Age differentially modulates the cortical tracking of the lower and higher level linguistic structures during speech comprehension.

Speech comprehension requires listeners to rapidly parse continuous speech into hierarchically-organized linguistic structures (i.e. syllable, word, phrase, and sentence) and entrain the neural activities to the rhythm of different linguistic levels. Aging is accompanied by changes in speech processing, but it remains unclear how aging affects different levels of linguistic representation. Here, we recorded magnetoencephalography signals in older and younger groups when subjects actively and passively listened to the continuous speech in which hierarchical linguistic structures of word, phrase, and sentence were tagged at 4, 2, and 1 Hz, respectively. A newly-developed parameterization algorithm was applied to separate the periodically linguistic tracking from the aperiodic component. We found enhanced lower-level (word-level) tracking, reduced higher-level (phrasal- and sentential-level) tracking, and reduced aperiodic offset in older compared with younger adults. Furthermore, we observed the attentional modulation on the sentential-level tracking being larger for younger than for older ones. Notably, the neuro-behavior analyses showed that subjects' behavioral accuracy was positively correlated with the higher-level linguistic tracking, reversely correlated with the lower-level linguistic tracking. Overall, these results suggest that the enhanced lower-level linguistic tracking, reduced higher-level linguistic tracking and less flexibility of attentional modulation may underpin aging-related decline in speech comprehension.

Synergically regulated silver species and surface oxygen on manganese oxide for promoted activity of formaldehyde oxidation.

Formaldehyde (HCHO) is a common indoor pollutant that is detrimental to human health. Its efficient removal has become an urgent demand to reduce the public health risk. In this work, Ag-MnOx-based catalysts were prepared and activated under different atmosphere (i.e., air, hydrogen (H2) and carbon monoxide (CO)) for efficient oxidation of HCHO. The catalyst activated with CO (Ag/Mn-CO) displayed the highest activity among the tested samples with 90% conversion at 100°C under a gas space velocity of 75,000 mL/(gcat·hr). Complementary characterizations demonstrate that CO reduction treatment resulted in synergically regulated content of surface oxygen on support to adsorb/activate HCHO and size of Ag particle to dissociate oxygen to oxidize the adsorbed HCHO. In contrast, other catalysts lack for either abundant surface oxygen species or metallic silver with the appropriate particle size, so that the integrate activity is limited by one specific reaction step. This study contributes to elucidating the mechanisms regulating the oxidation activity of Ag-based catalysts.

Catalytic Oxidation Mechanism of Toluene over CexMn1-xO2: The Role of Oxygen Vacancies in Adsorption and Activation of Toluene.

Catalytic oxidation has been extensively studied as a promising technology for the removal of toluene from industrial waste gases and indoor air. However, the debate regarding the oxidation mechanism is far from resolved. CexMn1-xO2 catalysts with different mixing ratios are prepared by the sol-gel method and found to exhibit better catalytic activities for toluene oxidation than a single oxide. Characterizations and theoretical calculations reveal that the doped Mn increases the number of oxygen vacancies and the ability of oxygen vacancies to activate aromatic rings, which promotes the rate-determining step of toluene oxidation, i.e., ring-opening reactions. The oxidation products detected by in situ diffuse reflectance infrared Fourier transform spectroscopy (DRIFTS) and Vocus proton transfer reaction mass spectrometry (Vocus-PTR-MS) show that the doped Mn significantly improves the ring-opening efficiency and subsequently yields more short-chain products, such as pyruvic acid and acetic acid. A comprehensive oxidation pathway of toluene is refined in this work.

Electronic Modification by Transitional Metal Dopants to Tune the Oxidation Activity of Pt-CeO2-Based Catalysts.

