Smartphone addiction, sleep quality, depression, anxiety, and stress among medical students.

Introduction: Studies consistently link excessive smartphone use to poor sleep quality, depression, anxiety, and stress. This study specifically aimed to investigate these associations among medical students in Belgrade and Nis (Central Serbia). Materials and methods: The cross-sectional study included a sample of 761 students, who were selected from both the Faculties of Medicine at the University of Belgrade and the University of Nis. Questionnaires, including the International Physical Activity Questionnaire - Short Form (IPAQ-SF), Smartphone Addiction Scale - Short Version (SAS-SV), the Pittsburgh Sleep Quality Index (PSQI), and the Depression, Anxiety, and Stress Scale - 21 items (DASS-21), were completed by the participants. Statistical analysis techniques, such as the Chi-square test, student's t-test, and logistic regression, were employed to examine the relationship between smartphone addiction, physical activity, sleep quality, depression, anxiety, and stress. Results: The findings indicated a prevalence of smartphone addiction among medical students at 21.7%, with rates of 22.9% among males and 21.1% among females. Females exhibited significantly higher scores on the SAS-SV scale compared to males (p = 0.032). Univariate logistic regression analysis revealed significant associations between smartphone addiction and spending over 4 h daily on smartphones (OR = 2.39; p < 0.001), poor sleep quality (OR = 1.65; p = 0,005), as well as elevated levels of stress (OR = 1.75; p = 0.003), anxiety (OR = 2.04; p < 0.001), and depression (OR = 2.29; p < 0.001). Multivariate regression analysis identified spending more than 4 h daily on smartphones (OR = 2.39; p < 0.001) and increased levels of depression (OR = 2.51; p < 0.001) as independent significant factors associated with smartphone addiction. Conclusion: This study sheds light on the prevalence of smartphone addiction among medical students, with spending excessive time on smartphones and higher levels of depression standing out as significant factors. Future research should delve into the underlying mechanisms and causal relationships between smartphone addiction and these psychosocial factors. Understanding these connections will aid in developing effective interventions and strategies to tackle this growing public health concern.

Long-Term Trend of Liver Cancer Mortality in Serbia, 1991-2015: An Age-Period-Cohort and Joinpoint Regression Analysis.

Background and Objectives: Trends of liver cancer mortality vary widely around the world. The purpose of this study was to assess the trend of liver cancer mortality in Serbia. Material and Methods: Descriptive epidemiological study design was used in this research. The age-standardized rates (ASRs, per 100,000) were calculated using the direct method, according to the World standard population. Temporal trends were assessed using the average annual percent change (AAPC) with 95% confidence interval (95% CI), according to joinpoint regression. An age-period-cohort analysis was used to evaluate the underlying factors for liver cancer mortality trends. Results: In Serbia from 1991 to 2015, over 11,000 men and nearly 8000 women died from liver cancer. The trend in liver cancer mortality significantly decreased both in men (AAPC = -1.3%; 95% CI = -1.7 to -0.9) and women (AAPC = -1.5%; 95% CI = -1.9 to -1.1). For liver cancer mortality, statistically significant cohort and period effects were observed in both genders. Conclusions: The downward trends in liver cancer mortality in Serbia are recorded during the past decades.

Effects of adding necitumumab to first-line chemotherapy in patients with stage IV non-small-cell lung cancer: Meta-analysis.

INTRODUCTION: Almost half of patients with non-small-cell lung cancer (NSCLC) are diagnosed at an advanced stage. Our aim was to assess the effects of adding necitumumab to chemotherapy in patients with stage IV NSCLC. MATERIAL AND METHODS: A comprehensive literature search was performed according to pre-specified inclusion and exclusion criteria. Data on overall survival, progression-free survival, objective response rate and adverse events were extracted. A meta-analysis was performed to obtain pooled hazard ratios (HR) and corresponding 95% confidence intervals (CI) for time-to-event data and pooled odds ratio (OR) with 95% CI for dichotomous outcomes. RESULTS: The meta-analysis included four randomized clinical trials with 2074 patients. The pooled results showed significant improvement for overall survival (HR = 0.87 (95% CI 0.79-0.95), p = 0.004) when necitumumab was added to chemotherapy in patients with advanced NSCLC. No statistically significant improvement was noted for progression-free survival and objective response rate (HR = 0.83 (95% CI 0.69-1.01), p = 0.06 and OR = 1.46 (95% CI 0.90-2.38), p = 0.13, respectively). Subgroup analysis showed that in patients with non-squamous NSCLC, there was no benefit in overall survival and objective response rate. Patients with advanced NSCLC who received necitumumab were at the highest odds of developing a skin rash (OR = 14.50 (95% CI 3.16-66.43), p = 0.0006) and hypomagnesaemia (OR = 2.77 (95% CI 2.23-3.45), p < 0.00001), while the OR for any grade ≥3 adverse event was 1.55 (95% CI 1.28-1.87, p < 0.00001). CONCLUSIONS: The addition of necitumumab to standard chemotherapy in a first-line setting in patients with stage IV NSCLC results in a statistically significant improvement in overall survival, while the results were not significant for progression-free survival and objective response rate.

Psychometric Properties of the World Health Organization's Quality of Life (WHOQOL-BREF) Questionnaire in Medical Students.

Background and Objectives: Studies on the effects of studying on a medical student's quality of life are sparse. The World Health Organization Quality of Life (WHOQOL-BREF) questionnaire is a widely used scale that enables the assessment and international comparisons of the quality of life. The aim of this study was to evaluate psychometric properties of the WHOQOL-BREF questionnaire among Serbian medical students. Material and Methods: We conducted a cross-sectional study that involved 760 medical students at a state medical faculty at the University of Kragujevac, Serbia. The reliability of the WHOQOL-BREF was evaluated using Cronbach's alpha coefficient and test-retest analysis, and the validity was examined using principal component analysis, with Promax rotation method. Results: Cronbach's alpha coefficient for the whole WHOQOL-BREF scale was 0.896. Internal reliability for all domains was above 0.70, except for the domain "Social Relationships" (0.533). The test-retest reliability for all domains was significant at p 0.01 level, showing good stability of the scale. Principal component analysis with Promax rotation method indicated four main components that explained 49.5% of variance. Conclusion: The Serbian version of the WHOQOL-BREF scale showed satisfactory psychometric properties that facilitate estimation of the quality of life of medical students.