A Novel Pollen-Pistil Interaction Conferring High-Temperature Tolerance during Reproduction via CLE45 Signaling

SummaryFlowering plants in the reproductive stage are particularly vulnerable to ambient temperature fluctuations [1–6]. Nevertheless, they maintain seed production under certain levels of exposure to temperature change. The mechanisms underlying this temperature tolerance are largely unknown. Using an in vitro Arabidopsis pollen tube culture, we found that a synthetic CLV3/ESR-related peptide, CLE45, prolonged pollen tube growth. A subsequent screen of Arabidopsis mutants of leucine-rich repeat receptor-like kinase genes identified two candidate receptors for CLE45 peptide, STERILITY-REGULATING KINASE MEMBER1 (SKM1) and SKM2. The double loss-of-function mutant was insensitive to CLE45 peptide in terms of pollen tube growth in vitro. The SKM1 protein actually interacted with CLE45 peptide. CLE45 was preferentially expressed in the stigma in the pistil at 22°C, but upon temperature shift to 30°C, its expression expanded to the transmitting tract, along which pollen tubes elongated. In contrast, both SKM1 and SKM2 were expressed in pollen. Disturbance of CLE45-SKM1/SKM2 signaling transduction by either RNAi suppression of CLE45 expression or introduction of a kinase-dead version of SKM1 into skm1 plants reduced seed production at 30°C, but not at 22°C. Taken together with the finding that CLE45 peptide application alleviated mitochondrial decay during the in vitro pollen tube culture, these results strongly suggest that the pollen-pistil interaction via the CLE45-SKM1/SKM2 signaling pathway sustains pollen performance under higher temperatures, leading to successful seed production

Psychiatric comorbidities in patients with Atypical Odontalgia

Objective: Atypical Odontalgia (AO) is a condition characterized by tooth pain with no apparent cause. Although psychiatric comorbidity seems to be very common, it has rarely been studied. To clarify the influence of psychiatric comorbidity on the clinical features in patients with AO, we retrospectively evaluated their examination records. Methods: Clinical features and psychiatric diagnoses of 383 patients with AO were investigated by reviewing patients' medical records and referral letters. Psychiatric diagnoses were categorized according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). We also analyzed visual analogue scale (VAS), self-rating depression scale (SDS), and the short-form McGill pain questionnaire (SF-MPQ) scores. Results: Of the 383 patients with AO, 177 (46.2%) had comorbid psychiatric disorders. The most common were depressive disorders (15.4%) and anxiety disorders (10.1%). Serious psychotic disorders such as bipolar disorder (3.0%) and schizophrenia (1.8%) were rare. Dental trigger of AO was reported in 217 (56.7%) patients. There were no significant correlations between psychiatric comorbidities and most of the demographic features. Higher VAS and SDS scores, higher frequency of sleep disturbance, and higher ratings of “Fearful” and “Punishing-cruel” descriptors of the SF-MPQ were found in patients with psychiatric comorbidity. Conclusions: About half of AO patients had comorbid psychiatric disorders. Dental procedures are not necessarily causative factors of AO. In AO patients with comorbid psychiatric disorders, pain might have a larger emotional component than a sensory one. VAS, SDS, and SF-MPQ scores might aid in the noticing of underlying comorbid psychiatric disorders in AO patients

The effect of in-bed leg cycling exercises on muscle strength in patients with intensive care unit-acquired weakness: a single-center retrospective study

Objective: To examine the effect of in-bed leg cycling exercise on patients with intensive care unit-acquired weakness (ICU-AW). Design: Single-center retrospective study. Subjects/Patients: Patients admitted to the ICU between January 2019 and March 2023 were enrolled in the ergometer group, and those admitted to the ICU between August 2017 and December 2018 were enrolled in the control group. Methods: The ergometer group performed in-bed leg cycling exercises 5 times per week for 20 min from the day of ICU-AW diagnosis. Furthermore, the ergometer group received 1 early mobilization session per day according to the early mobilization protocol, whereas the control group received 1 or 2 sessions per day. The number of patients with recovery from ICU-AW at ICU discharge and improvement in physical functions were compared. Results: Significantly more patients in the ergometer group recovered from ICU-AW than in the control group (87.0% vs 60.6%, p = 0.039). Regarding physical function, the ergometer group showed significantly higher improvement efficiency in Medical Research Council sum score (1.0 [0.7–2.1] vs 0.1 [0.0–0.2], p < 0.001). Conclusion: In-bed leg cycling exercise, in addition to the early mobilization protocol, reduced the number of patients with ICU-AW at ICU discharge

Interatrial conduction time is associated with left atrial low voltage area and predicts the recurrence after single atrial fibrillation ablation

