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INTRODUCTION: Fellowship directors (FDs) hold significant leadership roles within the academic urology community. We sought to characterize common trends in training and academic productivity among urology FDs. Moreover, we aimed to characterize gender differences across subspecialties to better inform gender-based inclusion efforts and contemporary leadership pathways. METHODS: FDs were studied across 6 urologic subspecialties. Society and institutional websites were queried for demographics, education/training institutions, timelines of career milestones, and academic productivity. χ2, Mann-Whitney U, and Kruskal-Wallis tests and Kendall tau rank correlation were employed with an alpha cutoff of .05. RESULTS: There were 219 FDs included, representing 208 fellowship programs at 93 institutions. FDs were 176 (80%) males and 43 (20%) females. There was a significant association between gender and subspecialty. The median age for all FDs was 52 years old. Significant differences in age were demonstrated across subspecialties. For all FDs, females were younger than males, at 49 and 53 years, respectively (P = .001). The median H-index for all FDs was 23.5. H-index was significantly different between genders and subspecialities. There was a strong, positive correlation between age vs H-index for all FDs. Half of FDs had completed fellowship training at one of 14 institutions. CONCLUSIONS: We describe the landscape of leadership in urology subspecialty training. There are an increasing number of female FDs. Composition of leadership varies by subspecialty; however, the careers of all current urology FDs are marked by lifelong achievements in academic productivity. Moreover, a small group of institutions produce a substantial number of FDs.
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Urologia , Humanos , Masculino , Feminino , Estados Unidos , Pessoa de Meia-Idade , Urologia/educação , Bolsas de Estudo , Fatores Sexuais , Liderança , DemografiaRESUMO
Genome-wide association studies (GWAS) are among the genetic tools for the mining of genomic loci associated with useful agronomic traits. The study enabled us to find new genetic markers associated with grain yield as well as quality. The sample under study consisted of spring wheat cultivars developed in different decades of the last century. A panel of 186 accessions was evaluated at VIR's experiment station in Pushkin across a 3-year period of field trials. In total, 24 SNPs associated with six productivity characteristics were revealed. Along with detecting significant markers for each year of the field study, meta-analyses were conducted. Loci associated with useful yield-related agronomic characteristics were detected on chromosomes 4A, 5A, 6A, 6B, and 7B. In addition to previously described regions, novel loci associated with grain yield and quality were identified during the study. We presume that the utilization of contrast cultivars which originated in different breeding periods allowed us to identify new markers associated with useful agronomic characteristics.
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To reveal genetic diversity for effective resistance to five foliar diseases and toxic aluminum ions, the entire collection of wheat species from the N.I. Vavilov All-Russian Institute of Plant Genetic Resources (VIR) originating from Ethiopia and Eritrea were studied regarding their traits. The collection contains 509 samples of four wheat species (Triticum aestivum-122 samples; T. aethiopicum-340 samples; T. polonicum-6 samples; and T. dicoccum-41 samples). The majority of accessions are new entries of landraces added to the Vavilov collection as a result of the Russian-Ethiopian expedition in 2012. Wheat seedlings were inoculated with causal agents of leaf rust (Pt), powdery mildew (Bgt), Septoria nodorum blotch (SNB), and dark-brown leaf spot blotch (HLB). The types of reaction and disease development were assessed to describe the levels of resistance. All samples of T. aethiopicum were also screened for seedling and adult resistance to Pt, Bgt, and yellow rust (Pst) under field conditions after double inoculation with the corresponding pathogens. To study tolerance to abiotic stress, seedlings were grown in a solution of Al3+ (185 µM, pH 4,0) and in water. The index of root length was used to characterize tolerance. Seedlings belonging to only two accessions out of those studied-k-68236 of T. aethiopicum and k-67397 of T. dicoccum-were resistant to Pt at 20 °C but susceptible at 25 °C. Specific molecular markers closely linked to the five genes for Pt resistance effective against populations of the pathogen from the northwestern region of Russia were not amplified in these two entries after PCR with corresponding primers. Four entries of T. dicoccum-k-18971, k-18975, k-19577, and k-67398-were highly resistant to Bgt. All samples under study were susceptible to HLB and SNB. Under field conditions, 15% of the T. aethiopicum samples were resistant to Pst, both at the seedling and the flag leaf stages, but all were susceptible to the other diseases under study. Among the evaluated samples, 20 entries of T. aestivum, 1 of T. polonicum (k-43765), and 2 of T. dicoccum (k-18971, k-67397) were tolerant to aluminum ions. The identified entries could be valuable sources for the breeding of T. aestivum and other wheats for resistance to biotic and abiotic stresses.
