False negative effect of high triglycerides concentration on vitamin D levels: A big data study

Background: Inaccurate test results may be a reason why vitamin D deficiency is seen as a common problem worldwide. Interferences from the sample matrix during testing are the most important factors in measurement errors. In this study, the relationship between triglycerides and total cholesterol levels and vitamin D levels in Turkey was investigated. Methods: The 25-hydroxyvitamin D test results and lipid test results studied in Turkey in 2021 were compared. Data were obtained from the Ministry of Health National Health Database. Simultaneously, 25-hydroxyvitamin D, triglyceride, and total cholesterol levels were studied, and 1,135,644 test results were taken as the basis. Results: In the group of patients with total cholesterol levels between 0-10.33 mmol/L, the proportion of patients below 20 mg/L ranged from 56.8% to 61.8%. In the patient group with cholesterol between 10.36-259 mmol/L, the rate of patients with less than 20 mg/L was between 70.8-100%, while the rate of patients with cholesterol above 100 mg/L was 0%. The mean 25-hydroxyvitamin D level was 20.1 mg/L in the patient group with a total cholesterol level between 0-10.33 mmol/L, and 16 mg/L in the patient group with a cholesterol level above 10.36 mmol/L. The mean 25-hydroxyvitamin D level was 20.11 mg/L in the patient group with triglycerides 0-10.16 mmol/L, and the 25-hydroxyvitamin D level was 12.28 mg/L in the patient group with triglycerides 10.17-113 mmol/L. The proportion of patients with vitamin D levels above 100 mg/L was found to be 0% in the group of patients with triglycerides above 10.17-113 mmol/L. Conclusions: According to this study, there is a risk of toxicity when administering vitamin D therapy in patients with high cholesterol and triglycerides levels. This study is the first of this size in the literature. High triglycerides and cholesterol levels can cause inaccurate measurement of vitamin D levels, so care should be taken when evaluating these tests

Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016

Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. FINDINGS: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. INTERPRETATION: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support. FUNDING: Bill & Melinda Gates Foundation

Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background Accurate assessments of current and future fertility—including overall trends and changing population age structures across countries and regions—are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios. Methods To estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10–54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50; the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in habitable areas, and under-5 mortality) were given equal weights, and analyses were conducted utilising the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. To capture time-series trends in CCF50 not explained by these covariates, we used a first-order autoregressive model on the residual term. CCF50 as a proportion of each 5-year ASFR was predicted using a linear mixed-effects model with fixed-effects covariates (female educational attainment and contraceptive met need) and random intercepts for geographical regions. Projected TFRs were then computed for each calendar year as the sum of single-year ASFRs across age groups. The reference forecast is our estimate of the most likely fertility future given the model, past fertility, forecasts of covariates, and historical relationships between covariates and fertility. We additionally produced forecasts for multiple alternative scenarios in each location: the UN Sustainable Development Goal (SDG) for education is achieved by 2030; the contraceptive met need SDG is achieved by 2030; pro-natal policies are enacted to create supportive environments for those who give birth; and the previous three scenarios combined. Uncertainty from past data inputs and model estimation was propagated throughout analyses by taking 1000 draws for past and present fertility estimates and 500 draws for future forecasts from the estimated distribution for each metric, with 95% uncertainty intervals (UIs) given as the 2·5 and 97·5 percentiles of the draws. To evaluate the forecasting performance of our model and others, we computed skill values—a metric assessing gain in forecasting accuracy—by comparing predicted versus observed ASFRs from the past 15 years (2007–21). A positive skill metric indicates that the model being evaluated performs better than the baseline model (here, a simplified model holding 2007 values constant in the future), and a negative metric indicates that the evaluated model performs worse than baseline. Findings During the period from 1950 to 2021, global TFR more than halved, from 4·84 (95% UI 4·63–5·06) to 2·23 (2·09–2·38). Global annual livebirths peaked in 2016 at 142 million (95% UI 137–147), declining to 129 million (121–138) in 2021. Fertility rates declined in all countries and territories since 1950, with TFR remaining above 2·1—canonically considered replacement-level fertility—in 94 (46·1%) countries and territories in 2021. This included 44 of 46 countries in sub-Saharan Africa, which was the super-region with the largest share of livebirths in 2021 (29·2% [28·7–29·6]). 47 countries and territories in which lowest estimated fertility between 1950 and 2021 was below replacement experienced one or more subsequent years with higher fertility; only three of these locations rebounded above replacement levels. Future fertility rates were projected to continue to decline worldwide, reaching a global TFR of 1·83 (1·59–2·08) in 2050 and 1·59 (1·25–1·96) in 2100 under the reference scenario. The number of countries and territories with fertility rates remaining above replacement was forecast to be 49 (24·0%) in 2050 and only six (2·9%) in 2100, with three of these six countries included in the 2021 World Bank-defined low-income group, all located in the GBD super-region of sub-Saharan Africa. The proportion of livebirths occurring in sub-Saharan Africa was forecast to increase to more than half of the world's livebirths in 2100, to 41·3% (39·6–43·1) in 2050 and 54·3% (47·1–59·5) in 2100. The share of livebirths was projected to decline between 2021 and 2100 in most of the six other super-regions—decreasing, for example, in south Asia from 24·8% (23·7–25·8) in 2021 to 16·7% (14·3–19·1) in 2050 and 7·1% (4·4–10·1) in 2100—but was forecast to increase modestly in the north Africa and Middle East and high-income super-regions. Forecast estimates for the alternative combined scenario suggest that meeting SDG targets for education and contraceptive met need, as well as implementing pro-natal policies, would result in global TFRs of 1·65 (1·40–1·92) in 2050 and 1·62 (1·35–1·95) in 2100. The forecasting skill metric values for the IHME model were positive across all age groups, indicating that the model is better than the constant prediction. Interpretation Fertility is declining globally, with rates in more than half of all countries and territories in 2021 below replacement level. Trends since 2000 show considerable heterogeneity in the steepness of declines, and only a small number of countries experienced even a slight fertility rebound after their lowest observed rate, with none reaching replacement level. Additionally, the distribution of livebirths across the globe is shifting, with a greater proportion occurring in the lowest-income countries. Future fertility rates will continue to decline worldwide and will remain low even under successful implementation of pro-natal policies. These changes will have far-reaching economic and societal consequences due to ageing populations and declining workforces in higher-income countries, combined with an increasing share of livebirths among the already poorest regions of the world

