Perceived Value of a Women's Health Journal Club in Rural Hawai'i.

OBJECTIVES: Rural Hawai'i faces a shortage of physicians specializing in women's health. Improving clinician collaboration and access to the scientific literature are potential strategies for improving physician retention in this community. In 2021, a monthly women's health journal club was established for local clinicians and trainees on Hawai'i Island. Although journal clubs are common in large academic institutions, there are limited data regarding the value of journal clubs in rural and community practices. This study aimed to evaluate the value of a women's health journal club on Hawai'i Island. METHODS: We used an anonymous Web-based survey to evaluate the value of the journal club. RESULTS: Of the 18 eligible clinicians participating in the women's health journal club, 13 completed a Web-based survey (response rate 72%). The common reasons for attending journal club included wanting to learn about research methods/statistics (100%), seeking opportunities to discuss current best practices (86%), and desiring to practice critical review skills (71%). The majority of respondents (77%) believed that journal club was a valuable activity, and 92% of respondents would recommend this activity to a colleague. This journal club allowed participants to improve their understanding of research methods (85%) and stay up-to-date with medical advancements (85%). CONCLUSIONS: This community-based journal club is a valuable activity for clinicians practicing on Hawai'i Island. Other rural communities may similarly benefit from engaging in structured scholarly discussion.

RIG-I and MDA5 are modulated by bone morphogenetic protein (BMP6) and are essential for restricting Zika virus infection in human Sertoli cells.

Sexual transmission of Zika virus (ZIKV) is associated with virus persistence in the testes and shedding in the seminal fluid for months after recovery. We previously demonstrated that ZIKV can establish long-term replication without causing cytotoxicity in human Sertoli cells (SC), responsible for maintaining the immune privileged compartment of seminiferous tubules. Functional gene expression analyses also predicted activation of multiple virus sensing pathways including TLR3, RIG-I, and MDA5. Here, we elucidated which of the RNA virus sensing receptors play a decisive role in restricting ZIKV replication. We show that both poly I:C and IFN-ß treatment induced a robust antiviral state and reduced ZIKV replication significantly, suggesting that virus sensing and antiviral signaling are functional in SC. Silencing of TLR3, 7, and 9 did not affect virus replication kinetics; however, both RIG-I and MDA5 played a synergistic role in inducing an anti-ZIKV response. Further, the impact of SC-specific immunosuppressive pathways that collectively regulate SC function, specifically the TGF-ß superfamily members, TGF-ß, Activin A, and BMP6, on ZIKV replication was investigated. While ZIKV did not modulate the expression of TGF-ß and Activin A, BMP6 signaling was suppressed at later stages of infection. Notably, treatment with BMP6 increased IFN-ß, p-IRF3, and p-STAT1 levels, and expression of key interferon-stimulated genes including MDA5, suggesting that BMP6 enhances antiviral response in SC. Collectively, this study further delineates the key role of the RIG-I-like receptors in sensing ZIKV in SC, and reveals a novel role of BMP6 in modulating innate immune and antiviral response in the testes.