Endocrinology Training Research Articles

Characterization of reproductive endocrinology and infertility (REI) fellowship applicants: guiding our mentees toward success

BackgroundAdvanced subspecialty training in reproductive endocrinology and infertility (REI) entails a competitive application process with many data points considered. It is not known what components weigh more heavily for applicants. Thus, we sought to study the REI fellow applicant and compare 1) those who apply but do not receive an interview, 2) those who receive an interview but do not match, and 3) those who successfully match.MethodsThis retrospective cohort study was conducted at a single REI fellowship program from 2013 to 2017. Academic variables assessed included standardized test scores and total number of publications listed on their curriculum vitae. Logistic regression models were constructed to determine variables that were predictive of being offered an interview in our program and of matching in any program.ResultsThere were 270 applicants, of which 102 were offered interviews. Interviewed applicants had significantly higher mean USMLE 1 and CREOG scores, as well as total publications and total abstracts. There was no difference in Step 2 and Step 3 scores or in number of book chapters. Of those interviewed, USMLE scores remained predictive of matching in any program; however, publications and scientific abstracts were no longer predictive.ConclusionsThe decision to offer applicants interviews appears to be influenced by objective standardized test scores, as well as a threshold of academic productivity. These items are less predictive of matching once the interview process begins, indicating that other factors, such as performance during the interview day, may be more heavily weighted.

Endocrine Trainees Exhibit Sensitive But Conservative Attitudes Towards the Management of Endocrine Conditions in HIV Patients in Singapore

With advances in the treatment of human immunodeficiency virus (HIV) infections, the life expectancy of people with HIV (PWH) is fast approaching that of the general population. Endocrine and metabolic disorders occur more frequently in PWH than in the general population. This study assessed the knowledge, practice patterns, and confidence levels among endocrinology trainees in Singapore in managing endocrine disorders in PWH. An anonymous, 31-item survey was administered to 23 endocrinology trainees. Four domains were assessed: (1) previous exposure to endocrine disorders in PWH; (2) attitudes towards treating PWH, (3) case studies in endocrinology designed to assess for differences in treatment philosophy between a PWH and a noninfected counterpart, and (4) confidence in managing endocrine disorders in PWH. The participation rate was 73.9%, with the majority of trainees (88.2%) having managed fewer than 5 PWH with endocrine disorders. A total of 94.1% of the trainees had little or no hesitation in treating PWH, but more than half (58.8%) felt inadequate in confidently managing them. A total of 82.4% deemed HIV endocrinology as an emerging field and were open to the idea of pursuing it as a subspecialty in the future. Re-assuringly, most trainees would not compromise medical treatment for a PWH if it were indicated. More than half were ambivalent about prescribing cross-hormonal therapy to transgender individuals. Endocrinology trainees feel that while HIV endocrinology is an emerging field, they lack exposure, training, and confidence in the management of these patients. Although they would treat medical conditions well, they lacked knowledge in hormonal treatment of transgender individuals. HIV = human immunodeficiency virus PWH = people with HIV.

Editorial introductions

Current Opinion in Endocrinology and Diabetes was launched in 1994, with Obesity added to the title in 2007. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of endocrinology and diabetes are divided into 12 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce one of the Journal's Section Editors for this issue. SECTION EDITORS Peter A. GottliebPeter A. GottliebDr Peter Gottlieb was born in Havana, Cuba, but at age 2 moved to New Jersey, USA, where he grew up. After receiving his undergraduate degree from the University of Pennsylvania, USA, he attended UMDNJ-Robert Wood Johnson Medical School, USA from which he graduated in 1984. Dr Gottlieb completed his internship and residency in internal medicine at the University of Massachusetts Medical School, USA and then continued his fellowship training in endocrinology and metabolism there as well. In 1990, after completing his fellowship, he moved to the Weizmann Institute in Israel to do post-doctoral training in T cell immunology. After surviving Gulf War I, he returned to UMass, USA and joined the staff as Clinical Director of Diabetes. He subsequently joined the Barbara Davis Center for Childhood Diabetes, Aurora, USA in 1995, where he is now a Professor of Pediatrics and Medicine and the Director of the Translational Research Unit at the Barbara Davis Center. He has authored, co-authored and collaborated on more than 140 publications, reviews and book chapters and served as section editor for several journal editions. His research areas of interest include the immunology of type 1 diabetes, intervention trials to prevent or reverse type 1 diabetes, and the genetics of autoimmune disease. He had led several multi-center trials in new onset type 1 diabetes and is an active member of the Steering Committee for Type 1 Diabetes TrialNet. Whitney WoodmanseeWhitney WoodmanseeDr Whitney Woodmansee is Director of the Clinical Neuroendocrine Program at Brigham and Women's Hospital, and Assistant Professor of Medicine at Harvard Medical School in Boston, MA, USA. Dr Woodmansee received her medical degree and completed her clinical training in internal medicine and endocrinology at the University of Colorado Health Sciences Center (UCHSC) in Denver, CO, USA. After completing her training, she joined the faculty at UCHSC in 1999 where she performed basic science research in the neuroendocrine field, as well as directed the Pituitary Disorders Program. She currently manages an active clinical practice caring for patients with pituitary disorders as a member of the Brigham and Women's Hospital's multi-disciplinary Pituitary/Neuroendocrine Center. She also directs the Dynamic Endocrine Testing Unit at her hospital. Dr Woodmansee has more recently shifted her research efforts from understanding the molecular biology of the pituitary to more clinical studies, and has a particular interest in the management of hypopituitarism.

