Direct Standardization Method Research Articles

Features of the incidence of breast cancer in the Republic of Kazakhstan

Aim of the study. Analysis of breast cancer incidence in Kazakhstan for the period 2020 – 2022.Materials and methods. The study included all registered cases of breast cancer morbidity and mortality in the Republic of Kazakhstan for the period 2020-2022. Data for analysis were taken from the official statistical source: Statistical collection «Health of the population of the Republic of Kazakhstan and the activities of healthcare organizations in 2020»; Statistical collection “Health of the population of the Republic of Kazakhstan and the activities of healthcare organizations in 2021-2022.” The search depth was 3 years, from 2020 to 2022. A direct standardization method using a global population standard was used to calculate standardized morbidity and mortality rates.Results and discussion. As a result of studying statistical data for 2020-2022, it was found that cancer incidence rates per 100 thousand population in 2022, compared with 2021, increased by 5.2%, and compared to 2020 increased by 13.5%. In the structure of incidence, both in 2020 and 2021, and in 2022, breast cancer occupied 1st place, with an increase in dynamics from 2020 to 2022 from 8.76 to 9.73 per 100 thousand population.An analysis of the incidence of breast cancer by stages of the disease in the context of regions of Kazakhstan showed that high rates of stages I and II of breast cancer were established in the Kyzylorda, Pavlodar, and Atyrau regions. The lowest incidence rates of stage I and II breast cancer were observed in Akmola, Mangistau and Turkestan regions.Conclusions. According to the results of our review, many studies indicate that this disease continues to be the most frequently diagnosed malignant neoplasm and the leading cause of death among women in various countries of the world, including Kazakhstan. The conclusion of this article is that the incidence and mortality from breast cancer continues to be an urgent epidemiological problem in Kazakhstan, requiring further scientific research to identify risk factors.

Development and application of a comprehensive measurement equation for the direct comparator standardization method of Instrumental Neutron Activation Analysis

A comprehensive model equation for the measurement of elemental mass fractions in solid materials using the direct standardization method of Instrumental Neutron Activation Analysis was developed. The extensive modelling established for the single comparator standardization was revised and changed for the direct standardization to obtain a complete mathematical description of the measurand by physical and chemical quantities having dimensions in SI units. The model equation is presented both in case measurement and standard samples are measured in the same γ-counting position and in different γ-counting positions. The first was successfully applied for the quantitative determination of As mass fraction in a seafood matrix with a percent level relative uncertainty. The SI traceability of the result is established by a traceable standard via the measurement equation and the uncertainty budget compiled to highlight the input quantities that contribute most to the combined uncertainty.

Mortality rates for men and women from cerebrovascular and nervous diseases in the regions of Russia in 2013 and 2022

In recent years, researchers have noted an increase in mortality from neurodegenerative diseases and a decrease in mortality from strokes. There have been no studies comparing mortality from these causes in the regions of the Russian Federation.Aim: comparative analysis of regional (age-) standardized death rate (SDR) among men and women from cerebrovascular diseases (CVD) and nervous system diseases (NSD) in 2013 and 2022 and discussion of factors influencing SDR.Materials and methods. Rosstat data obtained upon request were used. SDR was calculated using software (state registration number of computer program 216661114) using the European Standard Population using the direct standardization method per 100 thousand population; The average regional SDR values were calculated for the class of NSD and individual groups from this class, CVB (codes I60–69).Results. A decrease in the regional average SDR from CVD was revealed among men (218.09 ± 60.81 in 2013 and 159.41 ± 51.20 per 100 thousand people in 2022) and women (144.30 ± 39.33 and 103.51 ± 32.63 respectively) and the increase in SDR from LBP (19.77 ± 17.70 and 65.99 ± 56.67 for men, 10.99 ± 11.32 and 52.81 ± 46.13 for women). Only in 4 regions was there a decrease in SDR from both NSD and CVD in both men and women. The dispersion of regional SDRs from NSD and CVB in 2022 compared to 2013 increased by more than 10 times, which indicates a significant and growing regional variability of indicators. In the stroke group, the most significant decrease occurred from “Stroke not specified as hemorrhage or infarction” (code I64). The regional average contribution of acute stroke (codes I60–64) to the SCS from NSD and CVB (in total) decreased (in 2013 among women 51.57 ± 16.26 %, in 2022 33.96 ± 14.95 %; among men 54.0 ± 15.01 and 39.82 ± 14.26 respectively). Alzheimer’s disease makes a negligible contribution to mortality; In men in certain regions, alcohol-associated LBP is significant.Conclusions. Significant regional variability of SDR from individual groups of causes and a general trend towards a decrease in SDR from CVD and an increase in SDR from NSD were revealed, which is due to many factors. To eliminate the influence of different approaches to determining the cause of death, a unified protocol of criteria for their establishment is necessary.