While utilization of transitional metals as a promoter has been extensively studied to enhance the activity of Pt-based catalysts for the oxidation of formaldehyde (HCHO), there is still a lack of well elucidated property-function relationship for the rational selection of a promoter in catalyst design. Herein, we modified a Pt/CeO2 catalyst with two transitional metal dopants (i.e., Mn and Cu) that showed negligible influence on the physical structure of the Pt-CeO2 matrix but distinct effects on the activity of the catalyst. Complementary characterizations combined with density functional theory modeling revealed that the transitional metal dopants significantly modified the electronic structure of the catalyst and shifted the d-band of Pt to higher energy with different extents, which may tune the bonding strength of HCHO/intermediates with the Pt-CeO2 interface domain. The catalyst with moderate bonding strength (i.e., Pt-Mn/CeO2) displayed the highest reactivity under the ambient condition, while Pt-Cu/CeO2 with the highest bonding strength showed a dramatically decreased activity. No correlation was observed between the abundancy of the active oxygen and catalytic activity, likely due to the oxygen supply having a much higher rate than the rate-determining step. This work contributes to the elucidation about the property-function relationship of a transitional metal dopant in Pt-based catalysts for the oxidation of HCHO.

Survival Outcomes of Hemoperfusion and Hemodialysis versus Hemodialysis in Patients with End-Stage Renal Disease: A Systematic Review and Meta-Analysis.

BACKGROUND: The maintenance treatment of ESRD puts a great burden on individual patients, society, and the country of China as a whole. Hemoperfusion plus hemodialysis (HP + HD) in ESRD patients can yield modified outcomes such as prolonged life expectancy and improved dialysis quality and quality of life. This study aimed to systematically analyze the effect of HP + HD on the overall survival (OS) rates of ESRD patients and to provide support for clinical decision-making. METHODS: A computerized search was performed in the PubMed, Embase, Cochrane Library, CNKI, WanFang Data and SinoMed databases for relevant original research articles. Studies were included or excluded based on their compliance with predefined selection criteria. RESULTS: Twelve studies were included in the qualitative synthesis and quantitative synthesis (meta-analysis). The meta-analysis showed that the 1-year OS rate (odds ratio [OR]: 3.35, 95% CI: 1.89, 5.91, p < 0.05), 2-year OS rate (OR: 2.88, 95% CI: 1.84, 4.53, p < 0.05), and 5-year OS rate (χ2 = 4.3092, p < 0.05) of patients with ESRD treated with HP + HD were better than those treated with HD, but there was no significant difference in 3-year OS rate (OR: 1.97, 95% CI: 0.76, 5.06, p > 0.05). Subgroup analysis showed the same outcomes in different study designs (1-year OS rate: randomized controlled trials [RCTs]: OR: 4.38, 95% CI: 1.61, 11.88, p < 0.05; cohort studies: OR: 2.90, 95% CI: 1.44, 5.85, p < 0.05; 2-year OS rate: RCTs: OR: 2.99, 95% CI: 1.84, 4.84, p < 0.05) and different age-groups (1-year OS rate: 45-50 years: OR: 3.19, 95% CI: 1.55, 6.57, p < 0.05; 55-60 years: OR: 3.37, 95% CI: 1.07, 10.61, p < 0.05; 2-year OS rate: 50-55 years: OR: 2.86, 95% CI: 1.59, 5.16, p < 0.05: 60-65 years: OR: 4.41, 95% CI: 1.19, 16.30, p < 0.05). CONCLUSIONS: This meta-analysis suggests that the OS rates of ESRD patients treated with HP + HD were better than those of patients treated with HD. A speculative hypothesis for why this is the case may be that HP + HD can achieve the complementary elimination of metabolites, effectively preventing and treating complications caused by long-term dialysis and prolonging life expectancy. Therefore, HP + HD should be widely used in ESRD patients.

Quantitative proteomic analyses reveal that energy metabolism and protein biosynthesis reinitiation are responsible for the initiation of bolting induced by high temperature in lettuce (Lactuca sativa L.).