Global Application of the Assessment of Communication Skills of Paediatric Endocrinology Fellows in the Management of Differences in Sex Development Using the ESPE E-Learning.Org Portal

Background: Information sharing in chronic conditions such as disorders of/differences in sex development (DSD) is essential for a comprehensive understanding by parents and patients. We report on a qualitative analysis of communication skills of fellows undergoing training in paediatric endocrinology. Guidelines are created for the assessment of communication between health professionals and individuals with DSD and their parents. Methods: Paediatric endocrinology fellows worldwide were invited to study two interactive online cases (www.espe-elearning.org) and to describe a best practice communication with (i) the parents of a newborn with congenital adrenal hyperplasia and (ii) a young woman with 46,XY gonadal dysgenesis. The replies were analysed regarding completeness, quality, and evidence of empathy. Guidelines for structured assessment of responses were developed by 22 senior paediatric endocrinologists worldwide who assessed 10 selected replies. Consensus of assessors was established and the evaluation guidelines were created. Results: The replies of the fellows showed considerable variation in completeness, quality of wording, and evidence of empathy. Many relevant aspects of competent clinical communication were not mentioned; 15% (case 1) and 17% (case 2) of the replies were considered poor/insufficient. There was also marked variation between 17 senior experts in the application of the guidelines to assess communication skills. The guidelines were then adjusted to a 3-level assessment with empathy as a separate key item to better reflect the qualitative differences in the replies and for simplicity of use by evaluators. Conclusions: E-learning can play an important role in assessing communication skills. A practical tool is provided to assess how information is shared with patients with DSD and their families and should be refined by all stakeholders, notably interdisciplinary health professionals and patient representatives.

Endocrinology training programs in member countries of the International Society of Endocrinology (ISE): a pilot survey evaluation comparing regions and cultures

Endocrinology training programs in member countries of the International Society of Endocrinology (ISE): a pilot survey evaluation comparing regions and cultures

Perceptions about Training during Endocrinology Residency Programs in India over the Years: A Cross-sectional Study (PEER India Study).

Background:Residents' perception on quality of endocrinology training in India is not known. This study aimed to evaluate the perceptions about endocrinology residency programs in India among current trainees as compared to practicing endocrinologists.Methods:Trainees attending a preconference workshop at the annual conference of Endocrine Society of India (ESI) were given a questionnaire designed to evaluate their perceptions on their training. These evaluated the reasons for choosing endocrinology, their experiences during residency, and career plans. Practicing endocrinologists attending ESICON with at least 5-year experience were evaluated as controls.Results:Questionnaires from 63 endocrine trainees and 78 practicing endocrinologists were analyzed. Endocrinology is perceived to be the super-specialty with the best quality of life (QOL) but fair with regard to financial remuneration. Among current trainees, 61.89%, 31.74%, and 34.91% are satisfied with training in clinical endocrinology, laboratory endocrinology, and clinical/translational research, respectively. The corresponding figures for practicing endocrinologists are 71.78%, 25.63%, and 30.75%, respectively. Exposure to national endocrinology conferences during their endocrinology residency was adequate. However, exposure to international endocrinology conferences, research publications, project writing, and grant application are limited. Laboratory endocrinology is rated as the most neglected aspect during endocrine residency. Most of the trainees want to establish their own clinical practice in the long run. Very few trainees (17.46%) wish to join the medical education services.Conclusion:There is a good perception of QOL in endocrinology in spite of average financial remuneration. There is dissatisfaction with the quality of training in laboratory endocrinology and clinical research. Very few endocrine trainees consider academics as a long-term career option in India.

Fertility and sexual function: a gap in training in pediatric endocrinology.

