One of the most common statistical analyses in experimental psychology concerns the comparison of two means using the frequentist t test. However, frequentist t tests do not quantify evidence and require various assumption tests. Recently, popularized Bayesian t tests do quantify evidence, but these were developed for scenarios where the two populations are assumed to have the same variance. As an alternative to both methods, we outline a comprehensive t test framework based on Bayesian model averaging. This new t test framework simultaneously takes into account models that assume equal and unequal variances, and models that use t-likelihoods to improve robustness to outliers. The resulting inference is based on a weighted average across the entire model ensemble, with higher weights assigned to models that predicted the observed data well. This new t test framework provides an integrated approach to assumption checks and inference by applying a series of pertinent models to the data simultaneously rather than sequentially. The integrated Bayesian model-averaged t tests achieve robustness without having to commit to a single model following a series of assumption checks. To facilitate practical applications, we provide user-friendly implementations in JASP and via the RoBTT package in R . A tutorial video is available at https://www.youtube.com/watch?v=EcuzGTIcorQ.

• MeSH
• Bayesova věta MeSH
• experimentální psychologie * metody   MeSH
• interpretace statistických dat MeSH
• lidé MeSH
• statistické modely * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

BACKGROUND: Increased lung cancer risks for low socioeconomic status (SES) groups are only partially attributable to smoking habits. Little effort has been made to investigate the persistent risks related to low SES by quantification of potential biases. METHODS: Based on 12 case-control studies, including 18 centers of the international SYNERGY project (16,550 cases, 20,147 controls), we estimated controlled direct effects (CDE) of SES on lung cancer via multiple logistic regression, adjusted for age, study center, and smoking habits and stratified by sex. We conducted mediation analysis by inverse odds ratio weighting to estimate natural direct effects and natural indirect effects via smoking habits. We considered misclassification of smoking status, selection bias, and unmeasured mediator-outcome confounding by genetic risk, both separately and by multiple quantitative bias analyses, using bootstrap to create 95% simulation intervals (SI). RESULTS: Mediation analysis of lung cancer risks for SES estimated mean proportions of 43% in men and 33% in women attributable to smoking. Bias analyses decreased the direct effects of SES on lung cancer, with selection bias showing the strongest reduction in lung cancer risk in the multiple bias analysis. Lung cancer risks remained increased for lower SES groups, with higher risks in men (fourth vs. first [highest] SES quartile: CDE, 1.50 [SI, 1.32, 1.69]) than women (CDE: 1.20 [SI: 1.01, 1.45]). Natural direct effects were similar to CDE, particularly in men. CONCLUSIONS: Bias adjustment lowered direct lung cancer risk estimates of lower SES groups. However, risks for low SES remained elevated, likely attributable to occupational hazards or other environmental exposures.

• MeSH
• analýza mediace * MeSH
• dospělí MeSH
• kouření * epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• logistické modely MeSH
• nádory plic * epidemiologie   MeSH
• odds ratio MeSH
• rizikové faktory MeSH
• senioři MeSH
• společenská třída * MeSH
• studie případů a kontrol MeSH
• zkreslení výsledků (epidemiologie) * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVES: Decision-analytic models assessing the value of emerging Alzheimer's disease (AD) treatments are challenged by limited evidence on short-term trial outcomes and uncertainty in extrapolating long-term patient-relevant outcomes. To improve understanding and foster transparency and credibility in modeling methods, we cross-compared AD decision models in a hypothetical context of disease-modifying treatment for mild cognitive impairment (MCI) due to AD. METHODS: A benchmark scenario (US setting) was used with target population MCI due to AD and a set of synthetically generated hypothetical trial efficacy estimates. Treatment costs were excluded. Model predictions (10-year horizon) were assessed and discussed during a 2-day workshop. RESULTS: Nine modeling groups provided model predictions. Implementation of treatment effectiveness varied across models based on trial efficacy outcome selection (clinical dementia rating - sum of boxes, clinical dementia rating - global, mini-mental state examination, functional activities questionnaire) and analysis method (observed severity transitions, change from baseline, progression hazard ratio, or calibration to these). Predicted mean time in MCI ranged from 2.6 to 5.2 years for control strategy and from 0.1 to 1.0 years for difference between intervention and control strategies. Predicted quality-adjusted life-year gains ranged from 0.0 to 0.6 and incremental costs (excluding treatment costs) from -US$66 897 to US$11 896. CONCLUSIONS: Trial data can be implemented in different ways across health-economic models leading to large variation in model predictions. We recommend (1) addressing the choice of outcome measure and treatment effectiveness assumptions in sensitivity analysis, (2) a standardized reporting table for model predictions, and (3) exploring the use of registries for future AD treatments measuring long-term disease progression to reduce uncertainty of extrapolating short-term trial results by health-economic models.