BACKGROUND: Lettuce (Lactuca sativa L.), one of the most economically important leaf vegetables, exhibits early bolting under high-temperature conditions. Early bolting leads to loss of commodity value and edibility, leading to considerable loss and waste of resources. However, the initiation and molecular mechanism underlying early bolting induced by high temperature remain largely elusive. RESULTS: In order to better understand this phenomenon, we defined the lettuce bolting starting period, and the high temperature (33 °C) and controlled temperature (20 °C) induced bolting starting phase of proteomics is analyzed, based on the iTRAQ-based proteomics, phenotypic measurement, and biological validation by RT-qPCR. Morphological and microscopic observation showed that the initiation of bolting occurred 8 days after high-temperature treatment. Fructose accumulated rapidly after high-temperature treatment. During initiation of bolting, of the 3305 identified proteins, a total of 93 proteins exhibited differential abundances, 38 of which were upregulated and 55 downregulated. Approximately 38% of the proteins were involved in metabolic pathways and were clustered mainly in energy metabolism and protein synthesis. Furthermore, some proteins involved in sugar synthesis were differentially expressed and were also associated with energy production. CONCLUSIONS: This report is the first to report on the metabolic changes involved in the initiation of bolting in lettuce. Our study suggested that energy metabolism and ribosomal proteins are pivotal components during initiation of bolting. This study could provide a potential regulatory mechanism for the initiation of early bolting by high temperature, which could have applications in the manipulation of lettuce for breeding.

Tuning Metal-Support Interaction of Pt-CeO2 Catalysts for Enhanced Oxidation Reactivity.

Metal-support interaction (MSI) has been widely recognized to be playing a pivotal role in regulating the catalytic activity of various reactions. In this work, the degree of MSI between Pt and CeO2 support was finely tuned by adjusting the activation condition, and the obtained catalysts were tested for the oxidative abatement of CO and HCHO under ambient conditions. The characterization of catalysts shows that activation of strongly interacting Pt-CeO2 at higher temperatures by H2 leads to a weaker MSI with increased electron density of Pt, and this modification of local electronic properties is demonstrated to result in enhanced O2 adsorption/activation to prevent the CO self-poisoning effect, while it abates the activity of CO adsorption/activation and oxidation of adsorbed CO. The Pt-CeO2 catalyst with a moderate MSI, which is able to balance each step in the catalytic cycle over Pt and Pt-CeO2 interface domains, displays the highest activity for CO/HCHO oxidation under ambient conditions.

Boronate affinity material-based sensors for recognition and detection of glycoproteins.

Glycoproteins are closely linked to the occurrence and development of many diseases. Therefore, it is of great importance to develop highly selective, sensitive, efficient detection methods for glycoproteins. To overcome the problems with traditional detections methods, such as mass spectrometry, chromatography-mass spectrometry, and enzyme-linked immunosorbent assay, boronate affinity material (BAM)-based sensors have developed rapidly for the specific recognition and detection of glycoproteins because of the advantages of pH-controlled binding/release, reversibility of the reaction, high specificity, and high selectivity, showing their wide application prospects. In recent years, there have been many significant leaps in the use of BAMs for sensing and detecting glycoproteins, but there are still many challenges and room for development. Therefore, this review critically investigates and summarizes recent advances with BAM-based sensors for glycoprotein detection. We focus on the common boronate affinity ligands of BAMs and their grafting methods, functional materials utilized in the synthesis of BAM-based sensors, advanced technologies, and applications. Finally, we propose the remaining challenges and future perspectives to accelerate the development of BAMs, and to utilize it for further developing versatile BAMs with a variety of promising applications.

Beneficial Phytochemicals with Anti-Tumor Potential Revealed through Metabolic Profiling of New Red Pigmented Lettuces (Lactuca sativa L.).

The present study aimed to compare polyphenols among red lettuce cultivars and identify suitable cultivars for the development and utilization of healthy vegetables. Polyphenols, mineral elements, and antioxidant activity were analyzed in the leaves of six red pigmented lettuce (Lactuca sativa L.) cultivars; thereafter, we assessed the anti-tumor effects of cultivar B-2, which displayed the highest antioxidant activity. Quadrupole-Orbitrap mass spectrometry analysis revealed four classes of polyphenols in these cultivars. The composition and contents of these metabolites varied significantly among cultivars and primarily depended on leaf color. The B-2 cultivar had the highest antioxidant potential than others because it contained the highest levels of polyphenols, especially anthocyanin, flavone, and phenolic acid; furthermore, this cultivar displayed anti-tumor effects against the human lung adenocarcinoma cell line A549, human hepatoma cell line Bel7402, human cancer colorectal adenoma cell line HCT-8, and HT-29 human colon cancer cell line. Hence, the new red-leaf lettuce cultivar B-2 has a distinct metabolite profile, with high potential for development and utilization of natural phytochemical and mineral resources in lettuces and can be used as a nutrient-dense food product.

