of LE in rural residents. Conclusion Cerebrovascular disease mortality had a major impact on LE in China, with a significant difference between urban and rural residents. LE is likely to be further increased by reducing cerebrovascular disease mortality, and special attention should be paid to reducing premature deaths in people aged 〈65 years.

Nurse staffing and life expectancy at birth and at 65 years old:Evidence from 35 OECD countries

Objective: To measure the possible magnitude of the role nurse staffing has on increasing life expectancy at birth and at 65 years old.Methods: The statistical technique of panel data analysis was applied to investigate the relationship from the number of practicing nurses' density per 1000 population to life expectancy at birth and at 65 years old.Five control variables were used as the proxies for the levels of medical staffing,health care financial and physical resources,and medical technology.The observations of 35 member countries of Organization for Economic Co-operation and Development (OECD) were collected from OECD Health Statistics over 2000-2016 period.Results: There were meaningful relationships from nurse staffing to life expectancy at birth and at 65 years with the long-run elasticities of 0.02 and 0.08,respectively.Overall,the role of nursing characteristics in increasing life expectancy indicators varied among different health care systems of OECD countries and in average were determined at the highest level in Japan (0.25),followed by Iceland (0.24),Belgium (0.21),Czech Republic (0.21),Slovenia (0.20) and Sweden (0.18).Conclusion: A higher proportion of nursing staff is associated with higher life expectancy in OECD countries and the dependency of life expectancy to nursing staff would increase by aging.Hence,the findings of this study warn health policy makers about ignoring the effects nursing shortages create e.g.increasing the risk of actual age-specific mortality,especially in care of elderly people.

New Characteristics of Active Life Expectancy of the Elderly in China

Life expectancy of the elderly is a significant problem in China, and it changes not only the health care, but also the pension. This study used tracking data from the Chinese Urban and Rural Elderly Population Survey to calculate the age-specific Active Life Expectancy (ALE) of the Chinese elderly population aged 60 years and over. For analysis, this population was divided into different sub-populations according to gender, census register and region. The main conclusions of our study are as follows: 1) The quality of life for elderly males may be greater than that for elderly females;2) There were significant differences in Active Life Expectancy (ALE) and Inactive Life Expectancy (ILE) between urban and rural elderly;3) The differences in ALE between the eastern, central and western regions of China were not significant;and 4) The increased remaining life expectancy of the elderly was mainly attributed to the extended ALE in the lower age group and the expanded ILE in the higher age group. This study expands the knowledge of Chinese elderly’s life expectancy in different health status.

The Nationwide Impact of Injury-related Deaths on Average Life Expectancy in China

To expand the evidence base to inform future public policy aimed at accident prevention, we investigated the impact of different categories of injury on average life expectancy in China. We used data from the National Death Cause Registration Information System and National Maternity and Children Health Surveillance databases, as well as 2010 population data from the National Bureau of Statistics. We then calculated the average life expectancy of the Chinese population, in addition to life expectancy after eliminating injury-related mortality. The average life expectancy of the Chinese population in 2010 was 74.93 years. After eliminating deaths due to injuries, the fourth leading cause of mortality in China, average life expectancy increased by 1.36 years. When this was broken down by population sub-groups, these gains were 1.76 and 0.79 years in men and women, 0.94 and 1.56 years in urban and rural residents, and 1.11, 1.30, and 1.67 years for residents in the Eastern, Central and Western regions respectively. After eliminating all categories of injury, the average life expectancy of the Chinese population was found to increase by 1.36 years. This figure was higher for males and residents of rural areas and Western China.

Impact of Long-term Exposure to Air Particulate Matter on Life Expectancy and Survival Rate of Shanghai Residents

Objective To evaluate the impact of long-term air particulate matter exposure on the life expectancy and survival rate of Shanghai residents. Methods Epidemiology - based exposure-response function was used for the calculation of attributable deaths to air particulate matter in Shanghai, and the effect of long-term exposure to particulate matter on life expectancy and survival rate was estimated using the life table of Shanghai residents in 1999. Results It was shown that in 1999, the long-term air particulate matter exposure caused 1.34-1.69 years reduction of life expectancy and a decrease of survival rate for each age group of Shanghai residents. Conclusion The effect of long-term exposure to air particulate matter on life expectancy is substantial in Shanghai.

