Life Expectancy Research Articles

Effect analysis of the impact of health service supply on life expectancy

Effect analysis of the impact of health service supply on life expectancy

Influence of Women Head of Government on the Human Capital of Women in the Philippines, Indonesia, Thailand, and Vietnam

Purpose: This study aims to explore the influence of women heads of government on human capital development and gender inequality, specifically focusing on education and health in the Philippines, Indonesia, Thailand, and Vietnam from 1991 to 2021. Despite the increasing presence of women in leadership roles globally, their impact on human capital indicators remains underexplored. Methodology: To investigate this, the research employs a comparative approach that includes the Levin-Lin Chu Test, Im-Pesaran-Shin Test, Fixed Effects, Random Effects, and Ordinary Least Squares to analyze data from countries with female leaders and evaluate changes in educational attainment and health outcomes during their tenures. Findings: The findings reveal that while higher educational attainment among women and increased representation of women in political leadership do not automatically result in greater labor force participation, female life expectancy has a significant and positive effect on female labor force participation (FLFP), indicating that healthier women are more likely to engage in the workforce. Unique Contribution to Theory, Practice and Policy This research uniquely contributes to understanding the role of female leadership in fostering inclusive growth and emphasizes the importance of gender representation in political leadership for advancing human capital.

Influence of metastatic sites and burden on oncological outcomes in patients progressing to metastatic castration resistant prostate cancer

PurposeMetastatic castration-resistant prostate cancer (mCRPC) patients harbor reduced life expectancy after first-line treatment progression. Currently, no information is available regarding the influence of metastatic sites and osseous burden on progression-free (PFS) and overall survival (OS) of mCRPC patients.MethodsWe relied on the Frankfurt Metastatic Cancer Database of the Prostate (FRAMCAP) database to select patients progressing to mCRPC and stratified them according to lymph node vs. osseous vs. visceral metastatic sites. Moreover, we stratified osseous mCRPC patients regarding the number of metastatic lesions. Endpoints were PFS and OS in uni- and multivariable Cox regression models.ResultsOf 363 patients, 9.4% harbored M1a vs. 78% M1b vs. 12% M1c mCRPC with significantly higher PSA in M1b (9 vs. 22 vs. 8ng/ml). Rates of DeNovo (15% vs. 60% vs. 56%) were significantly lower in the M1a mCRPC group, compared to M1b and M1c (p < 0.001). In PFS analyses, a median of 12.7 vs. 10.1 vs. 15.9 months for M1a vs. M1b vs. M1c mCRPC was observed (p > 0.05). In multivariable Cox regression models, M1c mCRPC was independently at higher risk for progression (hazard ratio [HR]: 5.93, p = 0.048), relative to M1a. Regarding OS, significant differences were observed (p = 0.002), with median OS of 58 vs. 42 vs. 25 months for M1a vs. M1b vs. M1c mCRPC and corresponding HRs of 1.54 (p = 0.11) and 2.76 (p < 0.01). In multivariable models M1c mCRPC was associated with higher risk of death (HR: 3.56, p = 0.049), relative to M1a. No differences were observed after stratification according to number of bone lesions (all p ≥ 0.05).ConclusionM1c mCRPC patients are independently at higher risk for progression and death, while M1a patients harbor best cancer-control outcomes.

Environmental technology to stimulate life expectancy: A deep dive into the role of PM2.5 and carbon emission

As the Latin American economies contend with improving public health while simultaneously dealing with ecological issues, understanding the determinant of life expectancy becomes imperative. This study explores the interaction among environmental technology, economic development, cleaner energy transitions, industrial growth, particulate Matter 2.5 (PM2.5), carbon emission, and their collective impact on life expectancy across Latin American nations. The research incorporates advanced econometric approaches comprising Mean Group (MG), Pooled Mean Group (PMG), and Method of Moments Quantile Regression (MMQR). The study’s outcome established that cleaner energy transitions, Gross Domestic Product (GDP), industrialization and environmental technologies significantly improve life expectancy, especially at higher quantiles. However, the outcome highlighted that PM2.5 and carbon emissions reduce life expectancy. Additionally, this study supports the unidirectional connection between environmental technology, economic development, cleaner energy transitions, industrial growth, life expectancy, and the bidirectional connection flowing from carbon emission PM2.5 to life expectancy. The study offers a roadmap for Latin America and global economies to invest in technology, cleaner power supply and industrialization to provide a route toward sustainable development and better public health that will eventually improve their citizens’ life expectancy.

