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1.
Urology ; 187: 49-54, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38431159

RESUMO

MATERIALS AND METHODS: An Institutional Review Board-exempt REDCap survey was distributed through the Society of Academic Urologists to all 508 applicants registered for the 2023 Urology Match following the rank list submission deadline on January 10, 2023. The survey closed on February 1, 2023. Responses were anonymized, aggregated, and characterized using descriptive statistics. Thematic mapping of open text comments was performed by 2 reviewers. RESULTS: The response rate was 42% (215/508). Eighty-eight percent of respondents disapproved of the Dobbs ruling. Twenty percent of respondents (15% male/24% female) eliminated programs in states where abortion is illegal. Fifty-nine percent (51% male/70% female) would be concerned for their or their partner's health if they matched in a state where abortion was illegal, and 66% (55% male/82% female) would want their program to assist them or their partner if they required abortion care during residency. Due to the competitive nature of Urology, 68% of applicants reported feeling at least somewhat obligated to apply in states where abortion legislation conflicts with their beliefs. Of the 65 comments provided by respondents, 4 common themes emerged: (1) avoidance of states with restrictive abortion laws; (2) inability to limit applications because of the competitiveness of urology; (3) impacts on personal health care; and (4) desire for advocacy from professional urology organizations. CONCLUSION: The Dobbs ruling will impact the urology workforce by affecting urology applicants' decision-making regarding residency selection and ranking. Although the competitiveness of the Urology Match pressures applicants to apply broadly, many are taking reproductive health care access into consideration.


Assuntos
Urologia , Feminino , Humanos , Masculino , Urologia/educação , Estados Unidos , Inquéritos e Questionários , Tomada de Decisões , Adulto , Internato e Residência/estatística & dados numéricos , Aborto Induzido/legislação & jurisprudência , Aborto Induzido/estatística & dados numéricos
2.
Front Endocrinol (Lausanne) ; 13: 1011689, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36440232

RESUMO

Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous endocrine-disrupting combustion by-products that have been linked to preterm birth. One possible mechanism is through disruption of placental corticotropin releasing hormone (pCRH), a key hormone implicated in parturition. As an extension of recent research identifying pCRH as a potential target of endocrine disruption, we examined maternal PAH exposure in relation to pCRH in a large, diverse sample. Participants, drawn from the CANDLE cohort, part of the ECHO-PATHWAYS Consortium, completed study visits at 16-29 weeks (V1) and 22-39 weeks (V2) gestation (n=812). Seven urinary mono-hydroxylated PAH metabolites (OH-PAHs) were measured at V1 and serum pCRH at V1 and V2. Associations between individual log-transformed OH-PAHs (as well as two summed PAH measures) and log(pCRH) concentrations across visits were estimated using mixed effects models. Minimally-adjusted models included gestational age and urinary specific gravity, while fully-adjusted models also included sociodemographic characteristics. We additionally evaluated effect modification by pregnancy complications, fetal sex, and maternal childhood trauma history. We observed associations between 2-OH-Phenanthrene (2-OH-PHEN) and rate of pCRH change that persisted in fully adjusted models (ß=0.0009, 0.00006, 0.0017), however, positive associations with other metabolites (most notably 3-OH-Phenanthrene and 1-Hydroxypyrene) were attenuated after adjustment for sociodemographic characteristics. Associations tended to be stronger at V1 compared to V2 and we observed no evidence of effect modification by pregnancy complications, fetal sex, or maternal childhood trauma history. In conclusion, we observed modest evidence of association between OH-PAHs, most notably 2-OH-PHEN, and pCRH in this sample. Additional research using serial measures of PAH exposure is warranted, as is investigation of alternative mechanisms that may link PAHs and timing of birth, such as inflammatory, epigenetic, or oxidative stress pathways.


Assuntos
Síndrome de Quebra de Nijmegen , Fenantrenos , Hidrocarbonetos Policíclicos Aromáticos , Nascimento Prematuro , Humanos , Feminino , Recém-Nascido , Gravidez , Hormônio Liberador da Corticotropina , Hidrocarbonetos Policíclicos Aromáticos/efeitos adversos , Hidrocarbonetos Policíclicos Aromáticos/urina , Placenta/metabolismo , Síndrome de Quebra de Nijmegen/metabolismo , Vitaminas , Fenantrenos/metabolismo
3.
Sci Total Environ ; 645: 1057-1064, 2018 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-30248831