Key Social Determinants to Narrow the Gap between Health-adjusted Life Expectancy and Life Expectancy in Megacities

Objective Improvement in the quality of life is reflected in the narrowing of the gap between healthadjusted life expectancy(HALE)and life expectancy(LE).The effect of megacity expansion on narrowing the gap is rarely reported.This study aimed to disclose this potential relationship.Methods Annual life tables were constructed from identified death records and population counts from multiple administrative sources in Guangzhou,China,from 2010 to 2020.Joinpoint regression was used to evaluate the temporal trend.Generalized principal component analysis and multilevel models were applied to examine the county-level association between the gap and social determinants.Results Although LE and HALE in megacities are increasing steadily,their gap is widening.Socioeconomic and health services are guaranteed to narrow this gap.Increasing personal wealth,a growing number of newborns and healthy immigrants,high urbanization,and healthy aging have helped in narrowing this gap.Conclusion In megacities,parallel LE and HALE growth should be highly considered to narrow their gap.Multiple social determinants need to be integrated as a whole to formulate public health plans.

Progress in Research of Nutrition and Life Expectancy

Life expectancy is an important indicator to evaluate the social development of a country. Health and longevity can not only improve people＇s life quality but also ensure them to have more time to pursue their life goal. A one-year increase in life expectancy during ＇China＇s Twelfth Five-Year Economic and Social Development Plan＇ period has been used as an indicator to evaluate whether the goal of improving people＇s living standards continuously is met. Nutrition is one of the important factors affecting people＇s health. Both malnutrition and overnutrition are risk factors for disease and death. Many studies of the relationship between nutrition and life expectancy have been conducted in the world, and the results of them are quite valuable for China to improve people＇s life expectancy by targeted nutrition intervention strategy. This paper summarizes the progress in research of nutrition and life expectancy in the world.

Reduced Life Expectancy Model Analyses of Exposure Time Effects of Endocrine Disruptors to Teleost Fishes Based on Effect Concentration of Hepatic Biomarkers

In this current paper, the exposure time effects on four endocrine disruptors and teleost fishes were evaluated using the reduced life expectancy (RLE) model based on the effect concentration (EC50) of available literature published. The result on the regression analysis over different exposure times has demonstrated that the EC50 of hepatic biomarkers falls with increasing exposure times in a predictable manner. The slopes of the regression equations reflect the strength of the toxic effects on the various teleost fish. The EC50 reduction over time can be interpreted based on the bioconcentration process, which can be used to understand transfer routes of the compounds from water to fish body. RLE model also provides useful information in assessing the toxic effects on fish life expectancy as a result of the occurrence of compounds.

Test of Ordered Multivariate Discrete Selection Model for Average Life Expectancy

At present, there are significant regional differences in average life expectancy among countries in the world. Not only is there a great disparity in average life expectancy, but also the gender difference is positive and negative, and is distributed in a bipolar distribution of “long life in rich countries and short life in poor countries”. This paper analyzes the factors affecting the life grade by using the ordered multivariate discrete selection model and combined with the average life expectancy data of countries all over the world in 2017. The test results show that: 1) The growth of per capita GDP, elderly dependency ratio and the proportion of people using at least basic drinking water services can effectively improve the level of life expectancy;2) The birth rate has an inhibitory effect on the average life expectancy;3) Through model comparison, probit model is more suitable for the analysis of this kind of problems than logit model, and the properties of the obtained model are better.

