Browsing by Author "Pavlovic, Vedrana (57202093978)"

Background: Research involves the systematic collection and analysis of data to enhance understanding of a particular phenomenon. Participation in medical research is crucial for advancing healthcare practices. However, there has been limited focus on understanding the factors that motivate medical students to engage in research. Additionally, in the era of e-learning, the easy accessibility of online resources has contributed to a widespread ‘copy-paste culture’ among digital-native students, which is recognized in academia as plagiarism. Existing studies suggest that a contributing factor to the increasing prevalence of plagiarism is students’ limited understanding of this act. The purpose of this study was to assess medical students’ attitudes toward research and plagiarism, and to evaluate the psychometric properties of the Attitudes Toward Research (ATR) and Attitudes Toward Plagiarism (ATP) questionnaires. Methods: This was a multicenter study conducted among medical undergraduate and postgraduate students attending the three medical universities who were involved in research. Students’ attitudes toward research and plagiarism were assessed using the ATR and ATP questionnaires. The research instruments underwent translation and cultural adaptation in accordance with internationally accepted methodology. The psychometric properties of the ATR and ATP, including validity and reliability, were assessed. Confirmatory factor analysis was used to test the model’s fit to the data. Results: The ATR and ATP questionnaires were completed by 793 medical students who were involved in research (647 undergraduates and 146 PhD students). Cronbach’s alpha coefficients of 0.917 and 0.822 indicated excellent and good scale reliability for the ATR and ATP questionnaires, respectively. The five-and three- factor structures of ATR and ATP have been validated with maximum likelihood confirmatory analysis, and the results demonstrated an adequate level of model fit (TLI = 0.930, CFI = 0.942 and TLI = 0.924, CFI = 0.943, respectively). Medical students showed a high degree of positive attitudes toward research and favorable scores across all three domains of attitudes toward plagiarism. In multivariate regression models, age was found to be positively associated with favorable attitudes of research usefulness, positive attitudes, relevance to life subscales and total ATR scale (p < 0.001), while PhD study level was related to research anxiety (p < 0.001) and favorable attitudes across all three ATP domains (p < 0.001). Conclusion: Medical students who were involved in research showed a high degree of favorable attitudes toward research and plagiarism. Adjusting medical school curricula to include research courses would broaden the students’ interest in scientific research and maximize their impact on the full preservation of research ethics and integrity. © The Author(s) 2024.

Background: Research involves the systematic collection and analysis of data to enhance understanding of a particular phenomenon. Participation in medical research is crucial for advancing healthcare practices. However, there has been limited focus on understanding the factors that motivate medical students to engage in research. Additionally, in the era of e-learning, the easy accessibility of online resources has contributed to a widespread ‘copy-paste culture’ among digital-native students, which is recognized in academia as plagiarism. Existing studies suggest that a contributing factor to the increasing prevalence of plagiarism is students’ limited understanding of this act. The purpose of this study was to assess medical students’ attitudes toward research and plagiarism, and to evaluate the psychometric properties of the Attitudes Toward Research (ATR) and Attitudes Toward Plagiarism (ATP) questionnaires. Methods: This was a multicenter study conducted among medical undergraduate and postgraduate students attending the three medical universities who were involved in research. Students’ attitudes toward research and plagiarism were assessed using the ATR and ATP questionnaires. The research instruments underwent translation and cultural adaptation in accordance with internationally accepted methodology. The psychometric properties of the ATR and ATP, including validity and reliability, were assessed. Confirmatory factor analysis was used to test the model’s fit to the data. Results: The ATR and ATP questionnaires were completed by 793 medical students who were involved in research (647 undergraduates and 146 PhD students). Cronbach’s alpha coefficients of 0.917 and 0.822 indicated excellent and good scale reliability for the ATR and ATP questionnaires, respectively. The five-and three- factor structures of ATR and ATP have been validated with maximum likelihood confirmatory analysis, and the results demonstrated an adequate level of model fit (TLI = 0.930, CFI = 0.942 and TLI = 0.924, CFI = 0.943, respectively). Medical students showed a high degree of positive attitudes toward research and favorable scores across all three domains of attitudes toward plagiarism. In multivariate regression models, age was found to be positively associated with favorable attitudes of research usefulness, positive attitudes, relevance to life subscales and total ATR scale (p < 0.001), while PhD study level was related to research anxiety (p < 0.001) and favorable attitudes across all three ATP domains (p < 0.001). Conclusion: Medical students who were involved in research showed a high degree of favorable attitudes toward research and plagiarism. Adjusting medical school curricula to include research courses would broaden the students’ interest in scientific research and maximize their impact on the full preservation of research ethics and integrity. © The Author(s) 2024.