• MeSH
• Alzheimerova nemoc * ekonomika   farmakoterapie   MeSH
• analýza nákladů a výnosů * MeSH
• ekonomické modely MeSH
• kognitivní dysfunkce * ekonomika   MeSH
• kvalitativně upravené roky života MeSH
• lidé MeSH
• metody pro podporu rozhodování MeSH
• progrese nemoci MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

BACKGROUND: Colorectal cancer (CRC) is a common, fatal cancer. Identifying subgroups who may benefit more from intervention is of critical public health importance. Previous studies have assessed multiplicative interaction between genetic risk scores and environmental factors, but few have assessed additive interaction, the relevant public health measure. METHODS: Using resources from CRC consortia, including 45,247 CRC cases and 52,671 controls, we assessed multiplicative and additive interaction (relative excess risk due to interaction, RERI) using logistic regression between 13 harmonized environmental factors and genetic risk score, including 141 variants associated with CRC risk. RESULTS: There was no evidence of multiplicative interaction between environmental factors and genetic risk score. There was additive interaction where, for individuals with high genetic susceptibility, either heavy drinking (RERI = 0.24, 95% confidence interval [CI] = 0.13, 0.36), ever smoking (0.11 [0.05, 0.16]), high body mass index (female 0.09 [0.05, 0.13], male 0.10 [0.05, 0.14]), or high red meat intake (highest versus lowest quartile 0.18 [0.09, 0.27]) was associated with excess CRC risk greater than that for individuals with average genetic susceptibility. Conversely, we estimate those with high genetic susceptibility may benefit more from reducing CRC risk with aspirin/nonsteroidal anti-inflammatory drugs use (-0.16 [-0.20, -0.11]) or higher intake of fruit, fiber, or calcium (highest quartile versus lowest quartile -0.12 [-0.18, -0.050]; -0.16 [-0.23, -0.09]; -0.11 [-0.18, -0.05], respectively) than those with average genetic susceptibility. CONCLUSIONS: Additive interaction is important to assess for identifying subgroups who may benefit from intervention. The subgroups identified in this study may help inform precision CRC prevention.

• MeSH
• dieta MeSH
• dospělí MeSH
• genetická predispozice k nemoci * MeSH
• index tělesné hmotnosti MeSH
• interakce genů a prostředí * MeSH
• jednonukleotidový polymorfismus MeSH
• kolorektální nádory * genetika   epidemiologie   MeSH
• kouření škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• logistické modely MeSH
• pití alkoholu MeSH
• rizikové faktory MeSH
• senioři MeSH
• studie případů a kontrol MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Hemodynamically unstable patients with severe hypothermia and preserved circulation should be transported to dedicated extracorporeal life support (ECLS) centers, but not all are eligible for extracorporeal therapy. In this group of patients, the outcome of rewarming may sometimes be unfavorable. It is, therefore, crucial to identify potential risk factors for death. Furthermore, it is unclear what criterion for hemodynamic stability should be adopted for patients with severe hypothermia. The aim of this study is to identify pre-rewarming predictors of death and their threshold values in hypothermic patients with core temperature ≤ 28 °C and preserved circulation, who were treated without extracorporeal rewarming. We conducted a multicenter retrospective study involving patients in accidental hypothermia with core temperature 28 °C or lower, and preserved spontaneous circulation on rewarming initiation. The data were collected from the International Hypothermia Registry, HELP Registry, and additional hospital data. The primary outcome was survival to hospital discharge. We conducted a multivariable logistic regression and receiver operating characteristic curve (ROC) analysis. In the multivariate analysis of laboratory tests and vital signs, systolic blood pressure (SBP) adjusted for cooling circumstances and base excess (BE) were identified as the best predictor of death (OR 0.974 95% CI 0.952-0.996), AUC ROC 0.79 (0.70-0.88). The clinically relevant cutoff for SBP was identified at 90 mmHg with a sensitivity of 0.74 (0.54-0.89) and a specificity of 0.70 (0.60-0.79). The increased risk of death among hypothermic patients with preserved circulation occurs among those with an SBP below 90 mmHg and in those who developed hypothermia in their homes.

