UCL

I. Abubakar, R. Aldridge, D. Devakumar, M. Orcutt, R. Burns, M. Barreto, P. Dhavan, Fouad M. Fouad, N. Groce, Yanqing Guo, Sally Hargreaves, M. Knipper, J. J. Miranda, N. Madise, B. Kumar, D. Mosca, T. Mcgovern, L. Rubenstein, P. Sammonds, Susan M. Sawyer, K. Sheikh, S. Tollman, P. Spiegel, Cathy Zimmerman, Mustafa Eleanor Ayesha Bayes Seye Juan D Karl Philippe Fio Abbas Acer Ahmad Ahmed Abimbola Beltrán Blanchet B, M. Abbas, Eleanor Acer, Ayesha Ahmad, B. Ahmed, S. Abimbola, Juan D. Beltrán, K. Blanchet, P. Bocquier, F. Samuels, O. Byrne, S. Haerizadeh, R. Issa, M. Collinson, Carren Ginsburg, I. Kelman, Alys McAlpine, N. Pocock, Barbara Olshansky, D. Ramos, Katerina Stavrianaki, Michael J. White, Suzanne Zhou

Executive summary With one billion people on the move or having moved in 2018, migration is a global reality, which has also become a political lightning rod. Although estimates indicate that the majority of global migration occurs within low-income and middle-income countries (LMICs), the most prominent dialogue focuses almost exclusively on migration from LMICs to high-income countries (HICs). Nowadays, populist discourse demonises the very same individuals who uphold economies, bolster social services, and contribute to health services in both origin and destination locations. Those in positions of political and economic power continue to restrict or publicly condemn migration to promote their own interests. Meanwhile nationalist movements assert so-called cultural sovereignty by delineating an us versus them rhetoric, creating a moral emergency. In response to these issues, the UCL-Lancet Commission on Migration and Health was convened to articulate evidence-based approaches to inform public discourse and policy. The Commission undertook analyses and consulted widely, with diverse international evidence and expertise spanning sociology, politics, public health science, law, humanitarianism, and anthropology. The result of this work is a report that aims to be a call to action for civil society, health leaders, academics, and policy makers to maximise the benefits and reduce the costs of migration on health locally and globally. The outputs of our work relate to five overarching goals that we thread throughout the report. First, we provide the latest evidence on migration and health outcomes. This evidence challenges common myths and highlights the diversity, dynamics, and benefits of modern migration and how it relates to population and individual health. Migrants generally contribute more to the wealth of host societies than they cost. Our Article shows that international migrants in HICs have, on average, lower mortality than the host country population. However, increased morbidity was found for some conditions and among certain subgroups of migrants, (eg, increased rates of mental illness in victims of trafficking and people fleeing conflict) and in populations left behind in the location of origin. Currently, in 2018, the full range of migrants’ health needs are difficult to assess because of poor quality data. We know very little, for example, about the health of undocumented migrants, people with disabilities, or lesbian, gay, bisexual, transsexual, or intersex (LGBTI) individuals who migrate or who are unable to move. Second, we examine multisector determinants of health and consider the implication of the current sector-siloed approaches. The health of people who migrate depends greatly on structural and political factors that determine the impetus for migration, the conditions of their journey, and their destination. Discrimination, gender inequalities, and exclusion from health and social services repeatedly emerge as negative health influences for migrants that require cross-sector responses. Third, we critically review key challenges to healthy migration. Population mobility provides economic, social, and cultural dividends for those who migrate and their host communities. Furthermore, the right to the highest attainable standard of health, regardless of location or migration status, is enshrined in numerous human rights instruments. However, national sovereignty concerns overshadow these benefits and legal norms. Attention to migration focuses largely on security concerns. When there is conjoining of the words health and migration, it is either focused on small subsets of society and policy, or negatively construed. International agreements, such as the UN Global Compact for Migration and the UN Global Compact on Refugees, represent an opportunity to ensure that international solidarity, unity of intent, and our shared humanity triumphs over nationalist and exclusionary policies, leading to concrete actions to protect the health of migrants. Fourth, we examine equity in access to health and health services and offer evidence-based solutions to improve the health of migrants. Migrants should be explicitly included in universal health coverage commitments. Ultimately, the cost of failing to be health-inclusive could be more expensive to national economies, health security, and global health than the modest investments required. Finally, we look ahead to outline how our evidence can contribute to synergistic and equitable health, social, and economic policies, and feasible strategies to inform and inspire action by migrants, policy makers, and civil society. We conclude that migration should be treated as a central feature of 21st century health and development. Commitments to the health of migrating populations should be considered across all Sustainable Development Goals (SDGs) and in the implementation of the Global Compact for Migration and Global Compact on Refugees. This Commission offers recommendations that view population mobility as an asset to global health by showing the meaning and reality of good health for all. We present four key messages that provide a focus for future action.