Infertility and sexual dysfunction result from many different pediatric conditions and treatments and can profoundly impact quality of life. The American Academy of Pediatrics (AAP) has recommended consulting "fertility specialists" for counseling, but it remains unclear who these specialists are. Our objective was to assess whether pediatric subspecialists who manage hypogonadism and/or genitourinary conditions feel adequately trained to provide fertility and sexual function counseling. An online survey was distributed to members of Pediatric Endocrine Society (PES), Society for Pediatric Urology (SPU), and North American Society for Pediatric and Adolescent Gynecology (NASPAG). Providers' comfort in counseling various age groups about fertility and sexual function was assessed via a five-point Likert scale. Providers reported whether they felt adequately trained in these areas. Two hundred and eighty-four surveys were completed by endocrinologists, 124 surveys by urologists, and 41 surveys by gynecologists. Respondents (44% male, 86% Caucasian) represented 39 states and Canada. Seventy-nine percent were at academic centers. Thirty-four percent of providers had been practicing for >20 years. Comfort level was variable and lowest in young males. Ninety-one percent of pediatric endocrinologists reported routinely seeing patients at risk for infertility, but only 36% felt adequately trained in fertility, and 25% felt adequately trained in sexual function. Infertility and sexual dysfunction are often overlooked in pediatric care. Our results suggest that pediatric endocrinologists, who frequently manage male and female hypogonadism, should also receive formal training in these areas. Optimizing counseling would help prevent missed opportunities for fertility preservation and alleviate distress among patients and families.

Claude D Arnaud, Jr, MD (1929–2016): ASBMR Loses a Founding Father

Claude D Arnaud, Jr, MD (1929–2016): ASBMR Loses a Founding Father

Editorial introductions

Current Opinion in Endocrinology and Diabetes was launched in 1994, with Obesity added to the title in 2007. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of endocrinology and diabetes are divided into 12 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce one of the Journal's Section Editors for this issue. SECTION EDITORS Peter A. GottliebPeter A. GottliebDr Peter A. Gottlieb was born in Havana, Cuba, but at age 2 moved to New Jersey, USA, where he grew up. After receiving his undergraduate degree from the University of Pennsylvania, USA, he attended UMDNJ-Robert Wood Johnson Medical School, USA from which he graduated in 1984. Dr Gottlieb completed his internship and residency in internal medicine at the University of Massachusetts Medical School, USA and then continued his fellowship training in endocrinology and metabolism there as well. In 1990, after completing his fellowship, he moved to the Weizmann Institute in Israel to do post-doctoral training in T cell immunology. After surviving Gulf War I, he returned to UMass, USA and joined the staff as Clinical Director of Diabetes. He subsequently joined the Barbara Davis Center for Childhood Diabetes, Aurora, USA in 1995, where he is now a Professor of Pediatrics and Medicine and the Director of the Translational Research Unit at the Barbara Davis Center. He has authored, co-authored and collaborated on more than 140 publications, reviews and book chapters and served as section editor for several journal editions. His research areas of interest include the immunology of type 1 diabetes, intervention trials to prevent or reverse type 1 diabetes, and the genetics of autoimmune disease. He had led several multi-center trials in new onset type 1 diabetes and is an active member of the Steering Committee for Type 1 Diabetes TrialNet. Whitney WoodmanseeWhitney WoodmanseeDr Whitney Woodmansee is Director of the Clinical Neuroendocrine Program at Brigham and Women's Hospital and Assistant Professor of Medicine at Harvard Medical School in Boston, MA, USA. Dr Woodmansee received her medical degree and completed her clinical training in internal medicine and endocrinology at the University of Colorado Health Sciences Center (UCHSC) in Denver, CO, USA. After completing her training, she joined the faculty at UCHSC in 1999 where she performed basic science research in the neuroendocrine field, as well as directed the Pituitary Disorders Program. She currently manages an active clinical practice caring for patients with pituitary disorders as a member of the Brigham and Women's Hospital's multi-disciplinary Pituitary/Neuroendocrine Center. She also directs the Dynamic Endocrine Testing Unit at her hospital. Dr Woodmansee has more recently shifted her research efforts from understanding the molecular biology of the pituitary to more clinical studies, and has a particular interest in the management of hypopituitarism.

