Exploring Reproductive Experiences With Women Enrolled in the International Vasculitis Pregnancy Registry.

OBJECTIVE: This study explored the reproductive journeys of women with vasculitis, including their conversations with healthcare providers, disease activity, medication changes, and delivery experiences. METHODS: Interviews were conducted with women registered in the Vasculitis Pregnancy Registry (VPREG), an online patient-reported registry of pregnant women with vasculitis. A team of physicians, patients, and qualitative researchers developed a qualitative interview guide. Participant responses were evaluated using thematic analysis. RESULTS: Eighteen patients with vasculitis who had experienced pregnancy were interviewed (10 antineutrophil cytoplasmic antibody-associated vasculitis, 4 Takayasu arteritis, 2 Behçet disease, 1 IgA vasculitis, 1 relapsing polychondritis). Thematic analysis revealed common experiences in the decision-making process during pregnancy planning, including accessing information from multiple sources, communicating with medical professionals, and changing treatment for vasculitis. Women sought information about vasculitis and pregnancy from various sources, including social media; however, opinions from their physicians and family members were most influential. Patients were more likely than providers to initiate conversations regarding family planning. Balancing differing opinions from subspecialists was challenging as many patients recalled acting as a liaison between multiple physicians during pregnancy. The need for self-advocacy was a common experience among patients. Most women had pregnancies that resulted in live births with delivery at term. CONCLUSION: When making decisions about pregnancy, women of reproductive age with vasculitis used multiple resources. Patients consistently valued their medical provider's opinion over alternative sources of information. To ensure comprehensive medical care, half of women relied on self-advocacy to coordinate communication among subspecialists. Most women had pregnancies that resulted in live births with delivery at term.

Reproductive Outcomes for Women With Vasculitis.

OBJECTIVE: There are limited data on the reproductive health of women with vasculitis. This study used a prospective, international vasculitis pregnancy registry to survey women during and after pregnancy. METHODS: The Vasculitis Pregnancy Registry (VPREG) is imbedded within the Vasculitis Patient-Powered Research Network, an international online research infrastructure. Any pregnant woman with a diagnosis of vasculitis can self-enroll. After enrollment, women are invited to complete online surveys at study entry, once per trimester, and postpartum. Descriptive statistics are reported here. RESULTS: Between 2015 and 2022, 147 women with 149 pregnancies enrolled in VPREG from 16 countries. Data on 78 pregnancies with known outcomes were included in this analysis. During pregnancy, women on average experienced low levels of pain related to vasculitis (scale 0-10, median 2 [IQR 1-5]) and preserved feelings of wellness (scale 0-10, median 3 [IQR 1-5]). Thirty-six percent of women reported their vasculitis was active during pregnancy. Of the 14 women requiring hospitalization during pregnancy outside of delivery, 4 cited active vasculitis as the indication. Most women (54/73, 74%) were prescribed medications for vasculitis during pregnancy. Seventy-six (97%) pregnancies resulted in live births, with 64% delivering vaginally and 21% experiencing a preterm delivery. CONCLUSION: These results demonstrate that most women with vasculitis can experience pregnancies that result in live births delivered at term. During pregnancy, a minority of women reported flares of vasculitis or the need for hospitalization due to vasculitis. These data are useful to rheumatologists and patients to inform and facilitate discussions about reproductive health and vasculitis.

SRD-1 in AWA neurons is the receptor for female volatile sex pheromones in C. elegans males.

Pheromones are critical cues for attracting mating partners for successful reproduction. Sexually mature Caenorhabditis remanei virgin females and self-sperm-depleted Caenorhabditis elegans hermaphrodites produce volatile sex pheromones to attract adult males of both species from afar. The chemoresponsive receptor in males has remained unknown. Here, we show that the male chemotactic behavior requires amphid sensory neurons (AWA neurons) and the G-protein-coupled receptor SRD-1. SRD-1 expression in AWA neurons is sexually dimorphic, with the levels being high in males but undetectable in hermaphrodites. Notably, srd-1 mutant males lack the chemotactic response and pheromone-induced excitation of AWA neurons, both of which can be restored in males and hermaphrodites by AWA-specific srd-1 expression, and ectopic expression of srd-1 in AWB neurons in srd-1 mutants results in a repulsive behavioral response in both sexes. Furthermore, we show that the C-terminal region of SRD-1 confers species-specific differences in the ability to perceive sex pheromones between C. elegans and C. remanei These findings offer an excellent model for dissecting how a single G-protein-coupled receptor expressed in a dimorphic neural system contributes to sex-specific behaviors in animals.

Control of Healthcare-Associated Carbapenem-Resistant Acinetobacter baumannii by Enhancement of Infection Control Measures.