Use Of Explanatory Item Response Models In Computer Adaptıve Tests

The item bank development stage in computer adaptive testing is extremely challenging. It is assumed that the item difficulties are constant among different sub-groups, different positions and various test forms. The items violate these assumptions are eliminated. This may result in more time-consuming item pool development stage. The main purpose of this research is to investigate how average test length, item exposure, test overlap and precision of ability parameters change when explanatory item response models are utilized in computer adaptive testing. The study analysis conducted with simulated 10 item pools with 100 items and 1440 candidates in each. Each item bank calibrated using Rasch model, latent regression, linear logistic test model and latent regression linear logistic test model. Next, response patterns and prior ability estimates used for post-hoc simulations conducted in 10 replications for each item bank and models. The simulations are based on EAP estimation, two stop rules (precision and minInfo) and the item exposure control rule randomesque. The computer adaptive testing simulations based on explanatory item response models conducted using a modified version of “catR”. It is reported that if the sub-groups in population are ignored in post-hoc simulations all models estimate very similar ability score mean. It also found that explanatory item response models have no effect on average test length, test overlap and item exposure rate. It is an important finding that latent regression and linear logistic test model achieved to reduce item exposure rate for the first 20 items.Bilgisayar ortamında bireye uyarlanmış testlerde madde havuzunun geliştirilmesi süreci oldukça zahmetli bir iştir. Bu geliştirme sürecinde madde parametrelerinin farklı alt gruplara, kullanım sırasına, farklı test formatlarına göre değişim göstermemesi beklenir. Bunun için yapılan analizlerde böylesi bir durumun tespit edildiği maddeler elenir. Bu çalışmanın amacı açıklayıcı madde tepki modellerinin bilgisayar ortamında bireye uyarlanmış testlerde kullanımının, madde havuzu geliştirme sürecine, uygulanan madde sayısına, yetenek parametrelerinin kestiriminin kesinliğine etkisini incelemektir. Araştırmada her birinde 100 maddenin olduğu 10 madde havuzu ve 1440 katılımcıya ait cevap örüntüleri simülasyonla üretilmiştir. Geliştirilen tüm madde havuzları Rasch model, örtük regresyon, doğrusal lojistik test modeli ve örtük regresyon doğrusal lojistik test modeli ile kalibre edilmiştir. Ardından her bir modelden elde edilen cevap örüntüleri ve önsel yetenek puanları ile 10 döngüden oluşan post-hoc simülasyonları gerçekleştirilmiş ve tüm havuzlardan elde edilen sonuçların ortalamasına ulaşılmıştır. Post-hoc simülasyonlarında yetenek puan kestirimi olarak BSD (EAP), sonlandırma kuralı olarak kesinlik ve minInfo kuralı, madde kullanım sıklığı kontrol kuralı olarak randomesque kullanılmıştır. Açıklayıcı madde tepki modeli ile yapılan post-hoc simülasyonu “catR” paketine araştırmacı tarafından yazılan yeni fonksiyonlar ile gerçekleştirilmiştir. Araştırmada tüm madde havuzunda olduğu gibi post-hoc simülasyonlarında da alt gruplar göz ardı edildiğinde tüm modellerin çok yakın yetenek puan ortalaması kestirdiği belirlenmiştir. Alt gruplar dikkate alındığında ise modeller arasında manidar farklar tespit edilmiştir. Ayrıca parametre kestirim modelinin maddenin kullanım sıklığı, test uzunluğu ve test örtüşme oranı üzerinde etkisinin olmadığı tespit edilmiştir. Çalışmada madde havuzunda birey ve madde eşdeğişkenlerinin etkin olduğu maddelerin bulunduğu durumlarda, bilgisayar ortamında bireye uyarlanmış testlerin açıklayıcı madde tepki modellerine dayalı parametrelerle yapılması önerilmiştir