Abstract Background Interatrial conduction time (IACT) prolongs in fibrotic left atrium. We tested the hypothesis that IACT is related to left atrial low voltage area (LVA) and predicts the recurrence after single atrial fibrillation (AF) ablation. Methods One hundred sixty‐four consecutive AF patients (79 non‐paroxysmal) who underwent initial ablation in our institute were analyzed. IACT and LVA were defined as interval from the onset of P‐wave to the basal left atrial appendage (P‐LAA) activation, and area with bipolar electrogram < 0.5 mV covering over 5% of the total left atrial surface area during sinus rhythm, respectively. Pulmonary vein antrum isolation, non‐PV foci ablation, and atrial tachycardia (AT) ablation were performed without substrate modification. Results LVA was frequently identified in patients with prolonged P‐LAA ≥ 84 ms (n  = 28) compared with patients with P‐LAA < 84 ms (n  = 136). Patients with P‐LAA ≥ 84 ms were older (71 ± 10 vs. 65 ± 10 years, p  = .0061), and had more frequent non‐paroxysmal AF (75% vs. 43%, p  = .0018), larger left atrial diameter (43.5 ± 4.5 vs. 39.3 ± 5.7 mm, p  = .0003), and higher E/e’ ratio (14.4 ± 6.5 vs. 10.5 ± 3.7, p  < .0001) compared with P‐LAA < 84 ms patients. After a mean follow‐up period of 665 ± 153 days, Kaplan–Meier curve analysis showed that AF/AT recurrences was more frequently observed in patients with prolonged P‐LAA (Log‐rank p  = .0001). Additionally, univariate analysis revealed that P‐LAA prolongation (OR = 1.055 per 1 ms, 95% CI: 1.028–1.087, p  < .0001) and the existence of LVA (OR = 5.000, 95% CI: 1.653–14.485 p  = .0053) were predictors of AF/AT recurrences after single AF ablation. Conclusions Our results suggested that prolonged IACT as measured by P‐LAA was associated with LVA and predicts AT/AF recurrence after single AF ablation

Are simple verbal instructions sufficient to ensure that bladder volume does not deteriorate prostate position reproducibility during spot scanning proton therapy?

Objectives:The purpose of this study is to investigate whether verbal instructions are sufficient for bladder volume (BV) control not to deteriorate prostate position reproducibility in image-guided spot scanning proton therapy (SSPT) for localized prostate cancer.Methods:A total of 268 treatment sessions in 12 consecutive prostate cancer patients who were treated with image-guided SSPT with fiducial markers were retrospectively analyzed. In addition to strict rectal volume control procedures, simple verbal instructions to void urine one hour before the treatment were used here. The BV was measured by a Bladder Scan just before the treatment, and the prostate motion was measured by intraprostatic fiducial markers and two sets of X-ray fluoroscopy images. The correlation between the BV change and prostate motion was assessed by linear mixed-effects models and systematic and random errors according to the reproducibility of the BV.Results:The mean absolute BV change during treatment was from ?98.7 to 86.3 ml (median 7.1 ml). The mean absolute prostate motion of the patients in the left-right direction was ?1.46 to 1.85 mm; in the cranial-caudal direction it was ?6.10 to 3.65 mm, and in the anteroposterior direction ?1.90 to 5.23 mm. There was no significant relationship between the BV change and prostate motion during SSPT. The early and late genitourinary and gastrointestinal toxicity was minimal with a minimum follow up of 4.57 years.Conclusions:Simple verbal instructions about urination was suggested to be sufficient to control the BV not to impact on the prostate motion and clinical outcomes in image-guided SSPT. Careful attention to BV change is still needed when the seminal vesicle is to be treated.Advances in knowledge:Our data demonstrated that there was no apparent relationship between BV changes and prostate position reproducibility and simple verbal instruction about urination could be sufficient for image-guided SSP

Multiple accessory pathways coexisting with a persistent left superior vena cava: a case report

Abstract Background Wolff–Parkinson–White syndrome is characterized by a short PR interval (delta-wave), long QRS complex, and the appearance of paroxysmal supraventricular tachycardia. Patients with Wolff–Parkinson–White syndrome usually have one accessory pathway, whereas cases with multiple accessory pathways are rare. Persistent left superior vena cava is a vascular anomaly in which the vein drains into the right atrium through the coronary sinus at the junction of the left internal jugular and subclavian veins due to abnormal development of the left cardinal vein. The simultaneous presence of multiple accessory pathways and persistent left superior vena cava has not been reported before. Case presentation A 56-year-old Japanese man with a 5-year history of palpitations was referred for radiofrequency catheter ablation due to increased frequency of tachycardia episodes in the previous 2 months. Persistent left superior vena cava was confirmed by transthoracic echocardiography and computed tomography. An electrophysiological study revealed that the accessory pathways were located in the left lateral wall, anterolateral wall, and posteroseptal region. They were completely ablated with radiofrequency energy application. Conclusions We reported an extremely rare case of a patient with multiple accessory pathways and persistent left superior vena cava. Our case may suggest a potential embryological relationship between the multiple accessory pathways and persistent left superior vena cava