A Longitudinal Analysis of Mortality Related to Chronic Viral Hepatitis and Hepatocellular Carcinoma in the United States.

(1) Background: Hepatocellular carcinoma (HCC) contributes to the significant burden of cancer mortality in the United States (US). Despite highly efficacious antivirals, chronic viral hepatitis (CVH) remains an important cause of HCC. With advancements in therapeutic modalities, along with the aging of the population, we aimed to assess the contribution of CVH in HCC-related mortality in the US between 1999-2020. (2) Methods: We queried all deaths related to CVH and HCC in the multiple-causes-of-death files from the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) database between 1999-2020. Using the direct method of standardization, we adjusted all mortality information for age and compared the age-adjusted mortality rates (AAMRs) across demographic populations and by percentile rankings of social vulnerability. Temporal shifts in mortality were quantified using log-linear regression models. (3) Results: A total of 35,030 deaths were identified between 1999-2020. The overall crude mortality increased from 0.27 in 1999 to 8.32 in 2016, followed by a slight reduction to 7.04 in 2020. The cumulative AAMR during the study period was 4.43 (95% CI, 4.39-4.48). Males (AAMR 7.70) had higher mortality rates compared to females (AAMR 1.44). Mortality was higher among Hispanic populations (AAMR 6.72) compared to non-Hispanic populations (AAMR 4.18). Higher mortality was observed in US counties categorized as the most socially vulnerable (AAMR 5.20) compared to counties that are the least socially vulnerable (AAMR 2.53), with social vulnerability accounting for 2.67 excess deaths per 1,000,000 person-years. (4) Conclusions: Our epidemiological analysis revealed an overall increase in CVH-related HCC mortality between 1999-2008, followed by a stagnation period until 2020. CVH-related HCC mortality disproportionately affected males, Hispanic populations, and Black/African American populations, Western US regions, and socially vulnerable counties. These insights can help aid in the development of strategies to target vulnerable patients, focus on preventive efforts, and allocate resources to decrease HCC-related mortality.

Incidence and Prevalence of Dementia: A 2015–2020 Population-Based Study in the Campania Region of Italy

Plain Language SummaryDementia is a loss of memory and other functions related to thinking and to the ability to do everyday chores, usually occurring in the elderly and getting worse over time. The most common kind is Alzheimer’s dementia. Here, we estimated the number of people who are sick with dementia (prevalence) and how many new cases of dementia there are (incidence) in the Campania region (South Italy) from 2015 to 2020. We included individuals aged 65 years and above who have used dementia medications, were admitted to hospitals due to dementia, and/or had payment exemptions for dementia. Among 1,118,545 individuals older than 65 years living in the Campania region of Italy (among 5,624,260 inhabitants), we identified 80,392 people older than 65 years with dementia (62.4% females; age about 80 years), among which 35,748 people had Alzheimer’s dementia (63.0% females; age about 79 years). Based on these numbers, we estimated 77 people living with dementia per 1,000 people (85 for females and 67 for males) and 34 with Alzheimer’s dementia per 1,000 people (37 for females and 29 for males). The number of new cases per year was 82 per 100,000 for any dementia and 59 for Alzheimer’s dementia. We showed that our data were accurate by comparing results of tests measuring memory and other functions and found that only 1.7–3.0% of cases remained undetected. These measures will be important to identify risk factors, guide prevention strategies, and improve care and support for affected individuals and their families.