Risk factors for anastomotic fistula development after radical colon cancer surgery and their impact on prognosis

BACKGROUND Colon cancer is a common malignant tumor in the gastrointestinal tract that is typically treated surgically.However,postradical surgery is prone to complic-ations such as anastomotic fistulas.AIM To investigate the risk factors for postoperative anastomotic fistulas and their impact on the prognosis of patients with colon cancer.METHODS We conducted a retrospective analysis of 488 patients with colon cancer who underwent radical surgery.This study was performed between April 2016 and April 2019 at a tertiary hospital in Wuxi,Jiangsu Province,China.A t-test was used to compare laboratory indicators between patients with and those without postoperative anastomotic fistulas.Multiple logistic regression analysis was performed to identify independent risk factors for postoperative anastomotic fistulas.The Functional Assessment of Cancer Therapy-Colorectal Cancer was also used to assess postoperative recovery.RESULTS Binary logistic regression analysis revealed that age[odds ratio(OR)=1.043,P=0.015],tumor,node,metastasis stage(OR=2.337,P=0.041),and surgical procedure were independent risk factors for postoperative anastomotic fistulas.Multiple linear regression analysis showed that the development of postoperative anastomotic fistula(P=0.000),advanced age(P=0.003),and the presence of diabetes mellitus(P=0.015),among other factors,independently affected CONCLUSION Postoperative anastomotic fistulas significantly affect prognosis and survival rates.Therefore,focusing on the clinical characteristics and risk factors and immediately implementing individualized preventive measures are important to minimize their occurrence.

Dynamic prediction of landslide life expectancy using ensemble system incorporating classical prediction models and machine learning

With the development of landslide monitoring system,many attempts have been made to predict landslide failure-time utilizing monitoring data of displacements.Classical models(e.g.,Verhulst,GM(1,1),and Saito models)that consider the characteristics of landslide displacement to determine the failuretime have been investigated extensively.In practice,monitoring is continuously implemented with monitoring data-set updated,meaning that the predicted landslide life expectancy(i.e.,the lag between the predicted failure-time and time node at each instant of conducting the prediction)should be re-evaluated with time.This manner is termed“dynamic prediction”.However,the performances of the classical models have not been discussed in the context of the dynamic prediction yet.In this study,such performances are investigated firstly,and disadvantages of the classical models are then reported,incorporating the monitoring data from four real landslides.Subsequently,a more qualified ensemble model is proposed,where the individual classical models are integrated by machine learning(ML)-based meta-model.To evaluate the quality of the models under the dynamic prediction,a novel indicator termed“discredit index(b)”is proposed,and a higher value of b indicates lower prediction quality.It is found that Verhulst and Saito models would produce predicted results with significantly higher b,while GM(1,1)model would indicate results with the highest mean absolute error.Meanwhile,the ensemble models are found to be more accurate and qualified than the classical models.Here,the performance of decision tree regression-based ensemble model is the best among the various ML-based ensemble models.

Aging men-Challenges ahead

The prolongation of life expectancy and the drastic reduction of fertility rate are the primary cause of an agingworld. It is projected that the elderly (above 65) will increase within the next 25 years by 82% , whereas the new bornonly by 3% . Despite the enormous medical progress during the past few decades, the last years of life are still accom-panied by increasing ill health and disability. The ability to maintain active and independent living for as long as possi-ble is a crucial factor for aging in health and dignity. Therefore, the promotion of healthy aging and the prevention ofdisability in men, must assume a central role in medical research and medical practice as well as in the formulation ofnational health and social policies. Effective programs promoting health and aging will ensure a more efficient use ofhealth and social services and improve the quality of life in older persons by enabling them to remain independent andproductive. The most important and drastic gender differences in aging are related to organs and or systems dependantor influenced by reproductive hormones. In distinction to the course of reproductive aging in women, with the rapid de-cline in sex hormones and expressed by the cessation of menses, aging men experience a slow and continuous decline ofhormones. This decline in endocrine function involves; A decrease of testosterone, dehydroepiandrosterone (DHEA),oestrogens, thyroid stimulating hormone (TSH), growth hormone (GH), insulin-like growth factor-1 (IGF-1), andmelatonin. This decrease is concomitant with an increase of LH and FSH. In addition sex hormone binding globulin's(SHBG) increase with age resulting in further lowering the concentrations of free biologically active androgens. Inter-ventions such as hormone replacement therapy may prevent, delay or alleviate the debilitating conditions which may re-sult from secondary partial endocrine deficiency. Primary and secondary preventive strategies such as the promotion of asafe environment, healthy lifestyle including proper nutrition, appropriate exercise, avoidance of smoking, avoidanceof drug and alcohol abuses, if done effectively, should result in a significant reduction of the health and social costs,reduce pain and suffering, increase the quality of life of the elderly and enable them to remain productive and contributeto the well-being of society. In light of this, public awareness of medical knowledge needs to be increased and basic,clinical, socio-economic and epidemiological research intensified. (Asian J Androl 2001 Sep; 3; 161 - 168)