Antimicrobial stewardship and infection control measures are equally important in the control of antimicrobial-resistant organisms. We conducted a retrospective analysis of the incidence rate of hospital-onset carbapenem-resistant Acinetobacter baumannii (CRAB) infection (per 1000 patient days) in the Queen Mary Hospital, a 1700-bed, university-affiliated teaching hospital, from period 1 (1 January 2007 to 31 December 2013) to period 2 (1 January 2014 to 31 December 2019), where enhanced infection control measures, including directly observed hand hygiene before meal and medication rounds to conscious patients, and the priority use of single room isolation, were implemented during period 2. This study aimed to investigate the association between enhanced infection control measures and changes in the trend in the incidence rate of hospital-onset CRAB infection. Antimicrobial consumption (defined daily dose per 1000 patient days) was monitored. Interrupted time series, in particular segmented Poisson regression, was used. The hospital-onset CRAB infection increased by 21.3% per year [relative risk (RR): 1.213, 95% confidence interval (CI): 1.162−1.266, p < 0.001], whereas the consumption of the extended spectrum betalactam-betalactamase inhibitor (BLBI) combination and cephalosporins increased by 11.2% per year (RR: 1.112, 95% CI: 1.102−1.122, p < 0.001) and 4.2% per year (RR: 1.042, 95% CI: 1.028−1.056, p < 0.001), respectively, in period 1. With enhanced infection control measures, the hospital-onset CRAB infection decreased by 9.8% per year (RR: 0.902, 95% CI: 0.854−0.953, p < 0.001), whereas the consumption of the extended spectrum BLBI combination and cephalosporins increased by 3.8% per year (RR: 1.038, 95% CI: 1.033−1.044, p < 0.001) and 7.6% per year (RR: 1.076, 95% CI: 1.056−1.097, p < 0.001), respectively, in period 2. The consumption of carbapenems increased by 8.4% per year (RR: 1.84, 95% CI: 1.073−1.094, p < 0.001) in both period 1 and period 2. The control of healthcare-associated CRAB could be achieved by infection control measures with an emphasis on directly observed hand hygiene, despite an increasing trend of antimicrobial consumption.

Comparing a ciliate and a fish cell line for their sensitivity to several classes of toxicants by the novel application of multiwell filter plates to Tetrahymena.

Although ciliated protozoa such as Tetrahymena have many desirable properties as toxicological test organisms, their attributes would be better realized if multiple cultures could be simultaneously exposed to toxicants, quickly washed to terminate toxicant exposure, and conveniently evaluated for changes in cellular functions. Therefore, multiwell filter plates (MWFPs), manufactured primarily for biochemical applications, were used to expose Tetrahymena thermophila to copper, Triton X-100, and gliotoxin and compared to results of exposure in microcentrifuge tubes (MCTs). For MWFP, removal of toxicant solutions and retention of Tetrahymena in wells was done by placing plates on a manifold and applying pressure with a vacuum pump. Retained cells were resuspended in the same wells and their functions assessed with the fluorescent indicator dyes, Alamar blue to measure energy metabolism, and 5'-carboxyfluorescein diacetate acetoxymethyl ester to evaluate membrane integrity. For MCTs, exposures were terminated by centrifugation, and resuspended Tetrahymena were transferred to conventional multiwell plates for viability assessment with the same fluorescent dyes. Results were measured with a fluorescent multiwell plate reader and dose-response curves were obtained successfully with both procedures. However, MWFPs were much more convenient and rapid, potentially allowing 96 cultures to be processed at a time. Exposing Tetrahymena in MWFPs also allowed the ciliate and a rainbow trout gill cell line, RTgill-W1, to be compared for their sensitivity to toxicants under similar conditions of exposure and by common viability assays. Both cell systems showed toxic responses to Triton X-100 and copper at similar concentrations, but RTgill-W1 was more sensitive to gliotoxin.

Cosuppression of the chloroplast localized molecular chaperone HSP90.5 impairs plant development and chloroplast biogenesis in Arabidopsis.

BACKGROUND: HSP90.5 is a chloroplast localized HSP90 family molecular chaperone in Arabidopsis, and it has been implicated in plant abiotic stress resistance, photomorphogenesis and nuclear-encoded protein import into the chloroplast. However, how these processes are controlled by HSP90 is not well understood. To understand the role of HSP90.5 in chloroplast function and biogenesis, in this study, we generated transgenic Arabidopsis plants that overexpress a C-terminally FLAG-tagged HSP90.5. By characterizing three HSP90.5 cosuppression lines, we demonstrated the essential role of HSP90.5 in plant growth and chloroplast biogenesis. RESULTS: Immunoblotting and quantitative PCR analyses revealed three independent HSP90.5 cosuppressing transgenic lines. All three cosuppression lines displayed a certain degree of variegated phenotype in photosynthetic tissues, and the cosuppression did not affect the expression of cytosolic HSP90 isoforms. HSP90.5 cosuppression was shown to be developmentally regulated and occurred mostly at late developmental stage in adult leaves and inflorescence tissues. HSP90.5 cosuppression also caused significantly reduced rosette leaf growth, transient starch storage, but did not affect rosette leaf initiation or inflorescence production, although the fertility was reduced. Isolation of chloroplasts and size exclusion chromatography analysis indicated that the FLAG at the HSP90.5 C-terminus does not affect its proper chloroplast localization and dimerization. Finally, transmission electron microscopy indicated that chloroplast development in HSP90.5 cosuppression leaves was significantly impaired and the integrity of chloroplast is highly correlated to the expression level of HSP90.5. CONCLUSION: We thoroughly characterized three HSP90.5 cosuppression lines, and demonstrated that properly controlled expression of HSP90.5 is required for plant growth and development in many tissues, and especially essential for chloroplast thylakoid formation. Since the homozygote of HSP90.5 knockout mutant is embryonically lethal, this study provides transgenic lines that mimic the conditional knockout line or siRNA line of the essential HSP90.5 gene in Arabidopsis.