Prevalence of survivors of childhood cancer based on a population-based cancer registry in Osaka, Japan.

Although the survival rate of patients with childhood cancer has greatly improved, long-term survivors face specific problems such as the late effects of cancer treatment. In this study, we estimated the number of people who had experienced childhood cancer to predict their needs for medical care and social resources. Using data from the population-based Osaka Cancer Registry, we identified children aged 0-14 years who were diagnosed with cancer between 1975 and 2019. We estimated the prevalence on December 31, 2019, and the 5- and 10-year prevalence (i.e., the number of survivors living up to 5 or 10 years after the diagnosis of cancer) over time. The prevalence proportion was age-standardized using a direct standardization method. The prevalence estimates for Osaka were applied to the national population to determine the national prevalence in Japan. Among 8186 patients diagnosed with childhood cancer in Osaka, 5252 (987 per million) survived until December 31, 2019. The 5-year prevalence per million increased from 194 in 1979 to 417 in 2019 (+116%), while the 10-year prevalence increased from 391 in 1984 to 715 in 2019 (+83%). Based on the long-term registry data, an estimated 73,182 childhood cancer survivors were living in Japan by the end of 2019. The increasing 5-year and 10-year prevalence proportions indicate the continued need for cancer survivorship support for children, adolescents, and young adults. These estimates of the prevalence of childhood cancer survivors, including long-term survivors, may be useful for policymakers and clinicians to plan and evaluate survivorship care.

Has COVID-19 affected regional mortality from acute coronary artery disease? (comparison of two periods of 2017-2019 and 2020-2022)

Aim. To assess the changes of mortality from acute coronary artery disease (CAD) in the Russian regions during the coronavirus disease 2019 (COVID-19) pandemic in 2020-2022 in comparison with the prepandemic period (2017-2019).Material and methods. Rosstat data on the average annual population and mortality rate in one-year age groups for 82 regions Russian were used. In the brief Nomenclature of Causes of Death of Rosstat, the codes of the International Classification of Diseases, 10th revision (ICD-10) are grouped as follows: I21.0-9 (acute primary) myocardial infarction (MI), I22.0-9 (recurrent MI), I20, I24.1-9 (other types of acute coronary artery disease), U07.1 and U07.2 (coronavirus disease 2019 (COVID-19)). The regional average standardized mortality rates (SMR; M±SD) were calculated using the European population standard using the direct standardization method per 100 thousand population. Comparisons were made using the nonparametric Wilcoxon t-test (differences were considered significant at p<0,05).Results. A decrease in the regional average SMR (per 100 thousand population) in the pandemic compared to the pre-pandemic period was revealed: from the sum of all acute CAD types — from 51,24±31,98 to 50,21±33,38 and from repeated MI — from 7,65±5,42 to 4,80±4,84; increase in SMR from acute MI — from 24,00±10,1 to 25,57±11,55, from other acute CAD types — from 19,58±25,23 to 19,83±26,21. Significant regional variability was noted in both the dynamics of the SMR from three acute CAD types, as well as the minimum and maximum SMR. Only in 2 regions in the pandemic period there was an increase in SMR from each of the three acute CAD types compared to the pre-pandemic period. In 18 regions, there was a decrease in SMR from each of the three forms, and in the rest, multidirectional changes were noted. There was no correlation between SMR for COVID-19 and SMR for acute CAD (r=0,034; p=0,76).Conclusion. The COVID-19 pandemic did not have a significant impact on the regional average SMR from acute CAD. The significant decrease in SMR from recurrent MI is likely due to choice of the initial cause of death.

