bluuebunny/crossref_metadata_2025_split huggingface dataset:
Melatonin effects on sleep quality of COVID-19 patients: a protocol for systematic review and meta-analysis of randomised controlled trials with trial sequential analysis
Authors: Zhang Juan Juan , Sun Ran , Guo Sha , Zhang Hong 
Published: June 2023

IntroductionSleep disturbance is one of the common complaints of patients with COVID-19 infection. Melatonin is a physiological indoleamine involved in circadian rhythm regulation and it is currently used for secondary sleep disorders caused by various diseases. Some clinical randomised controlled trials (RCTs) have obtained a small amount of evidence and controversial results in support of their therapeutic effect on sleep disorders, but no studies have summarised and evaluated RCTs in all current databases to obtain conclusive results. Therefore, the aim of this systematic review and meta-analysis was to determine the efficacy and safety of melatonin in the treatment of sleep disturbances in patients with COVID-19.Methods and analysisWe will search for RCT-type studies of melatonin in the treatment of sleep disturbances in patients with COVID-19. From inception to October 2022 will be available on PubMed/MEDLINE, Web of Science, Embase, CINAHL, PsycINFO, LILACS, SCOPUS, Cochrane Central Register of Controlled Trials, ICTRP, Wanfang Data, VIP database and CNKI, VIP database, China Biomedical Literature Database to search for eligible studies. There are no language and geographical restrictions. Two authors will independently screen and select eligible studies, assess methodological quality and perform data extraction. Two additional authors will independently extract data from each study. Then, meta-analysis will then be carried out using a fixed-effects or random-effects model, using the mean difference for continuous outcomes and the relative risk for dichotomous outcomes. Risk of bias assessment will be assessed using the Cochrane risk-of-bias tool. Heterogeneity between studies was assessed by Cochrane Q-test and I2. The quality of evidence for each outcome will be assessed using the Grading of Recommendations Assessment, Development and Evaluation methodology. Funnel plots, Begg’s test and Egger’s test will be used to assess the risk of publication bias. Subgroup analysis, data synthesis, meta-analysis and overall incidence of adverse events will be performed using Review Manager V.5.4 software and Stata software. Trial sequential analysis will be performed if appropriate.Ethics and disseminationThis study is an extraction review of data from existing studies, and thus it is unnecessary to obtain ethical approval. The results of this systematic review will be published in a peer-reviewed journal.PROSPERO registration numberCRD42022359221.
Psychosocial dysfunction of children and adolescents during the COVID-19 lockdown in Ecuador: a cross-sectional study
Authors: Erazo Carlos V , Cifuentes Amelia C , Navas Adriana M , Carrión Freddy G , Caicedo-Gallardo Jose D , Andrade Mateo , Moncayo Ana L 
Published: June 2023

ObjectiveAlthough the risk of morbidity and mortality of children and adolescents was lower during the COVID-19 pandemic, it appears that their mental health was strongly impacted. The goal of this study is to document psychological dysfunction among children and adolescents who underwent confinement due to COVID-19 in Ecuador.DesignA cross-sectional, internet-based questionnaire.SettingEcuador.ParticipantsA total of 1077 caregivers of children and adolescents (4–16 years old).Outcome measuresCaregivers responded to Pediatric Symptom Checklist-35 to assess psychosocial dysfunction.ResultsThe prevalence of psychosocial dysfunction was 20.8%, with internalising symptoms being the most common (30.7%). The prevalence of psychosocial dysfunction was higher in children who had a poor family relationship during confinement (prevalence ratio (PR) 2.23; 95% CI 1.22 to 4.07), children who never helped with housework (PR 2.63; 95% CI 1.13 to 6.14) and those whose caregivers were worried about children’s need for emotional therapy (PR 2.86; 95% CI 1.97 to 4.15). Never playing video games (PR 0.34; 95% CI 0.17 to 0.69) or playing video games infrequently (PR 0.39; 95% CI 0.20 to 0.79) was a protective factor for the psychosocial problems of children and adolescents.ConclusionOur study demonstrates that children and adolescents have experienced a deterioration of mental health due to the pandemic. Family factors played an important role in the mental health of children during the lockdown. When a public crisis occurs, supportive mental health policies should be developed and implemented to promote children’s psychological welfare.
Changes in weekly working hours, proportion of doctors with hours above the limitations of European Working Time Directive (EWTD) and time spent on direct patient care for doctors in Norway from 2016 to 2019: a study based on repeated surveys
Authors: Rosta Judith , Rø Karin Isaksson 
Published: June 2023