A historical syndemic? The impact of synergistic epidemics of measles and scarlet fever on life expectancy in Victoria, Australia (1860s-1870s).

To explore whether synergistic epidemics of measles and scarlet fever in 1860s-1870s Victoria, Australia could be characterized as syndemics, we apply the methods of Sawchuk, Tripp, and Samakaroon (Social Science & Medicine 2022, 295, 112956) to quantify the impact of each of the two major co-occurring epidemic events (1867, 1875) in terms of life expectancy (LE) changes. Sawchuk et al. posit the presence of a harvesting effect, indicated by a statistically significant increase in LE in the immediate post-epidemic "fallow period", as a criterion for identification of a historical syndemic. We test an alternate hypothesis that the same methods can identify a short-term scarring effect. Using annual age- and cause-specific death statistics and census population data, we constructed abridged period life tables for baseline period, potential syndemic year, and "fallow" year for each of the two periods (1860s and 1870s). We compared LE at birth using Z-tests. We decomposed age-cause-specific mortality according to Arriaga's method to identify age-and cause-specific contributions to LE change. LE was significantly lower than baseline (1864-1865) in 1867 but not in the "fallow" year (1869). LE in 1875 and the 1878 "fallow" year were both significantly below baseline (1871-1873). Age-cause-specific decomposition showed similar patterns for 1867 and 1875 for measles and scarlet fever combined effects. Evidence of a scarring effect following the 1875 measles/scarlet fever combined peak supports the interpretation of this event as a syndemic. We suggest the short-term scarring effect can be a useful additional criterion for identifying historical syndemics.

Life Expectancy and Politics of Public Education and Pension with Endogenous Fertility

Implications of increased life expectancy on parental fertility decisions and subsequent shifts in political influence between younger and older generations carry significant consequences for government policies concerning education and pension. This study introduces an overlapping generations growth model incorporating these effects, qualitatively indicating that increased life expectancy correlates with lower fertility rates, decreased education expenditure-GDP ratio, and increased pension benefit-GDP ratio. A model simulation evaluates the impact of the projected increase in life expectancy until 2100 on four country groups: synthetic rich OECD, synthetic rich OECD Europe, Japan, and the United States. The findings demonstrate similar trends as in the qualitative analysis, yet growth rates are projected to vary significantly across regions and countries due to differing life expectancy increases.

Modeling severe uncontrolled asthma: transitioning away from health states

BackgroundModels developed to date to simulate long-term outcomes of asthma have been criticized for lacking granularity and ignoring disease heterogeneity. ObjectiveTo propose an alternative approach to modeling asthma and apply it to model long-term outcomes in a population with moderate-to-severe type 2 asthma (patients with raised fractional exhaled nitric oxide or eosinophils) and treated with conventional therapy. MethodsA discretely integrated condition event (DICE) approach was adopted, simulating individual profiles with asthma over patients’ lifetime in terms of exacerbations, asthma-related death, and death unrelated to asthma. The timing of these events is dependent on profile characteristics including lung function, asthma control, exacerbation history, and other baseline characteristics or contextual factors. Predictive equations were derived from a clinical trial to model time to exacerbation, change in asthma control, lung function, and utility. Real-world studies were used to supplement data gaps. Outcomes evaluated included life expectancy, quality-adjusted life-years (QALY), number of exacerbations, and lung function over time. ResultsAverage annual rates of severe and moderate exacerbations were 1.82 and 3.08 respectively, with rates increasing over time. Lung function declined at a higher rate compared with the general population. Average life expectancy was 75.2 years, compared with 82.4 years in a matched general population. The majority of life-years were spent with uncontrolled asthma and impaired lung function. ConclusionPatients with moderate-to-severe type 2 asthma and a history of exacerbations suffer from frequent exacerbations and reduced lung function and life expectancy. Capturing multiple conditions to simulate long-term outcomes in patients with asthma may provide more realistic projections of exacerbation rates.