KADIN TEKVANDO VE KARATECİLERDE KİLO DÜŞME DAVRANIŞLARI

KADIN TEKVANDO VE KARATECİLERDE KİLO D&Uuml;ŞME DAVRANIŞLARI&nbsp;1Osman İMAMOĞLU, 2Feyzullah KOCA, 3Hasan TAT&nbsp;1OM&Uuml; Yaşar Doğu Spor Bilimleri Fak&uuml;ltesi, 2Erciyes &Uuml;niversitesi Spor Bilimleri Fak&uuml;ltesi, 3OM&Uuml; Yaşar Doğu Spor Bilimleri Fak&uuml;ltesi&nbsp;&Ouml;ZET&nbsp;Bu araştırmanın amacı kadın Tekvando ve karatecilerde kilo d&uuml;şme davranışlarının belirlenmesidir. &Ccedil;alışmaya 88 Tekvando ve 78 karateci dahil edilmiştir. İstatistiksel olarak t -testi ve ki kare testi kullanılmıştır. Yaş ortalamaları Tekvandocuların 21,09 &plusmn; 0,30 ve karatecilerin 21,87&plusmn; 0,25 yıl bulunmuştur. Kilo d&uuml;şmeye başlama yaşları Tekvandocularda ortalama 14,15&plusmn;0,49 iken Karatecilerde 14,18&plusmn;0,41 yıl bulunmuştur. İlgili spora başlama yaşı, boy uzunluğu, v&uuml;cut ağırlığı ve kilo d&uuml;şmeye başlama yaşları arasında anlamlı fark tespit edilmemiştir (p &gt;0,05). M&uuml;sabakalar &ouml;ncesi devamlı kilo d&uuml;şenler Tekvandocularda % 45,45 ve karatecilerde %48,72 ve toplamda %46,99 bulunmuştur. Kilo d&uuml;şt&uuml;ğ&uuml; ma&ccedil;larda başarılı olanlar toplamda %42,26 iken kilo d&uuml;şmediği ma&ccedil;larda başarılı olanların toplam oranı %45,16&rsquo;dir. Kilo d&uuml;şenlerin %30,97&rsquo;si rakiplere karşı g&uuml;&ccedil;l&uuml; olmak i&ccedil;in ve %35,42&rsquo;si kazanma şansını artırmak i&ccedil;in kilo d&uuml;şt&uuml;klerini belirtmişlerdir. Branşlar arasında kilo d&uuml;şme nedenleri arasında anlamlı bir farklılık bulunmamıştır (p &gt;0,05). Sonu&ccedil;: Tekvando ve karateciler de kilo d&uuml;şme sırasındaki davranışları birbirine benzerdir. Her iki spordaki sporcuların kilo kaybetme konusunda doğru bir yaklaşımı olmadığı s&ouml;ylenebilir. Yarışma &ouml;ncesi d&ouml;nem, kilo verme veya kilo kontrol&uuml; konusunda bilin&ccedil;lendirme eğitimleri yapılmalıdır.&nbsp;Anahtar Kelimeler: Tekvando, Karate, Kilo d&uuml;şmeWEIGHT DESCENDING BEHAVIORS OF FEMALE TAEKWONDO AND KARATE&nbsp;1Osman İMAMOĞLU, 2Feyzullah KOCA, 3Hasan TAT&nbsp;ABSTRACT&nbsp;Abstract This study aims to find the weight descending behaviors of female Taekwondo and karate athletes. 88 Taekwondo and 78 karate female athletes answered the questionnaire prepared by the researchers. Statistically t-test and chi-square test were used. Age average for Taekwondo was 21, 09 &plusmn; 0, 30 and for karate&rsquo;s it was 21, 08&plusmn; 21, 87&plusmn; 0, 25. Weight decrease age for Taekwondo is 14, 15&plusmn;0, 49 on average and it is 14, 18&plusmn;0, 41 years for karate&rsquo;s. There is a meaningful no difference between the starting age of the related sport, height, body weight, and weight loss decrease (p &gt;0, 05). Continuous weight loss decreasing female athletes before competitions have a percentage of % 45, 16 for Taekwondo, %48, 72 for karate&rsquo;s and %46, 99 on total. Victorious female athletes who lost weight for the events have a percentage of %42, 26. The ones who did not lose weight have a percentage of %45,16. %30, 97 of the female athletes mentioned they lost weight in order to be powerful against their opponents and %35, 42 said they lost weight in order to increase their possibility of winning. No meaningful difference has been found between branches and their reasons of weight loss decreasing (p &gt;.05). Conclusion: Taekwondo and karate females have similar behaviors during weight decreasing. It can be said that the athletes in both sports do not have a correct approach towards losing weight. Period of before competitions, consciousness-raising trainings should be made about weight loss or weight control.&nbsp;Keywords: Taekwondo, Karate, Weight Loss</p