ObjectivesTo compare the total weekly working hours, proportions with work hours above the limitations of European working time directive (EWTD) and time spent on direct patient care in 2016 and 2019 for doctors working in different job positions in Norway.DesignRepeated postal surveys in 2016 and 2019.SettingNorway.ParticipantsRepresentative samples of doctors; the response rates were 73.1% (1604/2195) in 2016 and 72.5% (1511/2084) in 2019.Main outcome measuresSelf-reported weekly working hours, proportions with hours above the limitations of EWTD defined as >48 hours/week and time spent on direct patient care.AnalysesLinear mixed models with estimated marginal means and proportions.ResultsFrom 2016 to 2019, the weekly working hours increased significantly for male general practitioners (GPs) (48.7 hours to 50.9 hours) and male hospital doctors in leading positions (48.2 hours to 50.5 hours), and significantly decreased for female specialists in private practice (48.6 hours to 44.9 hours). The proportion of time spent on direct patient care was noted to be similar between genders and over time. In 2019, it was higher for specialists in private practice (66.4%) and GPs (65.5%) than for doctors in other positions, such as senior hospital consultants (43.5%), specialty registrars (39.8%) and hospital doctors in leading positions (34.3%). Working >48 hours/week increased significantly for both male and female GPs (m: 45.2% to 57.7%; f: 27.8% to 47.0%) and hospital doctors in leading positions (m: 34.4% to 57.1%; f: 17.4% to 46.4%), while it significantly decreased for female specialty registrars (13.2% to 6.9%).ConclusionsWorking hours increased significantly for GPs and hospital doctors in leading positions from 2016 to 2019, resulting in increased proportions of doctors with work hours above the EWTD. As work hours above the EWTD can be harmful for health personnel and for safety at work, initiatives to reduce long working weeks are needed.
Impact of practicing internal benchmarking on continuous improvement of cataract surgery outcomes: a retrospective observational study at Aravind Eye Hospitals, India
Authors: Balu Ganesh-Babu Subburaman , Gupta Sachin , Ravilla Ravindran D , Ravilla Thulasiraj D , Mertens Helen , Webers Carroll , Vasudeva Rao Shyam , van Merode Frits 
Published: June 2023

ObjectiveWe aim to assess the effectiveness of a cataract surgery outcome monitoring tool used for continuous quality improvement. The objectives are to study: (1) the quality parameters, (2) the monitoring process followed and (3) the impact on outcomes.Design and proceduresIn this retrospective observational study we evaluated a quality improvement (QI) method which has been practiced at the focal institution since 2012: internal benchmarking of cataract surgery outcomes (CATQA). We evaluated quality parameters, procedures followed and clinical outcomes. We created tables and line charts to examine trends in key outcomes.SettingAravind Eye Care System, India.ParticipantsPhacoemulsification surgeries performed on 718 120 eyes at 10 centres (five tertiary and five secondary eye centres) from 2012 to 2020 were included.InterventionsAn internal benchmarking of surgery outcome parameters, to assess variations among the hospitals and compare with the best hospital.Outcome measuresIntraoperative complications, unaided visual acuity (VA) at postoperative follow-up visit and residual postoperative refractive error (within ±0.5D).ResultsOver the study period the intraoperative complication rate decreased from 1.2% to 0.6%, surgeries with uncorrected VA of 6/12 or better increased from 80.8% to 89.8%, and surgeries with postoperative refractive error within ±0.5D increased from 76.3% to 87.3%. Variability in outcome measures across hospitals declined. Additionally, benchmarking was associated with improvements in facilities, protocols and processes.ConclusionInternal benchmarking was found to be an effective QI method that enabled the practice of evidence-based management and allowed for harnessing the available information. Continuous improvement in clinical outcomes requires systematic and regular review of results, identifying gaps between hospitals, comparisons with the best hospital and implementing lessons learnt from peers.
Acute paediatric asthma treatment in the prehospital setting: a retrospective observational study
Authors: Craig Simon , Delardes Belinda , Nehme Ziad , Wilson Catherine , Dalziel Stuart , Nixon Gillian M , Powell Colin , Graudins Andis , Babl Franz E 
Published: June 2023