Understanding European patterns of deprescribing antithrombotic medication during end-of-life care in patients with cancer

BackgroundEven though antithrombotic therapy (ATT) probably has little or even negative effect on the well-being of patients with cancer near the end of life, it is often continued until death, possibly leading to excess bleeding complications, increased disease burden, reduced quality of life and higher healthcare costs. AimTo explore and describe European practice patterns and perspectives of healthcare professionals from different disciplines and specialties on ATT in the end-of-life care (EOLC) of patients with cancer. MethodsWe performed a two-week international cross-sectional survey study using flash-mob research methodology. Eligible were healthcare professionals from different institutions across Europe, who prescribed ATT and/or dealt with EOLC of patients with cancer. The survey comprised three parts, including a series of choice sets (hypothetical scenarios involving a set of characteristics changing in level [e.g., high vs. low thrombotic risk]) on ATT management in EOLC. The discrete choice experiment analysis was conducted using multinomial logistic regression. ResultsOut of 467 pre-registrants, 208 participated in the survey from 4 to 18 July 2023. The majority (53 %) considered a patient with cancer as in EOLC when life expectancy is below 3 months. Respondents reported seeing or treating 20 patients with cancer on ATT in EOLC per year (IQR 10–50). The median estimated frequency of considering ATT deprescription per healthcare professional was 10 times per year (IQR 4–10), while the frequency of actual deprescription was 5 times per year (IQR 2–10). Twenty percent of respondents had never deprescribed ATT in the context of EOLC. Across the eight choice sets, five respondents (2.7 %) found deprescribing inappropriate in any scenario. Deprescribing was more often considered in patients with poor ECOG-performance status, high bleeding risk and low-molecular-weight heparin use as opposed to oral ATT. Haemato-oncology and cardiovascular medicine specialists were more inclined to deprescribe antiplatelet therapy than other specialties. ConclusionOur study describes medical decision-making regarding ATT in EOLC of patients with cancer. Healthcare professionals' perspectives and practice patterns vary, and some preferences appear associated with the therapists' professional focus and region of practice.

Risk Factors for Reduced Long-term Survival Following Isolated Surgical Aortic Valve Replacement in Different Age Groups.

According to recent guidelines, the selection of transcatheter vs. surgical aortic valve replacement (TAVR vs SAVR) in low-risk patients depends on age and life expectancy. Our objective was to understand independent risk factors for reduced life expectancy following isolated SAVR and the rate of re-do aortic valve (AV) intervention in different age groups, to delineate optimal intervention depending on patient characteristics. Between 2000-2015, 2026 patients underwent isolated SAVR with Edwards pericardial tissue valves. Multivariable models were conducted to determine independent risk factors for long-term survival in three age groups. The 10-year survival rates were 83.4±2.3%, 72.7± 2.6% and 39.8±3.0% in Group I (age <65 years, n=577), II (age 65 - <75 years, n=693) and III (age ≥75 years, n=756), respectively. Independent factors for the reduced long-term survival were pulmonary hypertension (PH), renal failure, peripheral vascular disease, diabetes, and NYHA class IV in Group I; PH, diabetes, current smoking, and atrial arrhythmia in Group II; and PH, anemia, and NYHA class IV in Group III. The re-do AV intervention rate at 10 years was much higher in Group I than in Groups II and III (14.7±2.5% vs. 3.4±1.1% and 0.8±0.4%, P<0.001). We identified risk factors for reduced long-term survival following isolated SAVR in different age groups and PH being the only risk factor across all ages, which should assist in decision-making for SAVR vs. TAVR. Our results also support the current recommendation of bioprostheses in patients aged >65 years given extremely low rate of re-do AV intervention.

Pharmacological Treatment of Obesity in Older Adults.

