Vertebrate kidneys contain nephron functional units where specialized epithelial cell types are organized into segments with discrete physiological roles. Many gaps remain in our understanding of how segment regions develop. Here, we report that the transcription factor empty spiracles homeobox gene 1 (emx1) is a novel nephron segment regulator during embryonic kidney development in zebrafish. emx1 loss of function altered the domains of distal segments without changes in cell turnover or traits like size and morphology, indicating that emx1 directs distal segment fates during nephrogenesis. In exploring how emx1 influences nephron patterning, we found that retinoic acid (RA), a morphogen that induces proximal and represses distal segments, negatively regulates emx1 expression. Next, through a series of genetic studies, we found that emx1 acts downstream of a cascade involving mecom and tbx2b, which encode essential distal segment transcription factors. Finally, we determined that emx1 regulates the expression domains of irx3b and irx1a to control distal segmentation, and sim1a to control corpuscle of Stannius formation. Taken together, our work reveals for the first time that emx1 is a key component of the pronephros segmentation network, which has implications for understanding the genetic regulatory cascades that orchestrate vertebrate nephron patterning.

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over the same time period. The drop in admission rates suggests an opportunity to shift the low-acuity cases of EP from the ED to the less expensive outpatient clinics. Additionally, adolescents who utilized the ED for EP more frequently belonged to the lowest income quartile and had Medicaid coverage which presents potential disparities in access to care and highlights a need for improved pediatric and adolescent gynecology outpatient services.

Introduction:In response to studies showing high rates of program initiated post-interview contact and the use of discriminatory personal questions on topics such as age, intent for children, and religion or political preferences during interviews the Society of Academic Urologists and the American Urological Association published revised guidelines for the 2020 Urology Match. This study assessed the impact of these changes on the applicant experience and prevalence of restricted questions.Methods: A total of 361 applicants to a single urology residency program were sent an anonymous 20-question survey about post-interview program contact and restricted interview questions. The 20-question survey used branching logic with followup questions based on initial responses.Results: A total of 100 survey responses were received. Of respondents 2% reported unsolicited program initiated post-interview contact and no Match commitments were reported. Among respondents 36% felt they were asked an inappropriate question during an interview, female applicants more commonly than males (50% vs 25%, p¼0.01). When asked about specific restricted topics, 98% of respondents reported encountering at least 1. Of the restricted topics asked women more frequently encountered questions about their intent for children (27.3% vs 10.7%, p¼0.032) and other programs to which they applied (100% vs 91%, p¼0.04).Conclusions: Following changes to the guidelines for the 2020 Urology Match unsolicited program initiated post-interview contact rates were lower than reported in previous studies. However, applicants continue to encounter restricted topics, and females disproportionately so, demonstrating that continued work must be done to decrease discrimination and bias throughout the interview process.