ObjectivesTo describe the incidence of and patterns of ‘escalated care’ (care in addition to standard treatment with systemic corticosteroids and inhaled bronchodilators) for children receiving prehospital treatment for asthma.DesignRetrospective observational study.SettingState-wide ambulance service data (Ambulance Victoria in Victoria, Australia, population 6.5 million)ParticipantsChildren aged 1–17 years and given a final diagnosis of asthma by the treating paramedics and/or treated with inhaled bronchodilators from 1 July 2019 to 30 June 2020.Primary and secondary outcome measuresWe classified ‘escalation of care’ as parenteral administration of epinephrine, or provision of respiratory support. We compared clinical, demographic and treatments administered between those receiving and not receiving escalation of care.ResultsParamedics attended 1572 children with acute exacerbations of asthma during the 1 year study period. Of these, 22 (1.4%) had escalated care, all receiving parenteral epinephrine. Patients with escalated care were more likely to be older, had previously required hospital admission for asthma and had severe respiratory distress at initial assessment.Of 1307 children with respiratory status data available, at arrival to hospital, the respiratory status of children had improved overall (normal/mild respiratory distress at initial assessment 847 (64.8%), normal/mild respiratory distress at hospital arrival 1142 (87.4%), p<0.0001).ConclusionsMost children with acute exacerbations of asthma did not receive escalated therapy during their pre-hospital treatment from ambulance paramedics. Most patients were treated with inhaled bronchodilators only and clinically improved by the time they arrived in hospital.
circ-0000512 inhibits PD-L1 ubiquitination through sponging miR-622/CMTM6 axis to promote triple-negative breast cancer and immune escape
Authors: Dong Li-Feng , Chen Fang-Fang , Fan Yang-Fan , Zhang Kun , Chen Hui-Hui 
Published: June 2023

BackgroundThis study reported the function and mechanism of circ-0000512 in the progression of triple-negative breast cancer (TNBC).Methodscirc-0000512 expression in TNBC tissues and paired adjacent normal tissues and cells was examined by qRT-PCR. Moreover, circ-0000512 expression in TNBC cells was modulated by transfection. Thereafter, colony formation assay, Transwell assay and flow cytometry were conducted to observe cell proliferation, migration and apoptosis. TNBC cells were treated with cycloheximide and the protease inhibitor MG132. Later, ubiquitination assay was performed to detect programmed cell death ligand 1 (PD-L1) ubiquitination in TNBC cells. The T cell killing ability was assessed by the T cell-mediated tumor cell killing assay. IFNγ and IL-2 levels were detected by ELISA. The percentage of activated T cells was detected with a flow cytometer. In addition, dual luciferase reporter gene assay and RNA immunoprecipitation assay were carried out to evaluate the binding between two genes. In vivo study was conducted on mice. CD8+ T cells in xenograft tumors were detected by immunohistochemistry.Resultscirc-0000512 was upregulated in patients with TNBC. circ-0000512 knockdown attenuated the proliferation and migration of TNBC cells and enhanced their apoptosis. circ-0000512 overexpression had opposite effects. circ-0000512 knockdown enhanced the PD-L1 protein ubiquitination in TNBC cells by inhibiting CMTM6. Meanwhile, circ-0000512 promoted CMTM6 expression by sponging miR-622. circ-0000512 knockdown increased the ratio of CD8+T cells and the lethality of T cells against TNBC cells. Besides, circ-0000512 knockdown inhibited the growth of TNBC cells in immunodeficient nude mice and normal immune mice and increased the ratio of CD8+T cells in xenograft tumors of normal immune mice.Conclusionscirc-0000512 inhibited PD-L1 ubiquitination by sponging the miR-622/CMTM6 axis, thus promoting TNBC progression and immune escape.
Systematic literature review informing the 2022 update of the EULAR recommendations for the management of ANCA-associated vasculitis (AAV): Part 2 - Treatment of eosinophilic granulomatosis with polyangiitis and diagnosis and general management of AAV
Authors: Sanchez-Alamo Beatriz , Schirmer Jan Henrik , Hellmich Bernhard , Jayne David , Monti Sara , Tomasson Gunnar , Luqmani Raashid Ahmed 
Published: June 2023