Quantitative Proteomics Analysis of Lettuce (Lactuca sativa L.) Reveals Molecular Basis-Associated Auxin and Photosynthesis with Bolting Induced by High Temperature.

Bolting is a key process in the growth and development of lettuce (Lactuca sativa L.). A high temperature can induce early bolting, which decreases both the quality and production of lettuce. However, knowledge of underlying lettuce bolting is still lacking. To better understand the molecular basis of bolting, a comparative proteomics analysis was conducted on lettuce stems, during the bolting period induced by a high temperature (33 °C) and a control temperature (20 °C) using iTRAQ-based proteomics, phenotypic measures, and biological verifications using qRT-PCR and Western blot. The high temperature induced lettuce bolting, while the control temperature did not. Of the 5454 identified proteins, 619 proteins presented differential abundance induced by high-temperature relative to the control group, of which 345 had an increased abundance and 274 had a decreased abundance. Proteins with an abundance level change were mainly enriched in pathways associated with photosynthesis and tryptophan metabolism involved in auxin (IAA) biosynthesis. Moreover, among the proteins with differential abundance, proteins associated with photosynthesis and tryptophan metabolism were increased. These findings indicate that a high temperature enhances the function of photosynthesis and IAA biosynthesis to promote the process of bolting, which is in line with the physiology and transcription level of IAA metabolism. Our data provide a first comprehensive dataset for gaining novel understanding of the molecular basis underlying lettuce bolting induced by high temperature. It is potentially important for further functional analysis and genetic manipulation for molecular breeding to breed new cultivars of lettuce to restrain early bolting, which is vital for improving vegetable quality.

Dihydrochalcone Compounds Isolated from Crabapple Leaves Showed Anticancer Effects on Human Cancer Cell Lines.

Seven dihydrochalcone compounds were isolated from the leaves of Malus crabapples, cv. "Radiant", and their chemical structures were elucidated by UV, IR, ESI-MS, ¹H-NMR and (13)C-NMR analyses. These compounds, which include trilobatin (A1), phloretin (A2), 3-hydroxyphloretin (A3), phloretin rutinoside (A4), phlorizin (A5), 6''-O-coumaroyl-4'-O-glucopyranosylphloretin (A6), and 3'''-methoxy-6''-O-feruloy-4'-O-glucopyranosyl-phloretin (A7), all belong to the phloretin class and its derivatives. Compounds A6 and A7 are two new rare dihydrochalcone compounds. The results of a MTT cancer cell growth inhibition assay demonstrated that phloretin and these derivatives showed significant positive anticancer activities against several human cancer cell lines, including the A549 human lung cancer cell line, Bel 7402 liver cancer cell line, HepG2 human ileocecal cancer cell line, and HT-29 human colon cancer cell line. A7 had significant effects on all cancer cell lines, suggesting potential applications for phloretin and its derivatives. Adding a methoxyl group to phloretin dramatically increases phloretin's anticancer activity.

[Application of double-tagging in monitoring of tumorigenesis and tracking of mesenchymal stem cells in mice].