Health Inequalities during 20 Years of Rapid Economic Development in China (1980-2000):A Mortality Analysis

Objective To examine the influence of China＇s economic reforms on population health and regional mortality rates.Methods Longitudinal study measuring the mortality trends and their regional variations.Using data from the three most recent national censuses,we used the model life table to adjust the mortality levels within the population for each census,and to calculate life expectancy.We then examined the variation in patterns of mortality and population health by economic status,region and gender from 1980-2000.Results Life expectancy varied with economic status,province,and gender.Results showed that,although life expectancy in China had increased overall since the early 1980s,regional differences became more pronounced.Life expectancy for populations who live in the eastern coastal provinces are greater than those in the western regions.Conclusion Differences in life expectancy are primarily related to differences in regional economic development,which in turn exacerbate regional health inequalities.Therefore,it is necessary to improve economic development in less developed regions and to improve health policies and the public health system that address the needs of everyone.

Reliability-Based Optimal Design for Very Large Floating Structure

Costs and losses induced by possible future extreme environmental conditions and difficulties in repairing post yielding damage strongly suggest the need for proper consideration in design rather than just life loss prevention. This can be addressed through the development of design methodology that balances the initial cost of the very large floating structure (VLFS) against the expected potential losses resulting from future extreme wave induced structural damage. Here, the development of a methodology for determining optimal, cost effective design will be presented and applied to a VLFS located in the Tokyo bay. Optimal design criteria are determined based on the total expected life cycle cost and acceptable damage probability and curvature of the structure, and a set of sizes of the structure are obtained. The methodology and applications require expressions of the initial cost and the expected life cycle damage cost as functions of the optimal design variables. This study includes the methodology, total life cycle cost function, structural damage modeling, and reliability analysis.

Relative longevity among retired military personnel: an historical-cohort study

Background: Occupation is a significant factor in life, health and well-being. Long-term military service is a unique career path that may influence life expectancy, even after excluding obvious risks such as battlefield mortality. However, it remains unclear what the effects of a military career are on the life trajectory of personnel who retire from service. We aimed to compare life expectancy among retired military personnel(RMP) to their sex- and birth cohortspecific reference populations.Methods: For this historical-cohort study we collected data on sex, year of birth, year of death, time in service, and rank at end of service for 4,862 Israeli RMPs. Data on reference populations were provided by the Israel Central Bureau of Statistics, by birth decade from 1900 to 1989. We calculated the difference between each individual RMP's age at death and the "expected" age at death, based on sex- and birth cohort-specific means in the reference populations. Results: Overall, 67.9% of RMPs lived longer than average relative to their sex specific birth cohort. This difference in life expectancy was more pronounced among women than among men. There was a significant trend of increasing difference between RMP males and reference males over time(P<0.002), whereas no significant trend was identified among females. Length of service and rank were not associated with relative longevity for RMPs.Conclusions: The mechanism of the protective effect of military service on life expectancy remains unknown, but our findings indicate that it affects men and women differently, with women being more likely to benefit from the protective effect of military service. The healthy worker effect is known to vary from one occupation to another. To the best of our knowledge, this is the first attempt to quantify the magnitude of the healthy worker effect among career military servicemen and women.