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Silent myocardial infarction (SMI) is a type of myocardial infarction (MI) that is asymptomatic or demonstrates mild symptoms; therefore, patients often do not seek medical treatment. SMI cases are often incidentally detected later by electrocardiogram (ECG). We present a case of a 59-year-old overweight woman with prediabetes, primary hypertension, and hypercholesterolemia who presented for herpes zoster (HZ) follow-up; she reported having skipped heartbeats and heart rate fluctuations during the review of systems. On further workup, ECG revealed low voltage QRS complexes, flat QRS complexes, flat T waves, and pathological Q waves, suggesting the diagnosis of SMI. Based on the identified risk factors, including high BMI, prediabetes, primary hypertension, hypercholesterolemia, HZ, and newly diagnosed SMI, the patient was advised to continue with lisinopril 20 mg daily, prescribed atorvastatin 80 mg daily, and was educated about maintaining a healthy diet, exercise, and receiving the shingles vaccination. To prevent the possible risks of poor outcomes such as those following MI, stroke, heart failure, arrhythmias, angina, and shortness of breath (SOB), the patient was referred to the cardiologist for a stress test and further treatment plan.
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Introduction Obstetrical research confirms that earlier onset prenatal care significantly improves pregnancy and birth outcomes. Initiating care in the second trimester or having less than 50% of recommended visits has been associated with an increased risk of prematurity, stillbirth, neonatal, and infant death. Studies have shown that women on public health insurance plans initiate prenatal care substantially later into pregnancy than those on private plans. The purpose of this study is to assess whether public health insurance limits Florida patients' access to obstetric care. Methods A cross-sectional study was conducted by collecting data on the four most populated zip codes for Medicaid in South Florida using HealthGrades.com. The following search parameters were used: "obstetric care", "four stars and up" and "10-mile distance". Each obstetrician was called three times to assess appointment availability for fictional nulliparous women at eight weeks of gestation requesting prenatal care. Accepted insurance types (Medicaid, Cigna, and United Health Group (UHG)), time to an appointment in business days, and self-pay rates were recorded. Practices with invalid contact information and retired obstetricians were excluded. Summary statistics, chi-squared analysis, and a two-way t-test were conducted for the primary outcome. Results Seventy-one out of 178 obstetricians were successfully contacted, of which 31 physicians accepted all three insurances, and 40 physicians did not accept at least one insurance. Of those, 97.2% accepted UnitedHealthcare, 98.6% accepted Cigna, and 45.1% accepted Medicaid. There was a statistically significant difference when comparing acceptance rates between UHC and Medicaid as well as Cigna and Medicaid (p<0.001). There was no statistically significant difference in acceptance rates in the direct comparison of the two private insurances, Cigna and UnitedHealthcare (p=0.559). The average number of days until the next available appointment was 12.7 (SD= 7.2) for UnitedHealthcare, 20.0 (SD=6.7) for Cigna, and 17.0 (SD=8.6) for Medicaid. There was a statistically significant trend between the type of insurance and the time to the earliest appointment (p=0.002). Conclusion This study demonstrated patients enrolled in Medicaid in South Florida have significantly less access to prenatal care than those with private insurance. This evidence shows that decreased access to care from Medicaid plans can possibly increase the risk of adverse outcomes associated with inadequate prenatal care. This information should be considered by policymakers when considering future Medicaid expansion.
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To identify new sources of effective resistance to four foliar diseases of wheat, 173 accessions of four wheat species, Triticum boeoticum, T. urartu, T. araraticum, and T. dicoccoides, from the VIR collection were tested at the juvenile and adult growth stages for resistance to leaf rust (Pt = Puccinia triticina), powdery mildew (Bgt = Blumeria graminis tritici), Septoria nodorum blotch (SNB), and dark-brown leaf spot blotch (HLB = Helminthospjrium leaf blotch). The accessions included new additions to the collection, some old samples that had never been tested before, as well as earlier tested samples noted for high levels of juvenile resistance to some fungal diseases. Natural populations of Puccinia triticina and Blumeria graminis f. sp. tritici, mixture of Parastagonospora nodorum and Bipolaris sorokiniana isolates were used to inoculate and to evaluate resistance to Pt, Bgt, SNB, and HLB, respectively. Two samples of T. boeoticum, three of T. urartu, and one of T. araraticum were resistant to leaf rust at both tested stages. Further tests (phytopathological and molecular analyses) excluded Lr9, Lr19, Lr24, Lr41, or Lr47 as single genes controlling resistance; hence, these accessions likely carry new effective leaf rust resistance genes. High level of Bgt resistance was identified in three entries of T. boeoticum, one of T. araraticum, and eleven of T. dicoccoides. All tested accessions were susceptible to HLB and SNB at both tested stages. Accessions identified as resistant are valuable plant material for introgressive hybridization in bread and durum wheat breeding. The results are discussed in the context of N.I. Vavilov's concept of crop origin and diversity, and the laws of plant natural immunity to infectious diseases.