ObjectiveTo summarise and update evidence to inform the 2022 update of the European Alliance of Associations of Rheumatology (EULAR) recommendations for the management of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).MethodsThree systematic literature reviews (SLR) were performed. PubMed, EMBASE and the Cochrane library were searched from 1 February 2015 to 25 February 2022. The evidence presented herein covers the treatment of eosinophilic granulomatosis with polyangiitis (EGPA) as well as diagnostic testing and general management of all AAV syndromes.ResultsFor the treatment of EGPA, diagnostic procedures and general management 3517, 4137 and 4215 articles were screened and 26, 110 and 63 articles were included in the final evidence syntheses, respectively. For EGPA patients with newly diagnosed disease without unfavourable prognostic factors, azathioprine (AZA) combined with glucocorticoids (GC) is not superior to GC monotherapy to induce remission (LoE 2b). In patients with active EGPA and unfavourable prognostic factors, cyclophosphamide or rituximab can be used for remission induction (LoE 2b). Treatment with Mepolizumab added to standard treatment results in higher rates of sustained remission in patients with relapsing or refractory EGPA without active organ-threatening or life-threatening manifestations (LoE 1b) and reduces GC use. Kidney biopsies have prognostic value in AAV patients with renal involvement (LoE 2a). In the context of suspected AAV, immunoassays for proteinase 3 and myeloperoxidase-ANCA have higher diagnostic accuracy compared with indirect immunofluorescent testing (LoE 1a).ConclusionThis SLR provides current evidence to inform the 2022 update of the EULAR recommendations for the management of AAV.
Characterization of an EPS-producing bifidobacterial strain based on integration of phenotypic and complete genome sequencing data
Authors: Liu Dianbin , Huang Haohan , Han Jinzhi , Wu Qiong , Xiang Yaoyao , Liu Yan , Wei Yanxia 
Published: June 2023

Bifidobacterium and Lactobacillus are known to be common members of the human intestinal microbiota, which play important roles in maintaining the homeostasis of host gut microenvironment. Several bifidobacterial and lactobacilli strains have been used as probiotics for health benefits. The exopolysaccharides (EPSs) produced by strains from Bifidobacterium and Lactobacillus are considered as beneficial traits mediating these beneficial effects. In this study, 21 strains belonging to Bifidobacterium and Lactobacillus were isolated from healthy infants’ stool and were screened for EPS-producing ability. Among these strains, Bifidobacterium longum XZM1 showed the highest EPS productivity, which was further confirmed and characterized. The complete genome of strain XZM1 was sequenced, which revealed the presence of a gene cluster for EPS production. Furthermore, comparative genome analysis was performed among XZM1 and other strains from B. longum species. Following purification, the molecular weight (Mw) of EPS from XZM1 was determined as 4023 Da (Mw) through gel permeation chromatography. Analysis of the EPS hydrolysates revealed that the EPS was composed of mannose, glucose, galactose, arabinose, and fucose. Additionally, the EPS exhibited higher scavenging abilities toward hydroxyl than 1,1-diphenyl-2-picrylhydrazyl free radical. Overall, these results suggest that XZM1 from B. longum species may be a promising probiotic candidate.
Circularly polarized metamaterial Antenna in energy harvesting wearable communication systems
Authors: Inuwa Bala , Idowu-Bismark Olabode , Oyeleke Oluseun , Paul Olugbeji Jemitola 
Published: June 2023