OBJECTIVE: To establish murine liver cancer cell line (Hepa1-6) and human mesenchymal stem cells (hMSCs) with dual-modality imaging lentiviral vector transfection and monitor the development of liver tumors and dynamically tracking of hMSCs by bioluminescent imaging in vivo. METHODS: The cell lines of Hepa 1-6 and hMSCs were constructed abd tranfected with RL-eGFP and FL2-mKate2 lentiviruses respectively. Then the eGFP(+)-Hepa1-6 and mKate2(+)-hMSCs cell lines were selected by fluorescence activated cell sorting (FACS). The bioluminescent imaging technology was employed to evaluate their bioluminescent abilities in vitro and in vivo. And the capacity of mKate2(+)-hMSCs migrating to HCC cell line (eGFP(+)-Hepa1-6) was evaluated by Transwell migration assay. RESULTS: DNA sequencing analysis confirmed that gene sequences of lentiviral vectors were correct without mutation. We successfully constructed the lentivirus vector, produced lentivirus and infected Hepa1-6 and hMSCs respectively. Subsequently eGFP(+)-Hepa1-6 cells and mKate2(+)-hMSCs were obtained by FACS. The expressions of fluorescent protein eGFP and mKate were confirmed by fluorescence microscope. By bioluminescent imaging system, bioluminescence intensity strongly correlated with cell number. The Transwell assay showed that hMSCs migrated toward heptocellular carcinoma (HCC) cells. CONCLUSION: A lentivirus vector has been successfully constructed for infecting Hepa1-6 and hMSCs and analyzed by fluorescence and bioluminescent imaging. And that makes it technically feasible to further monitor the interaction of hMSCs and liver tumor cells. These results provide rationales for further studying the mechanism of MSCs in the development and progression of HCC.

Cost effectiveness of implantable cardioverter defibrillators for 1.5 primary prevention of sudden cardiac arrest in China: an analysis from the Improve SCA study.

OBJECTIVES: Implantable cardioverter defibrillator (ICDs) for primary prevention (PP) of sudden cardiac arrest (SCA) is underutilized in developing countries. The Improve SCA study has identified a subset of 1.5 primary prevention (1.5PP) patients with a higher risk of SCA and a significant mortality benefit from ICD therapy. From the perspective of China's healthcare system, we evaluated the cost-effectiveness of ICD therapy vs. no ICD therapy among 1.5PP patients with a view to informing clinical and policy decisions. METHODS: A published Markov model was adjusted and verified to simulate the course of the disease and describe different health states of 1.5PP patients. The patient characteristics, mortality, utility and complication estimates were obtained from the Improve SCA study and other literature. Cost inputs were sourced from government tender prices, medical service prices and clinical experts' surveys in 9 Chinese public hospitals. For both ICD and no ICD therapy, the total medical costs and quality-adjusted life-years (QALYs) were modelled over a lifetime horizon and the incremental cost-effectiveness ratio (ICER) was calculated. Deterministic and probabilistic sensitivity analyses were performed to assess the uncertainty of the model parameters. We used the willingness-to-pay (WTP) threshold recommended by China Guidelines for Pharmacoeconomic Evaluations, one to three times China's GDP per capita (CNY85,698-CNY257,094) in 2022 Chinese Yuan. RESULTS: The incremental cost effectiveness ratio (ICER) of ICD therapy compared to no ICD therapy is 139,652 CNY/QALY, which is about 1-2 times China's GDP per capita. The probability that ICD therapy is cost effective was 92.1%. Results from sensitivity analysis supported the findings of the base case. CONCLUSIONS: ICD therapy compared to no ICD therapy is cost-effective for the 1.5PP patients in China.

Hexose/pentose ratio in rhizosphere exudates-mediated soil eutrophic/oligotrophic bacteria regulates the growth pattern of host plant in young apple-aromatic plant intercropping systems.

Introduction: The positive effect of intercropping on host plant growth through plant-soil feedback has been established. However, the mechanisms through which intercropping induces interspecific competition remain unclear. Methods: In this study, we selected young apple trees for intercropping with two companion plants: medium growth-potential Mentha haplocalyx Briq. (TM) and high growth-potential Ageratum conyzoides L. (TA) and conducted mixed intercropping treatment with both types (TMA) and a control treatment of monocropping apples (CT). Results: Our findings revealed that TM increased the under-ground biomass of apple trees and TA and TMA decreased the above-ground biomass of apple trees, with the lowest above-ground biomass of apple trees in TA. The above- and under-ground biomass of intercrops in TA and TMA were higher than those in TM, with the highest in TA, suggesting that the interspecific competition was the most pronounced in TA. TA had a detrimental effect on the photosynthesis ability and antioxidant capacity of apple leaves, resulting in a decrease in above-ground apple biomass. Furthermore, TA led to a reduction in organic acids, alcohols, carbohydrates, and hydrocarbons in the apple rhizosphere soil (FRS) compared to those in both soil bulk (BS) and aromatic plant rhizosphere soil (ARS). Notably, TA caused an increase in pentose content and a decrease in the hexose/pentose (C6/C5) ratio in FRS, while ARS exhibited higher hexose content and a higher C6/C5 ratio. The changes in exudates induced by TA favored an increase in taxon members of Actinobacteria while reducing Proteobacteria in FRS compared to that in ARS. This led to a higher eutrophic/oligotrophic bacteria ratio relative to TM. Discussion: This novel perspective sheds light on how interspecific competition, mediated by root exudates and microbial community feedback, influences plant growth and development.