Introduction: This study explored the complex relationship between anxiety, depression, compassion fatigue, and satisfaction among long-term care (LTC) workers following the COVID-19 pandemic. In addition, the study assessed psychometric properties of the Professional Quality of Life (ProQOL) scale, to ensure a reliable and valid instrument for identifying compassion fatigue and satisfaction in the Serbian healthcare system. Methods: A cross-sectional study was conducted across LTC facilities in the Republic of Serbia. A ProQOL was administered to physicians, nurses, and aids, to measure compassion fatigue (including burnout and secondary traumatic stress) and compassion satisfaction. The following standardized instruments were also distributed: Secondary Traumatic Stress Scale (STSS), Depression Anxiety and Stress Scale 21 (DASS-21) and 12-Item Short-Form Health 36 Survey (SF-12). Results: A total of 300 LTC workers participated, mostly women (86.3%), with an average age of 45.4 ± 10.5 years and a median work experience of 15 years (range: 1 to 42 years). The study reported a significant presence of anxiety and depression symptoms (53.3% and 43.3%, respectively), with LTC workers experiencing moderate levels of compassion fatigue, as indicated by burnout (58.3%) and stress (57.3%) subscales, and moderate or high levels of compassion satisfaction (49.0% and 50.0%, respectively). The study demonstrated that anxiety impacts depression both directly and indirectly (p<0.05). Specifically, burnout and compassion satisfaction mediated the positive effect of anxiety on depression, indicating that increased anxiety led to higher burnout and lower compassion satisfaction, which resulted in greater depression (p<0.05). The three-factor structure of the ProQOL was validated (IFI, TLI, and CFI were above the cut-off of ≥0.95, and the RMSEA was below the suggested value of ≤ 0.06). The Cronbach α of the three subscales was above 0.8, indicating good scale reliability. Conclusion: This study contributes to the broader literature on LTC workers wellbeing by examining the complex interplay between professional quality of life, anxiety, and depression. The findings should guide decision-makers in developing targeted interventions and policies that promote the psychological resilience and well-being of LTC workers, thereby enhancing both individual and organizational outcomes in the healthcare sector. Copyright © 2025 Vracevic, Pavlovic, Todorovic, Milic, Matejic, Brkic, Milic, Savic, Masic, Pavlovic, Stanisic, Tasic, Spaic, Matovic, Tiosavljevic and Stanisavljevic.

Purpose: To translate, culturally adapt and validate the Coronary Revascularisation Outcome Questionnaire (CROQ), a disease-specific tool for measuring health-related quality of life (HRQoL) in patients with ischaemic heart disease (IHD), into Serbian language (CROQ-S). Methods: Validation study was performed at the Clinic for Cardiac Surgery and Clinic for Cardiology, University Clinical Centre of Serbia. We included a convenience sample of 600 patients with IHD divided into four groups. Acceptability, reliability and validity of the CROQ-S were assessed. Results: CROQ-S was acceptable to patients as demonstrated by less than 1% of missing data for each single item. Cronbach's Alpha was higher than the criterion of 0.70 for all scales in each version except the Cognitive Functioning scale which only met this criterion in the CABG pre-revascularisation version. Mean values of item-total correlations were greater than 0.30 for all scales except the Cognitive Functioning scale in both the pre-revascularisation groups. Compared to the original version, exploratory factor analysis in our study showed more factors; however, the majority of items had a factor loading greater than 0.3 on the right scale. Correlations of CROQ-S scales with the 36-Item Short Form Health Survey and Seattle Angina Questionnaire showed the expected pattern whereby scales measuring similar constructs were most highly correlated. Conclusion: CROQ-S is an acceptable, reliable and valid disease-specific instrument for measuring HRQoL in this sample of Serbian speaking patients with IHD both before and after coronary revascularisation. However, the Cognitive Functioning scale did not meet all the psychometric criteria and further validation of its responsiveness is required. © 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG.