Application of SWSRA-DS algorithm in improving the model transfer for near infrared analysis of pulpwood holocellulose

The SWSRA-DS combined algorithm is proposed with the goal of sharing the near infrared analysis model of the holocellulose content of pulpwood on three different types of spectroscopic instruments. That is, the screening wavelengths based on spectrum ratio analysis (SWSRA) algorithm is used to select the wavelengths with good stability and consistency. These important wavelength variables, which are insensitive to the measured sample parameters, can reduce the differences in sample information response by different instruments or measurement conditions. Then the systematic errors that still existed after the SWSRA method calibration are further calibrated using the Direct Standardization (DS) method on the basis of these wavelengths. This combined algorithm can improve the generalizability of the master model, reduce the spectrum matrix dimension, and make the model transfer more stabilized and simple. The results show that the SWSRA-DS combined algorithm is able to reduce the RMSEP of the master model to predict the holocellulose content of samples measured on the target 1 and target 2 instruments from 2.01% and 9.45% to 0.96% and 1.08%, respectively. The SWSRA-DS algorithm result is compared with the calibration results of SWSRA and DS alone and the commonly used PDS and S/B model transfer algorithms to transfer performance is significantly improved, which provides a new idea for the sharing of NIR analysis models among different types of spectroscopic instruments.

Large variations in all-cause and overdose mortality among >13,000 patients in and out of opioid maintenance treatment in different settings: a comparative registry linkage study.

Opioid maintenance treatment (OMT) has the potential to reduce mortality rates substantially. We aimed to compare all-cause and overdose mortality among OMT patients while in or out of OMT in two different countries with different approaches to OMT. Two nation-wide, registry-based cohorts were linked by using similar analytical strategies. These included 3,637 male and 1,580 female patients enrolled in OMT in Czechia (years 2000-2019), and 6,387 male and 2,078 female patients enrolled in OMT in Denmark (years 2007-2018). The direct standardization method using the European (EU-27 plus EFTA 2011-2030) Standard was employed to calculate age-standardized rate to weight for age. All-cause and overdose crude mortality rates (CMR) as number of deaths per 1,000 person years (PY) in and out of OMT were calculated for all patients. CMRs were stratified by sex and OMT medication modality (methadone, buprenorphine, and buprenorphine with naloxone). Age-standardized rate for OMT patients in Czechia and Denmark was 9.7/1,000 PY and 29.8/1,000 PY, respectively. In Czechia, the all-cause CMR was 4.3/1,000 PY in treatment and 10.8/1,000 PY out of treatment. The overdose CMR was 0.5/1,000 PY in treatment and 1.2/1,000 PY out of treatment. In Denmark, the all-cause CMR was 26.6/1,000 PY in treatment and 28.2/1,000 PY out of treatment and the overdose CMR was 7.3/1,000 PY in treatment and 7.0/1,000 PY out of treatment. Country-specific differences in mortality while in and out of OMT in Czechia and Denmark may be partly explained by different patient characteristics and treatment systems in the two countries. The findings contribute to the public health debate about OMT management and may be of interest to practitioners, policy and decision makers when balancing the safety and accessibility of OMT.

The use of modern technologies to enhance the quality of teaching at higher education institutions

Currently, state-of-the-art technologies contribute to the development of the educational process, which entails the search for new approaches to providing information. The purpose of the study is to identify the effectiveness of using modern technologies to enhance the learning performance in higher education institutions. Attaining the said goal became possible due to calculating the variation coefficient of, the obtained level of knowledge, the Student coefficient as well as the direct standardization method. It was found that the greatest advantage of using modern technologies is the possibility of combining distance and in-class learning. However, the disadvantage is the difficulty of identifying the relevant technologies according to the training program. The elaborated mechanisms for ensuring the learning process were implemented with the help of Blackboard, CourseCraft, Trello, EdApp, Scheduler Maker software. It was established that among students who studied pedagogy and primary school methods (group 1), a high level of knowledge was attained with 71%. Students of group 2, who studied English, achieved a high level with 65% of students. The practical implications of the study lie in the improvement of the learning process at higher education institutions drawing on the use of modern technologies. Prospects for research may be related to comparing the effectiveness of programs used to provide learning with a traditional learning approach.