Incorporation of Epoxy Carbon onto CeO2-Supported Pt to Tackle the CO Self-Poisoning Issue.

The catalytic oxidation of carbon monoxide (CO) under ambient conditions plays a crucial role in the abatement of indoor CO, which poses risks to human health. Despite the notable activity exhibited by Pt-based catalysts in CO oxidation, their efficacy is usually diminished by the CO self-poisoning issue. In this work, three different Pt/CeO2-based catalysts, which have distinct coordinative environments of Pt but an identical Pt/CeO2 substrate structure, were synthesized by activating the catalyst with CO using different temperatures and durations. Compared with clean and graphite-covered Pt on CeO2, the one modified by epoxy carbon showed higher activity and stability. The combination of characterizations and density functional theory modeling demonstrated that the clean Pt on CeO2 rapidly deactivated due to the CO self-poisoning albeit high initial activity, and conversely, low initial activity was observed for the more stable graphite-covered catalyst due to the obstruction of the Pt site. In contrast, epoxy carbon species on Pt shifted the d-band of Pt to lower energy, weakening the Pt-CO binding strength. Such a modification mitigated the self-poisoning effect while maintaining ample active sites and enabling the complete oxidative removal of CO under ambient conditions. This work may provide a general approach to tackling the self-poisoning issue.

The chromosome-level genome assembly of the dwarfing apple interstock Malus hybrid 'SH6'.

Malus hybrid 'SH6' (M. honanensis × M. domestica)is a commonly used apple interstock in China, known for its excellent dwarfing characteristics and cold tolerance. In this study, a combined strategy utilizing PacBio HiFi, Hi-C and parental resequencing data were employed to assemble two haploid genomes for 'SH6'. After chromosome anchoring, the final hapH genome size was 596.63 Mb, with a contig N50 of 34.38 Mb. The hapR genome was 649.37 Mb, with a contig N50 of 36.84 Mb. Further analysis predicted that repeated sequences made up 59.69% and 62.52% of the entire genome, respectively. Gene annotations revealed 45,435 genes for hapH and 48,261 genes for hapR. Combined with genomic synteny we suggest that the hapR genome originates from its maternal parent M. domestica cv. Ralls Janet, while the hapH genome comes from its paternal parent, M. honanensis. The assembled genome significantly contributes to the discovery of genes associated with apple dwarfing and the molecular mechanisms governing them.

A haplotype-resolved genome assembly of Malus domestica 'Red Fuji'.

The 'Red Fuji' apple (Malus domestica), is one of the most important and popular economic crops worldwide in the fruit industry. Using PacBio HiFi long reads and Hi-C reads, we assembled a high-quality haplotype-resolved genome of 'Red Fuji', with sizes of 668.7 and 668.8 Mb, and N50 sizes of 34.1 and 31.4 Mb. About 97.2% of sequences were anchored in 34 chromosomes. We annotated both haploid genomes, identifying a total of 95,439 protein-coding genes in the two haplotype genomes, with 98% functional annotation. The haplotype-resolved genome of 'Red Fuji' apple stands as a precise benchmark for an array of analyses, such as comparative genomics, transcriptomics, and allelic expression studies. This comprehensive resource is paramount in unraveling variations in allelic expression, advancing quality improvements, and refining breeding efforts.