The Influence Of Using Plausible Values And Survey Weights On Multiple Regression And Hierarchical Linear Model Parameters

In large-scale assessments like Programme for International Students Assessment (PISA) and the Trends in International Mathematics and Science Study (TIMSS), plausible values are often used as students' ability estimations. In those studies, stratified sampling method is employed in order to draw participants, and hence, the data gathered has a hierarchical structure. In the context of large-scale assessments, plausible values refer to randomly drawn values from posterior ability distribution. It is reported that using one of plausible values or mean of those values as independent variable in linear models may lead to some estimation errors. Moreover, it is observed that sampling weights sometimes are not used during analysis of large-scale assessment data. This study aims to investigate the influence of three approaches on the parameters of linear and hierarchical linear regression models: 1) using only one plausible value, 2) using all plausible values, 3) incorporating sampling weights or not. Data used in the present study is obtained from school and student questionnaires in PISA (2015) Turkey database. Results revealed that the use of sampling weights and number of plausible values has significant effects on regression coefficients, standard errors and explained variance for both regression models. Findings of the study were discussed in details and some conclusions were drawn for practice and further research.WoSScopu

Effect of gestational age on gentamicin pharmacokinetic parameters in the newborn

This study investigates the pharmacokinetics of gentamicin in newborns in the Special Care Nursery in University Hospital. They were divided into 3 groups according to gestational age: Group I, 26 to 30 weeks (n=10), Group II, 31 to 35 weeks (n=27), and Group III, 36 to 40 weeks (n=36). Each subject received 2.5mg/kg gentamicin (gentamicin sulphate, David Bull) every 12 h initially. The pharmacokinetic parameters for each newborn were derived from the measured plasma Cmax and Cmin,' levels taken at steady state, according to the Sawchuk-Zaske method. The subsequent dosage regimen was calculated using these parameters. Gentamicin trough levels in the newborn ranged from 0.57 to 4.94 Jig/ml. while the peak levels ranged from 4.24 to 12.42 |.Lg/1nL. The apparent volume of distribution (Vd) (means i SEM) increased with gestational age, the Va being 0.81 i 0.09, 1.00 i 0.06 and 1.49 +- 0.06 L for groups I, II and III respectively. The differences between the groups were significant (P<0.01; Student's t-test). There was an observable decrease in t} with increasing gestational age, the tm (mean i SEM) being 10.02 i 1.19 h, 8.53 i 0.38 h and 7.10 i 0.31 h for Groups I, II and III respectively. This decrease in the tm was accompanied by a similar increase in CI. (0.07 +- 0.02, 0.09 +- 0.01 and 0.15 +- 0.01 I/h for Groups I, II and III respectively). The changes int and CL were significant (P<0.01) between Groups I and III, and between Groups II and III. These findings show that differences exist in the pharrnacolcinetic parameters of newborns when grouped according to gestational age. For the effective monitoring of gentamicin especially with regard to the initial estimation of drug dosage, the appropriate set of pharmacokinetic parameters should be used for the newborn of that gestational age