When battery powered sensors are spread out in places that are sometimes hard to reach, sustaining them become difficult. Therefore, to develop this technology on a large scale such as in the internet of things (IoT) scenario, it is necessary to figure out how to power them. The proffered solution in this work, is to get energy from the environment using energy harvesting Antennas. This work presents a wearable circular polarized efficient receiving and transmitting sensors for medical, IoT, and communication systems at the frequency range of WLAN, and GSM from 900 MHz up to 6 GHz. Using a cascaded system block of a circularly polarized Antenna, a rectifier and t-matching network, the design was successfully simulated. A DC charging voltage of 2.8V was achieved to power-up batteries of the wearable and IoT sensors. The major contribution of this work is the tri-band Antenna system which is able to harvest reflected Wi-Fi frequencies and also GSM frequencies combined in a miniaturized manner. This innovative configuration is a step forward in building devices with over 80% duty cycle.
Experimental study of four-wave mixing based on a quantum dot semiconductor optical amplifier
Authors: Akylbek Tokhmetov , Akhmet Tussupov , Liliya Tanchenko 
Published: June 2023

The article is devoted to the study of four-wave mixing (FWM) in a semiconductor optical amplifier with quantum dots (QD-SOA). Experimental measurements of FWM signals are characterized in nonlinear media of GaAs-based QD-SOA with gain in the 1,550 nm region. Theoretical part of nonlinear effect of FWM is studied and important all-optical communication applications are listed. Experimental studies of a four-wave system are described and an analysis of FWM signals is given for various input powers of pump signals and injection currents. The devices are compared in terms of such parameters as conversion efficiency and signal-to-noise ratio. The results of the study made it possible to reveal the possibility of the effect of FWM signals on useful signals in channels with spectral division multiplexing wavelength division multiplexing (WDM) in the downstream and upstream in a semiconductor optical amplifier. Based on the experimental results, it was concluded that FWM does not affect adjacent channels of WDM signals and does not generate additional optical noise when scaling the WDM gigabit passive optical network (GPON) up to 60 km using semiconductor optical amplifiers (SOAs).
Energy-efficient device-to-device communication in internet of things using hybrid optimization technique
Authors: M. Balakrishna Yashoda , Shivashetty Vrinda 
Published: June 2023

<span lang="EN-US">Device-to-device (D2D) communication has grown into notoriety as a critical component of the internet of things (IoT). One of the primary limitations of IoT devices is restricted battery source. D2D communication is the direct contact between the participating devices that improves the data rate and delivers the data quickly by consuming less battery. An energy-efficient communication method is required to enhance the communication lifetime of the network by reducing the node energy dissipation. The clustering-based D2D communication method is maximally acceptable to boom the durability of a network. The oscillating spider monkey optimization (OSMO) and oscillating particle swarm optimization (OPSO) algorithms are used in this study to improve the selection of cluster heads (CHs) and routing paths for D2D communication. The CHs and D2D communication paths are selected depending on the parameters such as energy consumption, distance, end-to-end delay, link quality and hop count. A simulation environment is designed to evaluate and test the performance of the OSMO-OPSO algorithm with existing D2D communication algorithms (such as the GAPSO-H algorithm, adaptive resource-aware split-learning (ARES), bio-inspired cluster-based routing scheme (Bi-CRS), and European society for medical oncology (ESMO) algorithm). The results proved that the proposed technique outperformed with respect to traditional routing strategies regarding latency, packet delivery, energy efficiency, and network lifetime.</span>
A profiling-based algorithm for exams’ scheduling problem
Authors: Alrawashdeh Tawfiq , Al-Moghrabi Khaldun G. , Al-Ghonmein Ali M. 
Published: June 2023

<span lang="EN-US">Typically, the problem of scheduling exams for universities aims to determine a schedule that satisfies logistics constraints, including the number of available exam rooms and the exam delivery mode (online or paper-based). The objective of this problem varies according to the university’s requirements. For example, some universities may seek to minimize operational costs, while others may work to minimize the schedule's length. Consequently, the objective imposed by the university affects the complexity of the problem. In this study, we present a grouping-based approach designed to address the problem of scheduling the exam timetable. The approach begins by profiling the courses’ exams based on their requirements, grouping exams with similar requirements to be scheduled at the same time. Then, an insertion strategy is used to obtain the exam schedule while satisfying the imposed constraints of the targeted university. We applied this approach to the problem of exam scheduling at Al-Hussein Bin Talal University in Jordan and achieved a balanced exam schedule that met all the imposed constraints.</span>