• MeSH
• dospělí MeSH
• hypotermie * mortalita   terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• logistické modely MeSH
• prognóza MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• ROC křivka MeSH
• senioři MeSH
• terapeutické zahřívání metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

Background: The use of tobacco products and electronic cigarettes is a growing public health concern, especially among children and adolescents. Understanding the factors that impact both the use, and the perception of the harm related to these products is essential for developing effective prevention strategies targeting young people. Objective: The aim of this study is to map the use of cigarettes and electronic cigarettes as well as the perceived risk of these products in a population of students from selected secondary schools in Prague. The partial aim was to determine whether the perceived harmfulness of the product, type of school, and gender play any role in the use of e-cigarettes or tobacco. Methods: We conducted a questionnaire survey in secondary schools in the Capital City of Prague in cooperation with prevention methodologists. Data were collected in the first years of vocational and general secondary schools from students with an average age of 15 years. Results and conclusion: The difference in frequency of tobacco product use between girls and boys was statistically insignificant, whereas the difference in tobacco product use between students at secondary schools providing general education and vocational education was found to be statistically significant. Perceived harmfulness of combustible cigarettes was significantly affected by the type of school. Regarding electronic cigarettes, the perceived harmfulness was significantly affected by both the type of school and gender. For electronic cigarettes and regular cigarettes, perceived harmfulness and school type appeared to be the predictors of use. Regarding electronic cigarettes, school type, perceived risk of the product, and gender were the predictors of use.

• MeSH
• kouření cigaret * epidemiologie   psychologie   škodlivé účinky   MeSH
• lidé MeSH
• logistické modely MeSH
• mladiství MeSH
• postoj MeSH
• průzkumy a dotazníky MeSH
• riziko MeSH
• studenti * MeSH
• systémy dodávající nikotin elektronicky MeSH
• tabákové výrobky škodlivé účinky   MeSH
• zdravotně rizikové chování MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH

Aim: Research on the health consequences of violent victimization of people with disabilities is lacking. This study aims to identify the factors that are associated with physical and mental health impacts of anti-disability bias victimization. Methods: The study drew on a unique sample of 331 self-identified people with disabilities, all over the age of 15, residing in Czechia. From this sample, 47 questionnaires were excluded. The respondents were asked about the most serious incident of anti-disability bias victimization in the last five years. A series of bivariate binary logistic regressions were performed - with the consequences of this incident as outcomes (mental health and physical health). Results: 90 respondents (32%) reported experiencing the most serious incident of bias victimization in the last five years. 60% of victims reported anxiety and sadness, and 28% deterioration in physical health. The results suggest that victims experience physical and mental health consequences unequally. Age, perceived disability in specific areas, visibility of disability, presence of multiple disabilities, and number of offenders are associated with the experience of physical health deterioration. Education, perceived disability in specific areas, and visibility of disability are associated with the experience of mental health impacts. Conclusion: Certain groups of people with disabilities who experience victimization report poorer physical and mental health outcomes. This differential experience should be considered in immediate responses and prevention programs.