Background/Aim. Infantile hypertrophic pyloric stenosis (IHPS) is the most common cause of surgery in newborns and young infants. Conservative treatment of IHPS is of great importance because it spares the newborn from stress caused by surgery and general anesthesia. The aim of this study was to evaluate the impact of various oral administration regimens of atropine on its efficacy in treating IHPS. Methods. The study included 45 patients with IHPS, conservatively treated by atropine sulfate in the period from 2006 to 2016. Clinical examination, laboratory analysis, and ultrasonography were performed on all patients on admission. The efficacy of treatment with different oral dosage regimens was analyzed and potential predictive factors of the negative outcome were defined. The evaluation of the success of the treatment was statistically analyzed by the method of the multivariate logistic regression model. Results. Out of 45 patients, 36 (80%) were successfully cured (p = 0.0008, without the need for surgery and without any complications. Gender prevalence, age, birth weight, body weight on admission, duration of symptoms, pyloric muscle thickness, and length had no statistically significant individual effect on the success of the atropine treatment. Patients who received a progressively increased dose of atropine had an 18 times higher risk of surgery, patients with hypochloremic alkalosis (HCA) had a 15 times higher risk, while others, with more than 5 vomitings within the first three days of the therapy, were 9 times more likely to be surgically treated. Conclusion. High success rate and no side effects represent an orally administered atropine treatment as a valid alternative choice for non-operative management of IHPS. Administration of initially high doses was shown to be more effective in relation to gradually increased oral doses of atropine sulfate. HCA and continued vomiting are considered as potential predictive factors of negative outcomes of the atropine treatment. © 2021 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background: Physical rehabilitation is an important segment in the treatment of hemodialysis patients as they often have numerous comorbidities, functional constraints and severe disabilities resulting from physical inactivity. Aim: To determine the effect of strength training program on muscle mass in patients on hemodialysis. Methodology: The study was organized in the Center for Hemodialysis, Kosovska Mitrovica, Serbia for the duration of 8 weeks. It involved 25 patients, 18 (72%) men and 7 (28%) women, of average age 52.9 ± 14 years, who had received chronic hemodialysis for 3 x 3-4 hours for at least 3 months using commercially available dialysers. During the first two hemodialyses, twice a week for 15-20 minutes, exercises were performed with a load to increase muscle mass of the upper and lower extremities together with isometric muscle contractions to strengthen the quadriceps, as well as a lateral flexion of the spinal column. Measurements were made before and after exercise. Routine laboratory analyses, oxygen saturation, demographic, anthropometric and clinical characteristics of the subjects were also evaluated. Results: After exercise oxygen saturation (p = 0.04) and venous pressure (p = 0.009) were significantly lower than pre-exercise values. Muscle strength of the fist (p = 0.001), the upper arm (p = 0.005) and forearms (p <0.001) also differed significantly before and after exercise. After exercise lower extremity muscles were significantly stronger, both in relation to the left and right muscles of the shin and thighs. Left side (p = 0.002) and right-side (p = 0.017) spinal column flexion was significantly higher after exercise. Conclusion: The study confirmed the positive effect of strength training program on the size of the exercising muscles, lateral flexion of the spinal column and venous pressure. © 2018 A. CARBONE Editore. All rights reserved.

Introduction: Potential benefits of implementing an electronic health record (EHR) to increase the efficiency of health services and improve the quality of health care are often obstructed by the unwillingness of the users themselves to accept and use the available systems. Aim: The aim of this study was to identify factors that influence the acceptance of the use of an EHR by physicians in the daily practice of hospital health care. Material and Methods: The cross-sectional study was conducted among physicians in the General Hospital Pancevo, Serbia. An anonymous questionnaire, developed according to the technology acceptance model (TAM), was used for the assessment of EHR acceptance. The response rate was 91%. Internal consistency was assessed by Cronbach’s alpha coefficient. A logistic regression analysis was used to identify the factors influencing the acceptance of the use of EHR. Results: The study population included 156 physicians. The mean age was 46.4 ± 10.4 years, 58.8% participants were female. Half of the respondents (50.1%) supported the use of EHR in comparison to paper patient records. In multivariate logistic regression modeling of social and technical factors, ease of use, usefulness, and attitudes towards use of EHR as determinants of the EHR acceptance, the following predictors were identified: use of a computer outside of the office for reading daily newspapers (p = 0.005), EHR providing a greater amount of valuable information (p = 0.007), improvement in the productivity by EHR use (p < 0.001), and a statement that using EHR is a good idea (p = 0.014). Overall the percentage of correct classifications in the model was 83.9%. Conclusion: In this research, determinants of the EHR acceptance were assessed in accordance with the TAM, providing an overall good model fit. Future research should attempt to add other constructs to the TAM in order to fully identify all determinants of physician acceptance of EHR in the complex environment of different health systems. © 2021 by the authors.

Introduction: Potential benefits of implementing an electronic health record (EHR) to increase the efficiency of health services and improve the quality of health care are often obstructed by the unwillingness of the users themselves to accept and use the available systems. Aim: The aim of this study was to identify factors that influence the acceptance of the use of an EHR by physicians in the daily practice of hospital health care. Material and Methods: The cross-sectional study was conducted among physicians in the General Hospital Pancevo, Serbia. An anonymous questionnaire, developed according to the technology acceptance model (TAM), was used for the assessment of EHR acceptance. The response rate was 91%. Internal consistency was assessed by Cronbach’s alpha coefficient. A logistic regression analysis was used to identify the factors influencing the acceptance of the use of EHR. Results: The study population included 156 physicians. The mean age was 46.4 ± 10.4 years, 58.8% participants were female. Half of the respondents (50.1%) supported the use of EHR in comparison to paper patient records. In multivariate logistic regression modeling of social and technical factors, ease of use, usefulness, and attitudes towards use of EHR as determinants of the EHR acceptance, the following predictors were identified: use of a computer outside of the office for reading daily newspapers (p = 0.005), EHR providing a greater amount of valuable information (p = 0.007), improvement in the productivity by EHR use (p < 0.001), and a statement that using EHR is a good idea (p = 0.014). Overall the percentage of correct classifications in the model was 83.9%. Conclusion: In this research, determinants of the EHR acceptance were assessed in accordance with the TAM, providing an overall good model fit. Future research should attempt to add other constructs to the TAM in order to fully identify all determinants of physician acceptance of EHR in the complex environment of different health systems. © 2021 by the authors.

Background: The objective of this study was to assess the complex relationship between the multiple determinants of the caregiving process, the caregiver burden, and depression during the COVID-19 pandemic in Serbia. Methods: A cross-sectional study was conducted on a nationally representative sample (n = 798) during the COVID-19 pandemic in Serbia from March to September 2020. A nine-section questionnaire designed for this study included the characteristics of caregivers, characteristics of care and care recipients, COVID-19 related questions, and the following standardized instruments: 12-Item Short-Form Health Survey, Fatigue Severity Scale, Activities of Daily Living Scale and Instrumental Activities of Daily Living Scale, Zarit Caregiver Burden Scale, and Beck Depression Inventory. Path analysis was used for the simultaneous assessment of the direct and indirect relationships of all determinants. Results: More than two thirds (71.9%) of informal caregivers experienced a burden, and more than one quarter (27.1%) had depression symptomatology. Self-rated physical health, need for psychosocial support, and caregiver burden were the main direct predictors of depression. Multiple determinants of the caregiving process had indirect effects on depressive symptomatology via the caregiver burden as a mediating factor. Conclusions: The subjective burden presented a significant risk factor for depressive symptoms in caregivers during the COVID-19 pandemic. The provision of psychosocial support was identified as an important opportunity to reduce depressive risk in informal caregivers. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Background: The objective of this study was to assess the complex relationship between the multiple determinants of the caregiving process, the caregiver burden, and depression during the COVID-19 pandemic in Serbia. Methods: A cross-sectional study was conducted on a nationally representative sample (n = 798) during the COVID-19 pandemic in Serbia from March to September 2020. A nine-section questionnaire designed for this study included the characteristics of caregivers, characteristics of care and care recipients, COVID-19 related questions, and the following standardized instruments: 12-Item Short-Form Health Survey, Fatigue Severity Scale, Activities of Daily Living Scale and Instrumental Activities of Daily Living Scale, Zarit Caregiver Burden Scale, and Beck Depression Inventory. Path analysis was used for the simultaneous assessment of the direct and indirect relationships of all determinants. Results: More than two thirds (71.9%) of informal caregivers experienced a burden, and more than one quarter (27.1%) had depression symptomatology. Self-rated physical health, need for psychosocial support, and caregiver burden were the main direct predictors of depression. Multiple determinants of the caregiving process had indirect effects on depressive symptomatology via the caregiver burden as a mediating factor. Conclusions: The subjective burden presented a significant risk factor for depressive symptoms in caregivers during the COVID-19 pandemic. The provision of psychosocial support was identified as an important opportunity to reduce depressive risk in informal caregivers. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Citations are an important, but often overlooked, part of every scientific paper. They allow the reader to trace the flow of evidence, serving as a gateway to relevant literature. Most scientists are aware of citations' errors, but few appreciate the prevalence of these problems. The purpose of the present study was to examine how often frequently cited papers in biomedical scientific literature are cited inaccurately. The study included an active participation of the first authors of included papers; to first-hand verify the citations accuracy. Findings from feasibility study, where we reviewed 1540 articles containing 2526 citations of 14 most cited articles in which the authors were affiliated with the Faculty of Medicine University of Belgrade, were further evaluated for external confirmation in an independent verification set of articles. Verification set included 4912 citations identified in 2995 articles that cited 13 most cited articles published by authors affiliated with the Mayo Clinic Division of Nephrology and Hypertension. A citation was defined as being accurate if the cited article supported or was in accordance with the statement by citing authors. At least one inaccurate citation was found in 11 and 15% of articles in the feasibility study and verification set, respectively, suggesting that inaccurate citations are common in biomedical literature. The most common problem was the citation of nonexistent findings (38.4%), followed by an incorrect interpretation of findings (15.4%). One-fifth of inaccurate citations were due to chains of inaccurate citations. Based on these findings, several actions to reduce citation inaccuracies have been proposed. © 2021 The Author(s).

Background: The purpose of this meta-analysis was to examine the prevalence of hypertensive disorders of pregnancy (HDPs), particularly preeclampsia (PE), in peripartum cardiomyopathy (PPCM)-affected pregnancies, and to evaluate whether a HDP significantly alters the prognosis of PPCM, with specific reference to the recovery of left ventricular function (LVEF) and mortality. Methods: A total of 5468 potentially eligible studies were identified, and 104 were included in the meta-analysis. For pooling proportions, the inverse variance methods with logit transformation were used. Complete recovery of LVEF (>50%) and mortality were expressed by odds ratios (ORs), with 95% confidence intervals (CIs). The Peto OR (POR) was used in cases of rare events. Baseline LV function and baseline LV end-diastolic diameter (LVEDD) were summarized by the mean difference (MD) and 95% confidence interval (CI). Results: The summary estimate of the prevalence of HDPs and PE in women with PPCM was 36% and 25%, respectively. Patients with HDPs and, more specifically, PE with PPCM had a higher chance of complete recovery (OR = 1.87; 95%CI = 1.64 to 2.13; p < 0.001 and OR = 1.98; 95%CI 1.69 to 2.32; p < 0.001, respectively), a higher baseline LVEF (MD, 1.42; 95% CI 0.16 to 2.67; p = 0.03 and MD, 1.69; 95% CI 0.21 to 3.18; p = 0.03, respectively), and a smaller baseline LVEDD (MD, −1.31; 95% CI −2.50 to −0.13; p = 0.03 and MD, −2.63; 95% CI −3.75 to −1.51; p < 0.001, respectively). These results, however, did not translate into a significant difference in 12-month mortality (POR = 0.80; 95% CI = 0.57 to 1.13; p = 0.21 and POR = 1.56; 95% CI 0.90 to 2.73; p = 0.12, respectively). Conclusions: The findings of this study may contribute to evidence that can be utilized to aid in the risk stratification of patients with PPCM regarding their long-term prognoses. © 2025 by the authors.

Introduction: Metabolic syndrome is considered as one at the most important public health problems and in hemodialysis patients it is one of the main factors of mortality. The aim of the study was to determine the predictive parameters of the mortality of patients with metabolic syndrome. Materials and methods: In a nine-year study, the outcome of the clinical treatment of 108 hemodialysis patients was analyzed, divided into a group of patients with metabolic syndrome and group of patients without metabolic syndrome. The demographic, anthropometric, clinical and laboratory characteristics of the examinees were evaluated. Results: Mortality of patients with metabolic syndrome was 28.1% and in the group of patients without metabolic syndrome 13.2%. Statistically significant difference was found between the group of patients with and without metabolic syndrome in comparison with body mass index (p <0.001), age (p = 0.027), diabetic nephropathy (p <0.001), number of comorbidities (p <0.001), the number of leukocytes (p = 0.043), total proteins (p = 0.044), albumin (p = 0.001), calcium (p = 0.016), glycemia (p = 0.002) and creatinine (p = 0.032). Predictive parameters of survival in patients on hemodialysis with metabolic syndrome are the body mass index (B - 0.056; SE 0.008; p <0.001) and diabetic nephropathy (B 0.397; SE 0.098; p <0.001). Conclusion: Lower body mass index and diabetic nephropathy are, in our study, the predictive parameters of mortality of patients on hemodialysis. © 2019 A. CARBONE Editore. All rights reserved.

Introduction: Preeclampsia (PE) is a pregnancy-associated, multi-organ, life-threatening disease that appears after the 20th week of gestation. The aim of this study was to perform a systematic review and meta-analysis to determine whether women with PE have disrupted miRNA expression compared to women who do not have PE. Methods: We conducted a systematic review and meta-analysis of studies that reported miRNAs expression levels in placenta or peripheral blood of pregnant women with vs. without PE. Studies published before October 29, 2021 were identified through PubMed, EMBASE and Web of Science. Two reviewers used predefined forms and protocols to evaluate independently the eligibility of studies based on titles and abstracts and to perform full-text screening, data abstraction and quality assessment. Standardized mean difference (SMD) was used as a measure of effect size. Results: 229 publications were included in the systematic review and 53 in the meta-analysis. The expression levels in placenta were significantly higher in women with PE compared to women without PE for miRNA-16 (SMD = 1.51,95%CI = 0.55–2.46), miRNA-20b (SMD = 0.89, 95%CI = 0.33–1.45), miRNA-23a (SMD = 2.02, 95%CI = 1.25–2.78), miRNA-29b (SMD = 1.37, 95%CI = 0.36–2.37), miRNA-155 (SMD = 2.99, 95%CI = 0.83–5.14) and miRNA-210 (SMD = 1.63, 95%CI = 0.69–2.58), and significantly lower for miRNA-376c (SMD = –4.86, 95%CI = –9.51 to –0.20). An increased level of miRNK-155 expression was found in peripheral blood of women with PE (SMD = 2.06, 95%CI = 0.35–3.76), while the expression level of miRNA-16 was significantly lower in peripheral blood of PE women (SMD = –0.47, 95%CI = –0.91 to –0.03). The functional roles of the presented miRNAs include control of trophoblast proliferation, migration, invasion, apoptosis, differentiation, cellular metabolism and angiogenesis. Conclusion: miRNAs play an important role in the pathophysiology of PE. The identification of differentially expressed miRNAs in maternal blood creates an opportunity to define an easily accessible biomarker of PE. Copyright © 2021 Cirkovic, Stanisavljevic, Milin-Lazovic, Rajovic, Pavlovic, Milicevic, Savic, Kostic Peric, Aleksic, Milic, Stanisavljevic, Mikovic, Garovic and Milic.

Introduction: Preeclampsia (PE) is a pregnancy-associated, multi-organ, life-threatening disease that appears after the 20th week of gestation. The aim of this study was to perform a systematic review and meta-analysis to determine whether women with PE have disrupted miRNA expression compared to women who do not have PE. Methods: We conducted a systematic review and meta-analysis of studies that reported miRNAs expression levels in placenta or peripheral blood of pregnant women with vs. without PE. Studies published before October 29, 2021 were identified through PubMed, EMBASE and Web of Science. Two reviewers used predefined forms and protocols to evaluate independently the eligibility of studies based on titles and abstracts and to perform full-text screening, data abstraction and quality assessment. Standardized mean difference (SMD) was used as a measure of effect size. Results: 229 publications were included in the systematic review and 53 in the meta-analysis. The expression levels in placenta were significantly higher in women with PE compared to women without PE for miRNA-16 (SMD = 1.51,95%CI = 0.55–2.46), miRNA-20b (SMD = 0.89, 95%CI = 0.33–1.45), miRNA-23a (SMD = 2.02, 95%CI = 1.25–2.78), miRNA-29b (SMD = 1.37, 95%CI = 0.36–2.37), miRNA-155 (SMD = 2.99, 95%CI = 0.83–5.14) and miRNA-210 (SMD = 1.63, 95%CI = 0.69–2.58), and significantly lower for miRNA-376c (SMD = –4.86, 95%CI = –9.51 to –0.20). An increased level of miRNK-155 expression was found in peripheral blood of women with PE (SMD = 2.06, 95%CI = 0.35–3.76), while the expression level of miRNA-16 was significantly lower in peripheral blood of PE women (SMD = –0.47, 95%CI = –0.91 to –0.03). The functional roles of the presented miRNAs include control of trophoblast proliferation, migration, invasion, apoptosis, differentiation, cellular metabolism and angiogenesis. Conclusion: miRNAs play an important role in the pathophysiology of PE. The identification of differentially expressed miRNAs in maternal blood creates an opportunity to define an easily accessible biomarker of PE. Copyright © 2021 Cirkovic, Stanisavljevic, Milin-Lazovic, Rajovic, Pavlovic, Milicevic, Savic, Kostic Peric, Aleksic, Milic, Stanisavljevic, Mikovic, Garovic and Milic.

