Background: The COVID-19 pandemic affects various aspects of everyone's life. One of the impacts of the pandemic is psychological disorders, such as decreased sleep quality and anxiety. Until now, there has been no research to assess the relationship between these two conditions in university students during the pandemic era. Therefore, this study aims to evaluate the relationship between decreased sleep quality and anxiety disorders in Indonesia’s university students during the COVID-19 pandemic.Methods: The cross-sectional study was conducted from September to October 2021 on 376 university students, both domiciled in Bali and outside Bali. Data were collected using a questionnaire consisting of participant demographic data, sleep quality assessment using the Pittsburg Sleep Quality Index (PSQI), and measurement of anxiety levels using the Zung Self-Rating Anxiety Scale (SAS). Bivariate analysis was performed using the Pearson correlation test.Result: 294 of the 376 participants had high PSQI scores (>5) and experienced sleep disturbances. Meanwhile, 44 participants reported experiencing anxiety disorders, with detail of 41 participants having SAS scores in the low category and 3 participants having SAS scores in the moderate category. The relationship between the PSQI and SAS variables showed a correlation coefficient of 0.619 and was statistically significant.Conclusion : Decreased sleep quality is positively correlated with anxiety disorders experienced by university students during the COVID-19 pandemic. The author suggests research with larger parameters and population size to get more accurate results.

Background C-X-C Motif Chemokine Receptor (CXCR4) is an oncogene that widely studied and associated with worse clinicopathological features and prognosis outcome on many types of cancer. Beside that, significance of CXCR4 expression on clinicopathological features and prognostic on osteosarcoma (OS) require further validation. Aim We conducted a meta-analysis to evaluate association between positive CXCR4 expression with clinicopathological features, and prognosis in OS. Methods Literature searches on Pubmed, Cochrane Library and Web of Science was conducted systematically up to December 2021 to find relevant references. Effect of CXCR4 expression on clinicopathological characteristic and prognostic were analyzed using Review Manager 5.4 (Cochrane Collaboration, Oxford, UK). Significance value less than 0.05 was considered statistically significant. Results By considering inclusion and exclusion criteria, 940 patients from 12 studies were suitable to included in qualitative analysis, and 10 studies were suitable for quantitative analysis. Association between CXCR4 expression and OS clinicopathological features was found significant on metastasis (OR = 4.01, 95%CI = 1.58–10.18; p = 0.003), stage (stage III & IV vs I & II, OR = 6.52, 95%CI = 1.05–40.62; p = 0.04), and tumor primary site (femur/tibia vs other, OR = 1.60, 95%CI = 1.04–2.45; p = 0.03), but not associated with histological type, gender, and age. Furthermore, CXCR4 expression is associated with poor overall survival in OS (HR = 2.13, 95%CI = 1.78–2.55; p < 0.001). Conclusion In conclusion, the results of our meta-analysis suggest that CXCR4 expression may be valuable as a histopathological predictor of poor clinicopathological features and prognosis of OS.