• MeSH
• duševní zdraví statistika a číselné údaje   MeSH
• emoce MeSH
• lidé MeSH
• logistické modely MeSH
• násilí psychologie   statistika a číselné údaje   MeSH
• postižení * psychologie   statistika a číselné údaje   MeSH
• předsudek * psychologie   statistika a číselné údaje   MeSH
• sociální problémy psychologie   statistika a číselné údaje   MeSH
• zdraví statistika a číselné údaje   MeSH
• zpráva o sobě MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH

BACKGROUND: The routine use of sedation and analgesia during post-cardiac arrest care and its association with clinical outcomes remain unclear. This study aimed to describe the use of sedatives and analgesics in post-cardiac arrest care, and evaluate associations with good functional outcome, survival, clinical seizures, and late awakening. METHODS: This was a post hoc analysis of the TTM2-trial, which randomized 1900 out-of-hospital cardiac arrest patients to either normothermia or hypothermia. In both groups, deep sedation (Richmond Agitation and Sedation Scale ≤ -4) was mandatory during the 40-h intervention. Cumulative doses of sedatives and analgesic drugs were recorded within the first 72 h from randomization. Outcomes were functional outcome (modified Rankin Scale) and survival status at 6 months, occurrence of clinical seizures during the intensive care stay, and late awakening (Full outline of unresponsiveness motor score of four 96 h after randomization). Cumulative propofol doses were divided into quartiles (Q1-Q4). Logistic regression models were used to assess associations between sedative doses and functional outcome and survival, clinical seizures, and late awakening, adjusting for the severity of illness and other clinical factors influencing sedation. RESULTS: A total of 1861 patients were analyzed. In a multivariable logistic regression model, higher propofol doses (Q3, 100.7-153.6 mg/kg) were associated with good functional outcome (OR 1.62, 95%CI 1.12-2.34) and (Q2 and Q3, 43.9-153.6 mg/kg) with survival (OR 1.49, 95%CI 1.05-2.12 and OR 1.84, 95%CI 1.27-2.65, respectively). Receiving fentanyl and remifentanil were associated with good functional outcome (OR 1.69, 95%CI 1.27-2.26 and OR 1.50, 95%CI 1.11-2.02) and survival (OR 1.80, 95%CI 1.35-2.40 and OR 1.56, 95%CI 1.16-2.10). Receiving fentanyl (OR 0.64, 95%CI 0.48-0.86) and higher propofol doses (Q2-4 (43.9-669.4 mg/kg) were associated with the occurrence of clinical seizures. The highest quartile of propofol dose (153.7-669.4 mg/kg, OR 3.19, 95%CI 1.91-5.42) was associated with late awakening. CONCLUSIONS: In this study, higher doses of propofol and the use of remifentanil and fentanyl were associated with good functional outcome and survival, occurrence of clinical seizures, and late awakening.

• MeSH
• analgetika terapeutické užití   MeSH
• analgezie * metody   normy   statistika a číselné údaje   MeSH
• hluboká sedace metody   normy   MeSH
• hypnotika a sedativa terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• logistické modely MeSH
• propofol terapeutické užití   MeSH
• senioři MeSH
• zástava srdce mimo nemocnici * terapie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