Editing of Kv1.1 RNA Transcripts is Altered by Human Mutations Respons‐ible for Episodic Ataxia Type‐1

Transcripts encoding the Kv1.1‐subtype of voltage‐gated potassium channel un‐der‐go an adenosine‐to‐inosine (A‐to‐I) RNA editing event resulting in the con‐ver‐sion of a genomically‐encoded isoleucine (AUU) to a valine codon (IUU) at amino acid position 400 (I400V). Previous studies have shown that this single amino acid change alters the recovery rate following channel inactivation and has been pro‐posed to mod‐u‐late the kinetics of neuronal repolarization due to its location within the predicted ion pore of the channel. Numerous nonsense and mis‐sense muta‐tions in the Kv1.1 gene (kcna1) have been associated with the hu‐man po‐tas‐sium channelopathy, Episodic Ataxia type‐1 (EA1), which is char‐ac‐ter‐ized by epi‐sodes of stress‐induced ataxia and myokymia, and can be associated with epi‐leptic seizures. Three human EA1 mu‐ta‐tions (V404I, I407M, and V408A) are within close prox‐imity to the I400V editing site, and are contained within the RNA duplex structure required for A‐to‐I con‐ver‐sion. We have employed both in vitro and in vivo systems to determine the impact that these EA1 mutations might have on Kv1.1 RNA editing, as well as determined the electro‐phys‐iological changes in chan‐nel function derived from tran‐scripts containing EA1 mutations with either an edited or non‐edited status. In vitro tran‐scribed RNA substrates containing EA1 mutations were incubated with nuclear extracts isolated from cells overexpres‐sing the ADAR2 editing enzyme. Each of the EA1 mu‐ta‐tions dif‐fer‐en‐tial‐ly de‐creased A‐to‐I conversion of Kv1.1 RNAs in relation to their over‐all prox‐im‐ity to the editing site. Furthermore, a mouse model of EA1, encoding the human V408A mutation at the endogenous kcna1 locus, also re‐vealed a significant decrease in Kv1.1 editing in all tissues examined. Analysis of EA1 mutant chan‐nels using a Xenopus oocyte expression system, in a non‐edited (I400) or edited (V400) background, revealed significant changes in the elec‐‐tro‐physiological char‐ac‐teristics of the channel. These observations suggest that altered Kv1.1 function in EA1 could result from both the missense mutation and alterations in editing ef‐fici‐ency. These results also are con‐sis‐tent with a gen‐et‐ically‐modified mouse mod‐el of Kv1.1 editing, where mice sole‐ly expressing the non‐edited Kv1.1 iso‐form exhibit stress‐in‐duced ataxia and an increase in induced‐sei‐zure suscepti‐bil‐i‐ty.Support or Funding InformationJoel G. Hardman Chair in Pharmacology (RBE)Multidisciplinary Training in Molecular Endocrinology (METP) NIH/NIDDK – T32 DK007563 (EFK)Ruth L. Kirschstein National Research Service Award NINDS F31 NS087911 (EFK)

‐Altered DNA‐Binding Specificity Transcription Activator Variant Provides Key To Unlocking Gene Activation Mechanism

Transcription activator proteins confer target selective, gene‐specific activation in response to appropriate stimuli. In order to dissect the molecular mechanisms of gene transcription activation, it is imperative to understand the role(s) of the transcription activator. Unfortunately, a subset of DNA‐binding transcriptional activator proteins are resistant to study by the conventional means of fusing putative Activation Domains (ADs) to heterologous DNA Binding Domains (DBDs) to identify key transcription factor functional elements. The budding yeast Saccharomyces cerevisiae Repressor Activator Protein 1 (Rap1) is one such activator protein. Rap1 specifically binds over 500 DNA sites in the yeast genome, serving key roles in multiple cellular processes including: (a) telomere stabilization; (b) transcription repression of silent mating type loci; and (c) activation of two of the most vigorously transcribed classes of yeast genes: the SAGA‐dominated glycolytic enzyme‐encoding genes (GEs) and the TFIID‐dominated ribosomal protein genes (RPGs). However, fusions of Rap1 or Rap1‐domains with heterologous DBDs reportedly fail to robustly drive reporter gene expression.To enable study of the role of Rap1 in activation, an altered DNA‐binding specificity Rap1 variant (Rap1 AS) was generated using a direct screening/selection strategy in yeast wherein activation of a selectable HIS3 reporter gene depended upon the ability of DBD‐mutagenized variant forms of Rap1 to efficiently drive expression from a mutant Rap1 enhancer (UASRAP1). Multiple candidate putative Rap1 AS variants scored in this screen. One has been characterized in detail. In both biochemical (DNA gel mobility shift) and functional (HIS3 reporter gene expression) assays, Rap1 AS preferentially bound the selecting mutant UASRAP1, displaying a significant discrimination for mutant vs. wild‐type (WT) UASRAP1 sequences. Yeast pseudodiploid for Rap1 (Rap1 WT and Rap1 AS) grow like WT, showing that Rap1 AS does not interfere with the many essential functions of Rap1 WT. Subsequent mutagenesis experiments with Rap1 AS identified a putative activation domain that mapped to a ~40 amino acid region within the C‐terminal 1/3 of Rap1. Systematic point mutagenesis of this mapped AD has identified eight amino acids that contribute critically to AD function.The collection of Rap1 AD mutants will be used to investigate the transcription activation mechanisms used to drive the TFIID‐dominated RPGs. Since we have previously shown that Rap1 interacts directly with TFIID, and is the only RPG activator absolutely required for RPG transcription, mechanistic analyses performed with the Rap1 AD mutants should unlock the key step(s) to RPG activation. Because few TFIID‐dependent activation mechanisms have been carefully dissected, these key steps will likely reveal general principles of TFIID‐dependent gene activation applicable to all organisms.Support or Funding InformationThis research was supported by the NIH Molecular Endocrinology Training Program (METP) training grant (T32 DK07563) and the NIH R01 grants GM52461 and GM115892.