Trends in the Diagnosed Prevalence and Incidence of Major Eye Diseases in Medicare Part B Fee-for-Service Beneficiaries 68 Years of Age or Older

To study contemporary trends in the diagnosed prevalence and incidence of age-related eye diseases among Medicare Fee-for-Service (FFS) beneficiaries. Analysis of Medicare administrative claims data. Medicare FFS beneficiaries 68 years of age and older from 2005 through 2020 who were enrolled continuously in both Part A and Part B for 3 years, including the index year and a 2-year lookback period. Annual cross-sectional diagnosed prevalence and incidence rates were calculated. Age standardization was performed using the direct standardization method to account for changes in the age structure of the study population. Rates stratified by demographics (age, sex, race, and ethnicity) also were calculated. Annual prevalence and incidence of diagnosed age-related macular degeneration (AMD), diabetic retinopathy (DR) (among those with diabetes), and glaucoma. At baseline, in 2005, 60% of included beneficiaries were female, 20% were 85 years of age or older, 86% were non-Hispanic White, and one-quarter had a diagnosis of diabetes. From 2005 through 2019, the prevalence of a diagnosis of any of the conditions studied increased from 16.4% (n = 3 628 996) to 17.9% (n= 3 731 281). Diagnosed incidence decreased over this period from 4.9% (n = 954 878) in 2005 to 4.2% in 2019 (n=757 696). The diagnosed prevalence of AMD increased from 6.8% (n= 1 504 770) to 9.4% (n= 1 965 176); the diagnosed prevalence of any DR among those with diabetes decreased from 9.3% (n= 504 135) to 9.0% (n=532 859), although the diagnosed prevalence of vision-threatening DR increased from 2.0% to 3.4%; and the diagnosed prevalence of any diagnosed glaucoma decreased from 8.8% (n= 1 951 141) to 8.1% (n= 1 692 837). In 2020, the diagnosed prevalence and incidence of all diagnoses decreased. During the study period, we detected demographic differences in the prevalence and incidence of diagnosis of each condition. This study presents updated data on the prevalence and incidence of diagnosed major chronic, age-related eye diseases among Medicare FFS beneficiaries. Compared with older epidemiologic estimates, we found that the diagnosed prevalence of each condition studied was higher in more recent years. These findings may inform public health and policy planning and resource allocation to address the eye health of an increasingly older United States population. The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Practical implications of the update to the 2015 Japan Standard Population: mortality archive from 1950 to 2020 in Japan.

The 2015 Japan Standard Population (2015 JSP) was established in response to changes in the age structure. However, the effects of major updates, especially the recategorization of older age groups, for interpreting various health metrics have not been clarified. Population data were collected and estimated for older age categories (85-89, 90-94, 95 years and over). Data on the number of deaths were also collected from the Vital Statistics. We recalculated the all-cause and leading cause-specific age-standardized mortality rate (ASMR) using the 2015 JSP by the direct standardization method for data from 1950 to 2020. We compared ASMRs calculated using the 2015 JSP with those calculated using the 1985 JSP. Pearson's correlation coefficients were used to evaluate the consistency of mortality trends between the 2015 and 1985 JSPs. The absolute all-cause ASMRs calculated using the 2015 JSP were 2.22-3.00 times higher than those calculated using the 1985 JSP. The ASMR ratios increased gradually over time. While trends in all-cause and cause-specific ASMRs calculated using the 2015 JSP and 1985 JSP were generally highly correlated (Pearson's correlation coefficient (r): 0.993 for all-cause), correlations were relatively low for malignant neoplasms (r: 0.720 for men and 0.581 for women) and pneumonia/bronchitis (r: 0.543 for men and 0.559 for women) due to non-monotonous trends over time and fluctuations in earlier time periods. The effect of introducing the new JSP for interpreting trends in all-cause mortality was considered minimal. However, caution is needed when interpreting trends in some cause-specific mortality rates.