BACKGROUND: Plant-based diets are gaining popularity due to their well-documented cardiometabolic benefits and environmental sustainability. However, these diets are often lower in specific micronutrients such as iodine, raising concerns about their potential impact on thyroid health. Therefore, we examined the associations between plant-based diets and the risk of hypothyroidism. METHODS: We analysed data from the UK (United Kingdom) Biobank cohort. Multivariable Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for incident hypothyroidism across vegans, vegetarians, pescatarians, poultry-eaters, low meat-eaters, and high meat-eaters aged 40-69 years. Ancillary to this, we carried out logistic regression analyses to evaluate associations between the diet groups and prevalent hypothyroidism according to International Classification of Diseases (ICD) codes at baseline. RESULTS: We included 466,362 individuals from the UK Biobank, of which 220,514 followed a high meat, 221,554 a low meat, 5242 a poultry-based, 10,598 a pescatarian, 8057 a vegetarian, and 397 a vegan diet. During a median SD (Standard Deviation) follow-up of 12.7 (± 3.2) years, 10,831 participants developed hypothyroidism. In multivariable Cox regression models without adjustment for body mass index (BMI), none of the diets were significantly associated with the risk of hypothyroidism. However, there was a tendency for a higher risk of hypothyroidism among vegetarians compared to people following a high meat diet (HR = 1.13, 95% CI 0.98-1.30). After controlling for BMI, a potential collider, the association for vegetarians (HR = 1.23, 95% CI 1.07-1.42) became stronger and statistically significant. Furthermore, we observed a positive association between low meat-eaters (OR = 1.05, 95% CI 1.03-1.08), poultry-eaters (OR = 1.15, 95% CI 1.04-1.28), pescatarians (OR = 1.10, 95% CI 1.01-1.19) and vegetarian (OR = 1.26, 95% CI 1.15-1.38) with hypothyroidism prevalence. CONCLUSIONS: In the present study, we found a moderately higher risk of hypothyroidism among vegetarians, after controlling for BMI, a potential collider. This slightly higher risk of hypothyroidism among vegetarians requires further investigation, taking iodine status and thyroid hormone levels into account.

• MeSH
• dieta vegetariánská * škodlivé účinky   MeSH
• dieta * škodlivé účinky   MeSH
• dospělí MeSH
• hypotyreóza * epidemiologie   etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• maso * MeSH
• proporcionální rizikové modely MeSH
• prospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• vegetariáni * statistika a číselné údaje   MeSH
• zvířata MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Spojené království MeSH

BACKGROUND: Muscle strength and postural control are essential components for performing daily living activities, particularly in older adults, and can therefore serve as screening tools for assessing fall risk in this population. METHODS: The aim of this quasi-experimental study was to evaluate the impact of a 12-week exercise intervention followed by a 2-week detraining period on lower limb strength and postural stability in older adults. The study involved 38 community-dwelling participants of Central European origin over 60 years of age. Participants underwent the measurements consisting of assessments of knee flexors and extensors strength (isokinetic dynamometer, 90° range of motion, 60°/s angular velocity, Humac Norm CSMI, Stoughton MA, USA), toe grip strength (toe grip dynamometer, Takei Scientific Instruments, Niigata, Japan), and postural stability (narrow stand, 30 s, Kistler, Switzerland). Testing was repeated three times during the study (pre-intervention, post-intervention, and post-detraining). Participants were separated into 3 groups according to the type of training: resistance training group (n = 13), proprioceptive training group (n = 14), and endurance training group (n = 11). The intervention program lasted 12 weeks, two 60-min sessions per week. A linear mixed model (LMM) predicted a change in postural stability after the resistance, proprioceptive, and endurance exercise interventions were applied. RESULTS: Results showed that knee extensor strength normalized to body mass significantly increased in the resistance training group post-intervention (p = 0.01). Toe grip strength was significantly higher after the intervention in the endurance training group (p = 0.02). A statistically significant increase in knee flexor strength was observed in the proprioceptive training group (p = 0.01). The 2-weeks detraining period revealed no statistically significant loss in training gains. The LMM found different predictions of postural stability changes related to knee extensor strength after each type of training intervention. The final LMM model explains well the variability of the dependent variable R2 = 0.866. CONCLUSIONS: These results highlight the unique characteristics of specific exercise interventions in enhancing muscular strength and postural stability, which are critical for fall prevention among older adults.

• MeSH
• časové faktory MeSH
• cvičení * fyziologie   MeSH
• dolní končetina * fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lineární modely MeSH
• odporový trénink * metody   MeSH
• posturální rovnováha * fyziologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• svalová síla * fyziologie   MeSH
• terapie cvičením * metody   MeSH
• úrazy pádem prevence a kontrola   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH