BackgroundAs median survival time for patients with malignant pleural effusions (MPE) is nine months, rapid and accurate diagnosis is important. Cytological examination of pleural uid has a good speci city but imperfect sensitivity. Published estimates of sensitivity vary substantially and predictors of false negative cytology are not well established. We aim to establish a local estimate of pleural uid cytology sensitivity and identify risk factors for false negative cytology. MethodsWe conducted a retrospective cohort study of patients who had cytology testing of pleural uid at

Introduction Medical students are undertaking an intense curriculum, the stress of which may cause or worsen insomnia and depressive symptoms. We aim to investigate factors which might affect the sleep of medical students, and how they currently manage their sleep. Methods A brief online survey was sent to medical students, consisting of validated questionnaires, and questions related to sleep management strategies. Results We recruited 828 participants—49.5% reported insomnia symptoms and 51.4% reported depressive symptoms. After adjusting for gender, ethnicity and age, depressive symptoms (Mild: odds ratio (OR) = 6.26; Moderate: OR = 18.13; Severe: OR = 15.57), and sleep hygiene (OR = 1.07) were associated with insomnia symptoms. Commonly endorsed strategies for sleep management by students were undertaking regular exercise (80.1%), having consistent sleep-wake time (71.3%), and limiting caffeine intake (70.3%). Few were willing to see a clinician (23.4%) or take medication (22.3%). Participants with insomnia symptoms were more likely to prefer limiting their alcohol intake (OR = 1.77), limiting daytime naps (OR = 1.5), seeing clinicians (OR = 1.86), and taking sleep medication (OR = 3.98), but less likely to prefer avoiding intense work (OR = 0.71) or minimizing using electronics (OR = 0.60) close to bedtime than those without insomnia symptoms. High sleep self-efficacy was associated with lower odds for having insomnia symptoms (OR = 0.74 (0.70, 0.77)). Discussion Self-reported insomnia and depression are common among medical students. Increased awareness and greater resources are needed to support the sleep health and emotional well-being of medical students.