TRENDS IN BURDEN OF HEART FAILURE MORTALITY IN TURKEY, 2009-2019

Introduction: Heart failure is the third most common cause of death after coronary artery disease and stroke. By monitoring mortality trends of heart failure, control over the disease progression can be increased. Therefore, we aimed to create a mortality trend by taking the data on deaths due to heart failure in Turkiye in the last ten years. Methods: We obtained population estimates for Turkey from the TurkStat website. Age- and sex-specific and age-standardized rates (ASRs, using the World standard population and the method of direct standardization) were calculated. Mortality trends from heart failure were assessed using the Joinpoint regression analysis. Statistical analysis was carried out with the Joinpoint software, version 4.9.0.0. We considered p values less than 0.05 to be statistically significant. Results: We found Turkey’s 10-year standardized mortality rate is 20.63%. The highest mortality rate is in western Marmara; the lowest one is in Eastern Karadeniz. We observed a significant increase in mortality at 10 years in the total population. (p:0,008). We detected a significant growth between 2009 and 2016 (p< 0.001) and a significant decrease after 2016 (p:0.047) Conclusion: We obtained standardized mortality rates of heart failure patients in Turkey between 2009 and 2019 according to age, sex, and years. We showed an overall mortality reduction after 2016.

The prevalence of oncological diseases among the population of the Siberia region and the Far East

The purpose of the study was to analyze cancer incidence in Siberia and the Russian Far East in 2010–2021. 
 Materials and methods. We used data from population-based cancer registries in 21 administrative territories of Siberia and the Russian Far East for 2010–2021. The calculations were carried out using the direct standardization method. 
 Results. In 2021, the most common cancer sites in males were: lung (18.7%), prostate (14.1%) and colorectum (11.1%); in females: breast (21.0%), skin (12.6%) and colorectum (11.3%). From 2010 to 2019, the overall cancer incidence rate increased by 26.7%. Age-standardized incidence rates in males increased from 301.2 to 332.10/0000. For females, age-standardized incidence rates increased from 220.8 to 256.10/0000.
 In 2020, cancer incidence rates decreased, the overall decline was 12.9%. Age-standardized cancer incidence rates in males and females were 288.5 and 223.2 per 100 000 population, respectively. In 2021, the corresponding rates for males and females were 288.2 and 235.80/0000, respectively. 
 Limitations. To assess the prevalence of oncological diseases in the territories of Siberia and the Russian Far East 1 233 759 new cases of malignant neoplasms were analyzed over 12 years, which is a sufficient reference sample.
 Conclusion. In Siberia and the Russian Far East, cancer incidence rates in 2020 were lower than in 2019 due to the COVID-19 pandemic, which led to the reduction in the number of cases diagnosed and referred for the first-line treatment. In 2021, an increase in the age-standardized cancer incidence rate was observed, with the age at diagnosis tended to be younger. In 2010, 80–84 years men and 75–79 years women exhibited the highest incidence rates (2536.5 and 1246.80/0000, respectively). In 2021, the highest cancer incidence rates for males and females were observed in the 70 to 74 years group (2717.1 and 1402.60/0000, respectively).

Direct standardization method according to Robson classification for comparison of cesarean rates

BackgroundCompare cesarean section rates between populations or within a population over time using the crude measure is biased mainly due to differences in the characteristics of the obstetric population. The Robson Ten Group Classification (RTGC) is being widely used all over the world based on a few basic obstetrics variables.ObjectivesPropose a method of direct standardization according to RTGC to make the overall rates of cesarean sections comparable between different populations or within the same population over time.MethodsWe used data from the WHO Global Maternal and Perinatal Health Survey (WHOGS) conducted between 2004 and 2008 and data from the WHO Multinational Survey on Maternal and Neonatal Health (WHOMCS) conducted between 2010 and 2011, covering information from obstetric population of 21 countries. The standard population was based in the average size of Robson Groups in WHOMCS. The crude and standardized rates, their differences intra and inter populations, and its respective confidence intervals were calculated.ResultsThe impact and importance of the method were demonstrated. The five leading countries list on cesarean rates was completely modified and changes of cesarean rates over time in the same country varied in both directions by the standardization.ConclusionThis method is useful to compare overall rates as an additional information when RTGC Report Table is been used or, for some type of studies as analytical ecologic studies with multiple groups, where leading with the report tables are laborious and hard to interpret. The use of Robson Ten Group Classification for direct standardization of cesarean rates is easy to apply and interpret.