RESUMO

BACKGROUND: Mounting evidence suggests that the natural and built environment can affect human health, but relatively few studies have considered links between features of the residential natural and built environment other than air pollution and complications of pregnancy. OBJECTIVES: To quantify the impact of features of the maternal residential natural and built environments on risk of gestational diabetes mellitus (GDM), gestational hypertension and preeclampsia among 61,640 women who delivered at a single hospital in Rhode Island between 2002 and 2012. METHODS: We estimated residential levels of ambient fine particulate matter (PM2.5) and black carbon (BC) using spatiotemporal models, neighborhood green space using remote sensing and proximity to recreational facilities, and neighborhood blue space using distance to coastal and fresh water. We used logistic regression to separately estimate the association between each feature and GDM, gestational hypertension, and preeclampsia, adjusting for individual and neighborhood markers of socioeconomic status. RESULTS: GDM, gestational hypertension, and preeclampsia were diagnosed in 8.0%, 5.0%, and 3.6% of women, respectively. We found 2nd trimester PM2.5 (OR = 1.08, 95% CI: 1.00, 1.15 per interquartile range increase in PM2.5) and living close to a major roadway (1.09, 95% CI: 1.00, 1.19) were associated with higher odds of GDM, while living <1 km from the coast was associated with lower odds of GDM (0.87, 95% CI: 0.78, 0.96). Living <500 m from a recreational facility was associated with lower odds of gestational hypertension (0.89, 95% CI: 0.80, 0.99). None of these features were associated with odds of preeclampsia. Results were qualitatively similar in mutually-adjusted models and sensitivity analyses. CONCLUSIONS: In this small coastal US state, risk of GDM was positively associated with PM2.5 and proximity to busy roadways, and negatively associated with proximity to blue space, highlighting the importance of the natural and built environment to maternal health.


Assuntos
Poluição do Ar/estatística & dados numéricos , Exposição Materna/estatística & dados numéricos , Complicações na Gravidez/epidemiologia , Poluentes Atmosféricos/análise , Diabetes Gestacional/epidemiologia , Exposição Ambiental/estatística & dados numéricos , Feminino , Humanos , Material Particulado/análise , Gravidez , Rhode Island/epidemiologia
4.
EBioMedicine ; 24: 64-75, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28988979

RESUMO

BACKGROUND: IRX3 was recently reported as the effector of the FTO variants. We aimed to test IRX3's roles in the browning program and to evaluate the association between the genetic variants in IRX3 and human obesity. METHODS: IRX3 expression was examined in beige adipocytes in human and mouse models, and further validated in induced beige adipocytes. The browning capacity of primary preadipocytes was assessed with IRX3 knockdown. Luciferase reporter analysis and ChIP assay were applied to investigate IRX3's effects on UCP1 transcriptional activity. Moreover, genetic analysis of IRX3 was performed in 861 young obese subjects and 916 controls. RESULTS: IRX3 expression was induced in the browning process and was positively correlated with the browning markers. IRX3 knockdown remarkably inhibited UCP1 expression in induced mouse and human beige adipocytes, and also repressed the uncoupled oxygen consumption rate. Further, IRX3 directly bound to UCP1 promoter and increased its transcriptional activity. Moreover, 17 rare heterozygous missense/frameshift IRX3 variants were identified, with a significant enrichment in obese subjects (P=0.038, OR=2.27; 95% CI, 1.02-5.05). CONCLUSIONS: IRX3 deficiency repressed the browning program of white adipocytes partially by regulating UCP1 transcriptional activity. Rare variants of IRX3 were associated with human obesity.


Assuntos
Adipócitos Marrons/metabolismo , Adipócitos Brancos/metabolismo , Proteínas de Homeodomínio/genética , Proteínas de Homeodomínio/metabolismo , Obesidade/metabolismo , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Proteína Desacopladora 1/genética , Adulto , Animais , Estudos de Casos e Controles , Linhagem Celular , Modelos Animais de Doenças , Feminino , Mutação da Fase de Leitura , Técnicas de Silenciamento de Genes , Predisposição Genética para Doença , Humanos , Masculino , Camundongos , Mutação , Mutação de Sentido Incorreto , Obesidade/genética , Regiões Promotoras Genéticas , Termogênese , Proteína Desacopladora 1/metabolismo , Adulto Jovem
5.
Obesity (Silver Spring) ; 25(1): 252-260, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27925416

RESUMO

OBJECTIVE: To determine the relationship of the gain-of-function variant A750T in leucine-rich repeat containing G protein-coupled receptor 4 (LGR4) with central obesity and related metabolic phenotypes. METHODS: The LGR4 A750T (c.2248 G > A) variant was detected by Sanger sequencing in a discovery young population and a validation community-based population with obesity from eastern China. Fat indices determined by anthropometry and computed tomography scans and clinical biochemical measurements were collected for association analysis. RESULTS: LGR4 A750T was significantly correlated with waist circumference (P = 0.030) and waist-to-height ratio (P < 0.001) in the young cohort (N = 594) and with waist-to-hip ratio (P = 0.013) in the community population (N = 1067). Combined analysis showed a significant correlation of the variant with waist circumference (P < 0.001) and waist-to-hip ratio (P = 0.021). Moreover, the variant had a remarkable correlation with abdominal visceral fat area (P = 0.004) and was associated with 2-h plasma insulin (P = 0.009) and the Matsuda index (P = 0.027) after an oral glucose tolerance test in young subjects with obesity. CONCLUSIONS: The LGR4 A750T variant may contribute to central obesity characterized by abdominal visceral fat accumulation.


Assuntos
Variação Genética , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/genética , Receptores Acoplados a Proteínas G/genética , Adolescente , Adulto , Glicemia/metabolismo , Pressão Sanguínea , Índice de Massa Corporal , China , Colesterol/sangue , Técnicas de Genotipagem , Humanos , Insulina/sangue , Resistência à Insulina/genética , Gordura Intra-Abdominal , Modelos Lineares , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X , Circunferência da Cintura , Relação Cintura-Quadril , Adulto Jovem
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