Chromosomal level genome assemblies of two Malus crabapple cultivars Flame and Royalty.

Malus hybrid 'Flame' and Malus hybrid 'Royalty' are representative ornamental crabapples, rich in flavonoids and serving as the preferred materials for studying the coloration mechanism. We generated two sets of high-quality chromosome-level and haplotype-resolved genome of 'Flame' with sizes of 688.2 Mb and 675.7 Mb, and those of 'Royalty' with sizes of 674.1 Mb and 663.6 Mb, all anchored to 17 chromosomes and with a high BUSCO completeness score nearly 99.0%. A total of 47,833 and 47,307 protein-coding genes were annotated in the two haplotype genomes of 'Flame', and the numbers of 'Royalty' were 46,305 and 46,920 individually. The assembled high-quality genomes offer new resources for studying the origin and adaptive evolution of crabapples and the molecular basis of the accumulation of flavonoids and anthocyanins, facilitating molecular breeding of Malus plants.

Sleep disorders and risk of infertility: A meta-analysis of observational studies.

OBJECTIVE: The purpose of this study was to determine the relationship between sleep disorders and risk of infertility. METHOD: Three databases (PubMed, Embase, and Cochrane Library) were searched form their inception to April 30, 2023. Information of study design, control group and experimental group, number of participants, and study outcomes was extracted. The quality of the studies was evaluated using the Newcastle-Ottawa Scale (NOS scale) and the Agency for Healthcare Research and Quality (AHRQ scale). Narrative synthesis and meta-analysis were used to analyze these studies. RESULT: Eight cohort, cross-sectional, and case-control studies were considered. The reviewed studies were high-quality. Pooled analysis showed that the risk of infertility was 1.43-fold higher in patients with sleep disturbance (HR = 1.43, 95% CI, 0.97-2.11, z = 1.79), but this was not statistically different; the risk was 1.58-fold higher in patients with OSA compared to those without OSA (HR = 1.58, 95%, CI, 0.99-2.52, z = 1.91), but this was not statistically significant. Wake-up time is also associated with infertility (OR = 1.14; 95%CI = 1.01-1.28; P = 0.037). For every hour they stay awake beyond 8:00 AM, participants had a 41% higher risk of infertility (P = 0.004). The early-to-bed/late-to-rise (EL), LE, and LL groups had a higher risk of infertility than the EE group. CONCLUSION: The present study did not find an association between sleep disorders and the risk of infertility. Therefore, more observational studies are warranted to explore the association between sleep disorders and the risk of infertility.

Anti-amphiphysin encephalitis: Expanding the clinical spectrum.

Objective: An analysis of the clinical features of autoimmune encephalitis accompanied by anti-amphiphysin antibodies. Methods: The data of encephalitis patients with anti-amphiphysin antibodies were retrospectively evaluated, including demographics, neurological and laboratory findings, imaging, treatment, and prognostic predictions. Results: Ten patients aged between 29 and 78 years (median age 52 years) were included. The male: female ratio was 4:6. Limbic encephalitis was found in nine patients while epileptic seizures were present in seven patients. All patients showed anti-amphiphysin antibody positivity in sera while one ninth was positive for CSF antibody. The EEG findings were abnormal, including reductions in background activity, and the presence of diffuse slow waves, sharp waves, and spikes and waves. Five patients showed signs of increased T2 signals in the medial temporal lobe on MRI while PET showed either hyper- or hypo-metabolic changes in several brain regions, including the temporal lobe, hippocampus, basal ganglia, frontal and parietal cortices. Nine of ten patients were treated with immunotherapy, with improvements of varying degrees. There was a significant reduction in seizure frequency, and all patients were seizure-free at last follow-up. Conclusion: Autoimmune encephalitis with anti-amphiphysin antibodies has a variety of clinical manifestations. The most common symptom is limbic encephalitis. Although relief from seizures can be achieved relatively easily, many patients suffer psychiatric, cognitive, and sleep sequelae. The disease was found to be associated with a lower incidence of cancer than has been previously reported for paraneoplastic neurologic syndromes.