Estimates and Forecasts on the Burden of Prediabetes and Diabetes in Adult and Elderly Population in Turkiye.

Diabetes mellitus is a chronic disease that limits the quality and duration of life. We aimed to estimate the impact of demographic change on the burden of prediabetes and diabetes between 2010 and 2021, and the projections to 2030 and 2045 in Turkiye. Prediabetes and diabetes estimates were calculated by direct standardization method using age- and sex-specific prevalence data from the previous 'Turkish Epidemiology Survey of Diabetes, Hypertension, Obesity and Endocrine Disease' (TURDEP-II) as reference. The 2010-2021 population demographics were obtained from TurkStat. Comparative age-adjusted diabetes prevalence was estimated using the standard population models of world and Europe. Estimates depicted that the population (20-84years) of any degree of glucose intolerance in Turkiye increased by over 5.7 million (diabetes: 2.4 million and prediabetes: 3.3 million) from 2010 to 2021. While the increase in prediabetes and diabetes prevalence was 24.3% and 35.2% in overall population, corresponding increase were 46.5% and 51.3% in the elderly. Estimated prevalence of prediabetes and diabetes in 2021 was significantly higher in women than in men (prediabetes: 32.6% vs. 25.2%; diabetes: 17.1% vs. 14.2%). The comparative age-adjusted diabetes prevalence to the European population model was higher than that of the world population model (19.4% vs. 15.0%). According to the projections the prevalence of diabetes will reach 17.5% in 2030 and 19.2% in 2045. Assuming age- and sex-specific diabetes prevalence of TURDEP-II survey remained constant, this study revealed that the number of people with diabetes in the general population (particularly in the elderly) in the last 11years in Turkiye has increased in parallel with the population growth and aging; it will continue to grow over the coming decades. This means the burden of diabetes on the social, economic and health services will remain to increase. The fact suggests that there is an urgent need for re-organization of care as well as to develop and implement a country-specific prevention program to reduce this burden.

Trends in suicide rates by race and ethnicity among members of the United States Army.

Efforts were focused on identifying differences in suicide rates and time-dependent hazard rate trends, overall and within age groups, by race and ethnicity among United States Army members who returned from an index deployment (October 2007 to September 2014). This retrospective cohort study was conducted using an existing longitudinal database, the Substance Use and Psychological Injury Combat Study (SUPIC). Demographic (e.g., race and ethnicity) and military data from the Department of Defense compiled within SUPIC, as well as Department of Veterans Affairs data were linked with National Death Index records (through 2018) to identify deaths by suicide including those that occurred after military service. The cohort included 860,930 Army Service members (Active Duty, National Guard, and Reserve). Age-adjusted (using the direct standardization method) and age-specific suicide rates per 100,000 person years were calculated and rate ratios (RR) were used for comparisons. Trends were evaluated using hazard rates over time since the end of individuals' index deployments. Among those aged 18-29 at the end of their index deployment, the suicide rate for American Indian/Alaskan Native (AI/AN) individuals was 1.51 times higher (95% confidence interval [CI]: 1.03, 2.14) compared to White non-Hispanic individuals (WNH), and lower for Hispanic and Black non-Hispanic (BNH) than for WNH individuals (RR = 0.65 [95% CI: 0.55, 0.77] and RR = 0.71 [95% CI: 0.61, 0.82], respectively). However, analyses revealed increasing trends in hazard rates post-deployment (≤ 6.5 years) within groups of Hispanic and BNH individuals (Average Annual Percent Change [APC]: 12.1% [95% CI: 1.3%, 24.1%] and 11.4% [95% CI: 6.9%, 16.0%], respectively) with a smaller, increase for WNH individuals (APC: 3.1%; 95% CI: 0.1%, 6.1%). Findings highlight key subgroups at risk for post-deployment suicide (i.e., WNH, AI/AN and younger individuals), as well as heterogeneous trends overtime, with rates and trends varying within race and ethnic groups by age groups. Post-deployment suicide prevention efforts that address culturally relevant factors and social determinants of health associated with health inequities are needed.