Obesity is a complex health issue with growing prevalence worldwide. It is also becoming more prevalent in the population of older adults (i.e., 65 years of age and older), affecting frequency and severity as well as other comorbidities, quality of life and consequently, life expectancy. In this article we review currently available data on pharmacotherapy of obesity in the population of older adults and its role in obesity management. Even though there is growing evidence, in particular in the general population, of favourable efficacy and safety profiles of glucagon-like peptide-1 (GLP-1) receptor agonists liraglutide and semaglutide, and recently dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) agonist tirzepatide, concise guidelines for older adults are not available to this day. We further discuss specific approaches to frequently represented phenotype of obesity in older adults, in particular sarcopenic obesity and rationale when to treat and how. In older adults with obesity there is a need for more drug trials focusing not only on weight loss, but also on geriatric endpoints including muscle mass preservation, bone quality and favourable fat distribution changes to get enough data for evidence-based recommendation on obesity treatment in this growing sub-population.

The Economic Implications of Population Aging on Current Account Balance

This paper focuses on the demographic determinants of current account balance (CAB) across income groups, continents, and time periods between 1993 and 2021. The benchmark model employs a panel data analysis, particularly a two-way effects estimator (Baltagi, 2021), with CAB as the main dependent variable, while savings rate (SAV) is used as an alternative dependent variable. It was found that the old dependency ratio, fertility rate, life expectancy, population growth, and mortality rate have a statistically significant effect on CAB and SAV, but the effects are heterogeneous across income groups and continents. In Africa, an increase in the old dependency ratio has a negative effect on CAB in accordance with the theories of Modigliani & Sterling (1983), Graham, (1987), and Masson & Tryon (1990). Fertility rate has a negative effect on CAB in Africa while having an ambiguous effect in Asia and Europe. In line with the findings of Mason & Lee (2006), there is a positive relationship between fertility rates and CAB and SAV in lower-middle-income countries and negative relationship in high-income countries. Conversely, population growth affects negatively CAB and SAV in lower middle-income countries and positively in high-income countries.

Limited Role of Biological Aging in Unhealthy Aging: A Cross-Sectional Analysis of Global Life Expectancy and Disability Data

BackgroundBiological aging is known to impact quality of life, but its precise role is debated. ObjectiveThis study explores how biological aging, measured by life expectancy at birth (e0), affects unhealthy aging as indicated by years lost due to disability (YLD). MethodsData from international organizations, including e0, YLD, and confounding factors like income, obesity, and urbanization, were analyzed. Correlations were visualized with scatter plots, and associations were assessed using Pearson's and nonparametric methods. Partial, multilevel modelling and multiple regression analyses were conducted to determine e0′s impact on YLD. Resultse0 strongly correlated with YLD, explaining about 50% of its variance. After adjusting for confounders, e0’s contribution fell to 12.18%. Multiple regression identified e0 and urbanization as significant predictors. ConclusionsBiological aging influences YLD, but its effect diminishes when accounting for other factors, highlighting the need for a comprehensive approach to healthy aging.

Exploring the Impact of Environmental Degradation, Income Inequality, Technological Development and Food Availability on Quality of Life: Recent Evidence From South Asia

ABSTRACTThis study investigates the determinants of quality of life in South Asian countries, focusing on Bangladesh, India, Sri Lanka, Nepal, and Pakistan from 2000 to 2018. Life expectancy is used as the dependent variable, representing life quality. The independent variables include carbon emissions, remittances, information and communication technology, income inequality, government health expenditure, economic development, and food security. Cross‐sectional time series FGLS is the main analytical method, supplemented by Pedroni and Kao cointegration tests and the Drisc/Kraay method. The findings indicate that information and communication technology, remittances, economic progress, and food security positively impact life expectancy, while CO2 emissions, income inequality, and government health expenditures negatively affect it. The study proposes several policy recommendations to improve the quality of life in the South Asian region.

ChatKG: Visualizing time-series patterns aided by intelligent agents and a knowledge graph

Line-chart visualizations of temporal data enable users to identify interesting patterns for the user to inquire about. Using Intelligent Agents (IA), Visual Analytic tools can automatically uncover explicit knowledge related information to said patterns. Yet, visualizing the association of data, patterns, and knowledge is not straightforward. In this paper, we present ChatKG, a novel visual analytics strategy that allows exploratory data analysis of a Knowledge Graph that associates temporal sequences, the patterns found in each sequence, the temporal overlap between patterns, the related knowledge of each given pattern gathered from a multi-agent IA, and the IA’s suggestions of related datasets for further analysis visualized as annotations. We exemplify and informally evaluate ChatKG by analyzing the world’s life expectancy. For this, we implement an oracle that automatically extracts relevant or interesting patterns, populates the Knowledge Graph to be visualized, and, during user interaction, inquires the multi-agent IA for related information and suggests related datasets to be displayed as visual annotations. Our tests and an interview conducted showed that ChatKG is well suited for temporal analysis of temporal patterns and their related knowledge when applied to history studies.