Background: Effective biliary tree decompression plays a central role in the palliation of malignant biliary obstruction (MBO). When endoscopic drainage is unfeasible or unsuccessful, percutaneous transhepatic biliary drainage (PTBD) is the method of choice and preferred treatment approach in advanced hilar MBO. The prognostic nutritional index (PNI) reflects the patient’s immunonutritional status, while the neutrophil to lymphocyte ratio (NLR) reflects the patient’s inflammation status. The aim of the present study was to evaluate the prognostic value of preprocedural PNI and NLR on short-term survival in the advanced stage MBO population threatened with PTBD and to characterize the differences in immunonutritional and inflammatory status between 60-day survivors and non-survivors, as well as analyze other variables influencing short-term survival. Methods: This single-center retrospective study was conducted on patients undergoing palliative PTBD caused by MBO as a definitive therapeutic treatment between March 2020 and February 2022. After the procedure, patients were followed until the end of August 2022. Results: A total of 136 patients with malignant biliary obstruction were included in the study. Based on receiver operating characteristic (ROC) curve analysis, optimal cut off-values for NLR (3) and PNI (36.7) were determined. In univariate regression analysis, age, absolute neutrophil count, albumin level, NLR ≤ 3, and PNI ≥ 36.7 were significant predictors of 60-day survival. Level of obstruction and PNI ≥ 36.7 were statistically significant independent predictors of 60-day survival in a multivariate regression model. Using PNI ≥ 36.7 as a significant coefficient from the multivariate regression model with the addition of NLR ≤ 3 from univariate analysis, a 60-day survival score was developed. Conclusions: PNI and NLR are easy to calculate from routine blood analysis, which is regularly conducted for cancer patients. As such, they represent easily available, highly reproducible, and inexpensive tests capable of expressing the severity of systemic inflammatory responses in patients with cancer. Our study highlights that preprocedural PNI and NLR values provide predictors of short-term survival in patients with MBO treated with palliative PTBD. In addition, the proposed 60-day survival score can contribute to better selection of future candidates for PTBD and recognition of high-risk patients with expected poor outcomes. © 2022 by the authors.

Background/Objectives: The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire is a widely employed self-report tool for assessing upper extremity function. The aim of this study was to assess the psychometric properties of the Serbian version of the DASH by determining its criterion and construct validity, as well as internal consistency. Methods: This cross-sectional study was conducted among patients with hand and wrist disabilities at the Institute for Orthopedics “Banjica”, Serbia. The psychometric properties of the Serbian version of the DASH were analyzed through an examination of its factorial structure and internal consistency. The DASH consists of 30 items, 24 of which assess function, 21 of which focus on physical function and three on social/role function. The remaining six items evaluate symptoms related to pain, tingling/numbness, weakness, and stiffness. Results: A total of 297 patients were included in the study. The mean age was 47.4 ± 16.8 years, with 50.5% males. Three models were assessed to determine the reliability and validity of the questionnaire across different domains. Model 1 examined a single-factor structure. In Model 2, the items were divided into two domains: Physical Function and Psychosocial/Symptoms. In Model 3, items were subdivided into three domains: Physical Function, Symptoms, and Psychosocial. All models demonstrated an excellent internal consistency with a Cronbach’s alpha > 0.9 for most domains. The values for the fit indices Tucker–Lewis index (TLI) and Comparative-Fit Index (CFI) were above their cut-off criteria of 0.9, while the Root Mean Square Error of Approximation (RMSEA) and Standardized Root Mean Square Residual (SRMR) were below the suggested value of 0.06, indicating an excellent level of models fit. Standardized factor loadings were statistically significant (p < 0.05). Conclusions: The present study provided the evidence for the appropriate metric properties of the Serbian version of the DASH. Results support both the unidimensional and multidimensional structures of the DASH. © 2024 by the authors.

Background and objectives: The COVID-19 pandemic has had an unprecedented reliance on informal caregivers as one of the pillars of healthcare systems. The aim of this study was to assess the quality of life of informal caregivers during the COVID-19 epidemic in Serbia. Materials and Methods: A cross-sectional study was conducted among informal caregivers during the COVID-19 epidemic in Serbia. Physical and mental quality of life was measured by the 36-Item Short-Form Health Survey. Additional data included sociodemographic characteristics, caregiver and care recipient characteristics, and COVID-19 related concerns. The qualitative component was performed using focus groups and individual in-depth interviews. Results: Out of 112 informal caregivers enrolled, most were female (80%), and the average age was 51.1 ± 12.3 years. The majority was delivering care to one person, who was a family member, on a daily basis (86.4%, 92%, and 91.1%, respectively). In multiple regression models, significant predictors of caregivers’ physical health were delivering care to a family member and a higher level of care complexity, while significant predictors of caregivers’ mental health were a higher level of care complexity and increased concerns about self-health and the health of the person being cared for due to the COVID-19 epidemic. Conclusions: Informal caregivers are experiencing negative physical and mental health outcomes during the COVID-19 epidemic in Serbia. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

Background: As digital health services are increasingly developing and becoming more interactive in Serbia, a comprehensive instrument for measuring eHealth literacy (EHL) is needed. Objective: This study aimed to translate, culturally adapt, and investigate the psychometric properties of the Serbian version of the eHealth Literacy Questionnaire (eHLQ); to evaluate EHL in the population of primary health care (PHC) users in Serbia; and to explore factors associated with their EHL. Methods: The validation study was conducted in 8 PHC centers in the territory of the Mačva district in Western Serbia. A stratified sampling method was used to obtain a representative sample. The Translation Integrity Procedure was followed to adapt the questionnaire to the Serbian language. The psychometric properties of the Serbian version of the eHLQ were analyzed through the examination of factorial structure, internal consistency, and test-retest reliability. Descriptive statistics were calculated to determine participant characteristics. Differences between groups were tested by the 2-tailed Students t test and ANOVA. Univariable and multivariable linear regression analyses were used to determine factors related to EHL. Results: A total of 475 PHC users were enrolled. The mean age was 51.0 (SD 17.3; range 19-94) years, and most participants were female (328/475, 69.1%). Confirmatory factor analysis validated the 7-factor structure of the questionnaire. Values for incremental fit index (0.96) and comparative fit index (0.95) were above the cutoff of ≥0.95. The root mean square error of approximation value of 0.05 was below the suggested value of ≤0.06. Cronbach α of the entire scale was 0.95, indicating excellent scale reliability, with Cronbach α ranging from 0.81 to 0.90 for domains. The intraclass correlation coefficient ranged from 0.63 to 0.82, indicating moderate to good test-retest reliability. The highest EHL mean scores were obtained for the understanding of health concepts and language (mean 2.86, SD 0.32) and feel safe and in control (mean 2.89, SD 0.33) domains. Statistically significant differences (all P<.05) for all 7 eHLQ scores were observed for age, education, perceived material status, perceived health status, searching for health information on the internet, and occupation (except domain 4). In multivariable regression models, searching for health information on the internet and being aged younger than 65 years were associated with higher values of all domain scores except the domain feel safe and in control for variable age. Conclusions: This study demonstrates that the Serbian version of the eHLQ can be a useful tool in the measurement of EHL and in the planning of digital health interventions at the population and individual level due to its strong psychometric properties in the Serbian context. © 2024 JMIR Publications Inc.. All rights reserved.

Aim: The study aim was to analyze the epidemiology and clinical characteristics of severe acute respiratory infection (SARI) cases and to compare demographic and clinical characteristics as well as outcomes of influenza-positive SARI cases to those of influenza-negative SARI cases in Montenegro. Methods: SARI surveillance was established in 2014 in nine healthcare institutions. Retrospective analysis of case-based surveillance data pertaining to all reported SARI cases during three seasons was conducted. Results: Among the 90 identified SARI cases, 64 (71%) were influenza positive. Death outcome was reported in 25 (28%) of all registered SARI cases. Cardiovascular disease was more prevalent among the patients in the influenza-positive SARI group (36% vs. 12%, p =.021), as was concurrence of two or more chronic medical conditions (57% vs. 30%, p =.042). These patients were also more likely to be immunocompromised (16% vs. 0%, p =.057) and have viral pneumonia (14.4% vs. 20.3%, p =.017), compared to those in the influenza-negative SARI group. Younger age, presence of cardiovascular disease and being immunocompromised were patient characteristics independently associated with SARI related to influenza. Conclusion: Continued and extended monitoring of SARI is necessary in order to fully assess the burden of flu disease, define risk groups and establish better control measures. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.