Prevalence of smoking, alcohol consumption, and drug abuse in Iranian adults: Results of Azar Cohort Study.

Substance abuse has significant health impacts on families and society as a whole. We aimed to provide detailed prevalence estimates of substance abuse among the Azar Cohort Study respondents in Tabriz, Iran. Data on 15006 participants of Azar Cohort Study were analyzed. The variables included tobacco smoking, alcohol use, drug abuse, and socio-demographic characteristics. The prevalence of substance abuse (with a 95% confidence interval) was calculated using the direct standardization method. Overall, 9.3% and 6.2% of the participants were regular and heavy cigarette smokers, respectively. Also, 1.9% and 2.1% of participants reported a history of using illicit drugs and alcohol, respectively. Substance abuse was more prevalent among males than females. Substance abuse varied significantly with age and socioeconomic variables. We identified specific demographic and socioeconomic groups with a higher prevalence of all studied behaviors. Such high-risk groups should be targeted when designing substance abuse prevention programs.

GLMM을 이용한 지역간 건강도 비교 연구

In this paper, we first examined the problem of the direct standardization method, which is mainly used to measure the regional health level by analyzing the data obtained from the Korea Community Health Survey, and proposed a new standardization method based on the Generalized Linear Mixed Model (GLMM). In order to evaluate the performance of the proposed standardization as an alternative to the existing direct standardization method, we used the data which obtained from the Korea Community Health Survey conducted in 2019. Using this data, we compared and analyzed three regional health level standard values through the new standardization method, GLMM, the direct standardization method based on the national population in 2005, and the direct standardization method based on the national population in 2019. The results of this study can be summarized as follows. First, the direct standardization method currently used is based on the national population estimated in 2005, but it does not reflect the current demographic structure that is aging much. Second, the GLMM-based standard value correlated higher with 2019 standardization rate than with 2005 standardization rate, which implies that the proposed standardization method sufficiently reflects demographic changes.
 Finally, GLMM-based standard value was related to the disease variables and health-related variables, which were mostly similar to those shown in the direct standardization rates.

Model transfer method based on piecewise direct standardization in laser-induced-breakdown spectroscopy.

A large number of certified samples are usually required to build models in the quantitative analysis of complicated matrices in laser-induced-breakdown spectroscopy (LIBS). Because of differences among instruments, including excitation and collection efficiencies, a quantitative model made on one instrument is difficult to apply directly to other instruments. Each instrument requires a large number of samples to model, which is very labor intensive and will hinder the rapid application of the LIBS technique. To eliminate the differences in spectral data from different instruments and reduce the cost of building new models, a piecewise direct standardization method combined with partial least squares (PLS_PDS) is studied in this work. Two portable LIBS instruments with the same configuration are used to obtain spectral data, one of which is called a master instrument because its calibration model is directly built on a large number of labeled samples, and the other of which is called a slave instrument because its model is obtained from the master instrument. The PLS_PDS method is used to build a transfer function of spectra between the master instrument and slave instrument to reduce the spectral difference between two instruments, and thus one calibration model can adapt to different instruments. Results show that for multiple elemental analyses of aluminium alloy samples, the number of samples required for slave modeling was reduced from 51 to 14 after model transferring by PLS_PDS, and the quantitative performance of the slave instrument was close to that of the master instrument. Therefore, the model transfer method can obviously reduce the sample number of building models for slave instruments, and it will be beneficial to advance the application of LIBS.