Quality of life and survivorship in patients with low-grade ovarian cancer

ObjectiveHigh-grade (HGOC) and low-grade ovarian carcinoma (LGOC) are distinct malignancies with different biological features, treatment paradigms, and life expectancies. However, differences in quality of life (QOL), sleep, and depressive symptoms have not been examined by grade, and neither have inflammatory profiles associated with these symptoms. We aim to characterize QOL and biomarkers by OC grade. MethodsParticipants included patients with HGOC (N = 578) or LGOC (N = 85). Participants completed baseline assessments of psychosocial factors prior to primary surgery or neoadjuvant chemotherapy and contributed saliva for cortisol and blood for interleukin-6 (IL-6) quantification. Samples were collected intraoperatively to quantify tumor cortisol. General linear models were used to examine differences in biological and psychological variables by grade. ResultsAt baseline, patients with LGOC reported less depression (p = 0.018) and sleep disturbances (p = 0.014), but no significant difference in depressive mood (p = 0.11) or QOL (p = 0.51) compared to patients with HGOC, adjusting for age and disease stage. There were trends towards lower tumor cortisol levels (p = 0.078) in LGOC compared to HGOC. One-year post-diagnosis, we found a significant improvement in QOL and fatigue, and a decrease in vegetative depression and IL-6 levels irrespective of grade. ConclusionsWe present the first characterization of psychosocial experiences of patients with LGOC. Despite having a better disease prognosis, patients with LGOC were just as likely to have mood disturbances as those with HGOC. There was a trend towards differences in tumor cortisol by grade. Our findings highlight the need to address well-being in patients with both low- and high-grade ovarian malignancies.

GUCA2A dysregulation as a promising biomarker for accurate diagnosis and prognosis of colorectal cancer

Colorectal cancer is a leading cause of global mortality and presents a significant barrier to improving life expectancy. The primary objective of this study was to discern a unique differentially expressed gene (DEG) that exhibits a strong association with colorectal cancer. By achieving this goal, the research aims to contribute valuable insights to the field of translational medicine. We performed analysis of colorectal cancer microarray and the TCGA colon adenoma carcinoma (COAD) datasets to identify DEGs associated with COAD and common DEGs were selected. Furthermore, a pan-cancer analysis encompassing 33 different cancer types was performed to identify differential genes significantly expressed only in COAD. Then, comprehensively in-silico analysis including gene set enrichment analysis, constructing Protein–Protein interaction, co-expression, and competing endogenous RNA (ceRNA) networks, investigating the correlation between tumor-immune signatures in distinct tumor microenvironment and also the potential interactions between the identified gene and various drugs was executed. Further, the candidate gene was experimentally validated in tumoral colorectal tissues and colorectal adenomatous polyps by qRael-Time PCR. GUCA2A emerged as a significant DEG specific to colorectal cancer (|log2FC|> 1 and adjusted q-value < 0.05). Importantly, GUCA2A exhibited excellent diagnostic performance for COAD, with a 99.6% and 78% area under the curve (AUC) based on TCGA-COAD and colon cancer patients. In addition, GUCA2A expression in adenomatous polyps equal to or larger than 5 mm was significantly lower compared to smaller than 5 mm. Moreover, low expression of GUCA2A significantly impacted overall patient survival. Significant correlations were observed between tumor-immune signatures and GUCA2A expression. The ceRNA constructed included GUCA2A, 8 shared miRNAs, and 61 circRNAs. This study identifies GUCA2A as a promising prognostic and diagnostic biomarker for colorectal cancer. Further investigations are warranted to explore the potential of GUCA2A as a therapeutic biomarker.