Yongzhen Wang, Xu Yan, F. Wang, Haoran Xie, Wenhan Yang, Mingqiang Wei, J. Qin

While the wisdom of training an image dehazing model on synthetic hazy data can alleviate the difficulty of collecting real-world hazy/clean image pairs, it brings the well-known domain shift problem. From a different yet new perspective, this paper explores contrastive learning with an adversarial training effort to leverage unpaired real-world hazy and clean images, thus alleviating the domain shift problem and enhancing the network’s generalization ability in real-world scenarios. We propose an effective unsupervised contrastive learning paradigm for image dehazing, dubbed UCL-Dehaze. Unpaired real-world clean and hazy images are easily captured, and will serve as the important positive and negative samples respectively when training our UCL-Dehaze network. To train the network more effectively, we formulate a new self-contrastive perceptual loss function, which encourages the restored images to approach the positive samples and keep away from the negative samples in the embedding space. Besides the overall network architecture of UCL-Dehaze, adversarial training is utilized to align the distributions between the positive samples and the dehazed images. Compared with recent image dehazing works, UCL-Dehaze does not require paired data during training and utilizes unpaired positive/negative data to better enhance the dehazing performance. We conduct comprehensive experiments to evaluate our UCL-Dehaze and demonstrate its superiority over the state-of-the-arts, even only 1,800 unpaired real-world images are used to train our network. Source code is publicly available at https://github.com/yz-wang/UCL-Dehaze.

Binbin Ding, Shuai Shao, Fan Jiang, Peipei Dang, Chunqiang Sun, Shanshan Huang, Ping'an Ma, D. Jin, A. A. A. Kheraif, Jun Lin

Upconversion nanoparticles (UCNPs) and MnO2 hybrid theranostic nanoplatform (UCMn) is highly desired; however, the rational design of such UCMn hybrid nanomaterials is still a great challenge. Herein, a simple and versatile strategy for the in situ growth of MnO2 on the surfaces of UCNPs was reported using a sacrificial template method to construct an ideal MnO2-disguised and tumor microenvironment–triggered architecture. Such sophisticated architecture not only achieves activatable magnetic resonance imaging and restorable upconversion luminescence (UCL) imaging with over 100-fold enhancement of UCL in vivo but also significantly improves the efficiency of chemodynamic therapy (CDT) by glutathione depletion- and cisplatin-activation-enhanced •OH generation simultaneously. Additionally, the synergetic effect of CDT and chemotherapy presents excellent therapeutic effect in vivo as compared to either CDT or chemotherapy alone. We believe that the ideal design of the MnO2-disguised upconversion hybrid nanoco...

Hanyi Fang, Mengting Li, Qingyao Liu, Y. Gai, Lujie Yuan, Sheng Wang, Xiao Zhang, M. Ye, Yongxue Zhang, Mingyuan Gao, Yi Hou, X. Lan

A biomimetic nanoprobe was built with cancer cell membrane-coated and Gd 3+ -doped upconversion nanoparticles. The nanoprobe could be applied to in vivo UCL/MRI/PET multimodality precise imaging and successfully differentiated MDA-MB-231 tumor models through in vivo tri-modality imaging, which may be used for breast cancer molecular classification. Triple-negative breast cancer (TNBC) is a subtype of breast cancer in which the estrogen receptor and progesterone receptor are not expressed, and human epidermal growth factor receptor 2 is not amplified or overexpressed either, which make the clinical diagnosis and treatment very challenging. Molecular imaging can provide an effective way to diagnose TNBC. Upconversion nanoparticles (UCNPs), are a promising new generation of molecular imaging probes. However, UCNPs still need to be improved for tumor-targeting ability and biocompatibility. This study describes a novel probe based on cancer cell membrane-coated upconversion nanoparticles (CCm-UCNPs), owing to the low immunogenicity and homologous-targeting ability of cancer cell membranes, and modified multifunctional UCNPs. This probe exhibits excellent performance in breast cancer molecular classification and TNBC diagnosis through UCL/MRI/PET tri-modality imaging in vivo. By using this probe, MDA-MB-231 was successfully differentiated between MCF-7 tumor models in vivo. Based on the tumor imaging and molecular classification results, the probe is also expected to be modified for drug delivery in the future, contributing to the treatment of TNBC. The combination of nanoparticles with biomimetic cell membranes has the potential for multiple clinical applications.