The Effect of MiR320a on Lung Cancer.

Lung cancer has a high mortality rate among cancers in both women and men. Currently, lung cáncer diagnosis is made with clinical examination, low-dose CT scan and molecular-based methods and its treatment options include chemotherapy, surgery, radiotherapy or immunotherapy. However, the life expectancy of lung cancer is not very high, and still it is usually diagnosed very lately, which leads to poorer prognosis. MicroRNAs [miRNAs] are small noncoding RNAs that regulate many diverse activities in the cell that can affect tumorigenesis by regulating many cell functions related to cancer, such as cell cycle, metastasis, angiogenesis, me-tabolism, and apoptosis. Also, it can have a potential diagnostic, therapeutic, and prognostic value for lung cancer. MiR320a is a promising microRNA that may help us in the diagnosis, treatment and prognosis of lung cancer, but some aspects of its clinical application are still vague, especially its effect on heavy smokers, delivery mechanism, toxicity and lack of reliable critical value. In this paper, we examined its comprehensive molecular interactions that lead to its tumor suppres-sor effect, and we reviewed its clinical application until now.

The contribution of avoidable mortality to life expectancy differences and lifespan disparities in the European Union: a population-based study

Twenty years after the 2004 European Union (EU) enlargement, life expectancy differences between established (EMS) and new member states (NMS) remain large. Contributing to this gap are deaths that can be avoided through preventive services or adequate medical treatment. We estimate the impact of reducing avoidable mortality on life expectancy and lifespan disparities in the enlarged EU. Using World Health Organization mortality database data, we analysed the potential of reducing avoidable mortality, as defined by Eurostat and the Organisation for Economic Cooperation and Development, to close themortality gap between NMS and EMS. We decomposed the changes in life expectancy and lifespan disparity by age and cause using linear integral decomposition. Averting all avoidable deaths across the EU from 2005 to 2019 would decrease the average life expectancy gap from 5.8 to 2.4 years in men and 3.3-2 years in women and eliminate the lifespan disparity gap. Had NMS achieved the average EMS avoidable mortality rates during the same period, the average life expectancy gap would have been reduced to 1.8 years in men and 1.6 years in women, and the lifespan disparities gap would have been reversed. Avoidable circulatory and injury-related deaths in middle and older age drove the observed mortality changes. Our results suggest that the gap in life expectancy and lifespan disparity across the EU could be reduced by strengthening health systems and investing in averting circulatory and injury-related deaths in middle and older age in NMS. None.

Diabetes and mental health: towards integrated care

The reduced life expectancy and higher mortality of people suffering from mental disorders compared to the general population represent a major public health challenge. Numerous individual and collective factors contribute to this inequality, particularly in the case of chronic pathologies such as diabetes. Integrated, coordinated care would help reduce health disparities and guarantee equitable access to care for this vulnerable population.

Clinical study on anorexia in patients with terminal cancer.

Patients with terminal cancer tend to have an increased frequency of a variety of clinical symptoms, including anorexia, at 1 month of life expectancy. This study examined clinical symptoms affecting anorexia in patients with terminal cancer. Of 1068 patients with terminal cancer who died and were discharged from our hospital between April 2014 and March 2016, we included 471 patients whose clinical symptoms could be subjectively assessed within 4 weeks before death.Patients were evaluated subjectively on a scale of 0 to 10 (11-point scale) using the Numerical Rating Scale (NRS) once a week for nine major clinical symptoms: (1) pain, (2) general fatigue, (3) dyspnea, (4) depressed mood, (5) anorexia, (6) insomnia, (7) nausea, (8) constipation, and (9) dry mouth. Primary data within 4 weeks prior to death were used for analysis, and Spearman's rank correlation was used to examine clinical symptoms affecting anorexia. Spearman's rank correlation coefficients between anorexia and the following clinical symptoms were: pain, 0.186; general fatigue, 0.414; dyspnea, 0.15; depressed mood, 0.287; insomnia, 0.327; nausea, 0.297; constipation, 0.215; and dry mouth, 0.204. General fatigue was positively correlated with anorexia. General fatigue may influence anorexia in patients with terminal cancer.