Seeing where the action really is: experiences of a specialist training post in primary care

As the prevalence of diabetes, and the complexity of care increases, developing new models of care that cross the hospital boundary in to the community is of considerable importance. In order to improve training in community diabetes, and to help forge stronger links with primary care colleagues in Northumbria, this specialist training post was developed by the Health Education North-East Diabetes and Endocrinology training programme. This article describes the experience of the post, and the feedback gained from both the trainee and the healthcare professionals in primary care. This was a positive experience from a trainee and primary care perspective, promoting a better understanding for all of the challenges faced in both primary and secondary care, and facilitating supportive working relationships which ultimately should have a beneficial impact on patient care.

Diabesity management worldwide.

Francesca Lake, Managing Editor, speaks to Chinnadorai Rajeswaran. Dr Rajeswaran is a consultant physician (Diabetes & Endocrinology) at Mid Yorkshire NHS Trust. He gained specialist training in Leeds, in diabetes and endocrinology. He has a special interest in obesity and is involved in research in obesity and diabetes. He also has a number of publications, book chapters and presentations to his credit. He along with other co-authors has published a book on weight loss surgery, titled: “The Ultimate Guide to Weight Loss Surgery.” He leads the specialist obesity service at the Mid Yorkshire Trust and Kirklees weight management service. With the help of colleagues in diabetes and obesity he set up the National Diabesity Forum. Dr Rajeswaran is also the medical advisor for Simplyweight, a global specialist weight management organization. He is also involved in both local and international charity work.

The Impact and Successes of a Paediatric Endocrinology Fellowship Program in Africa.

Background. The prevalence and distribution of endocrine disorders in children in Africa are not well known because most cases are often undiagnosed or diagnosed too late. The awareness of this led to the launch of the Paediatric Endocrinology Training Center for Africa (PETCA) designed to improve quality and access to health care by training paediatricians from Africa in paediatric endocrinology. Methods. The fellowship is undertaken over an 18-month period: six months of clinical and theoretical training in Kenya, nine months of project research at the fellow's home country, and three months of consolidation in Kenya. Upon completion, certified paediatricians are expected to set up centers of excellence. Results. There have been two phases, phase I from January 2008 to October 2012 and phase II from January 2012 to April 2015. Fifty-four fellows from 12 African countries have been certified, 34 (phase I) and 20 (phase II). Over 1,000 patients with wide ranging diabetes and endocrine disorders have been diagnosed and treated and are being followed up at the centers of excellence. Conclusion. The successes of the PETCA initiative demonstrate the impact a capacity building and knowledge transfer model can have on people in resource-poor settings using limited resources.

Training needs in adolescent and young adult health and transition in UK paediatric and adult higher specialist trainees in endocrinology and diabetes

Background: There is a concern that medical training contains insufficient emphasis on adolescent and young adult health and transition. Clinicians working in diabetes and endocrinology across paediatric and adult services need to have the skills to work effectively with this age group. The aim of the present survey was to ascertain the current state of training of paediatric and adult trainees in endocrinology and diabetes in the UK. Methods: A questionnaire assessing training in adolescent and young adult health was developed using existing questionnaire formats. An online survey was disseminated to UK trainees in paediatric and adult endocrinology and diabetes through the Young Diabetologists and Endocrinologists Forum (YDEF), the British Society of Paediatric Endocrinology and Diabetes (BSPED), and the Society for Endocrinology (SfE) to assess access and quality of adolescent and young adult health and transition training. Results: 146 responses were received from 97 adult trainees, 38 paediatric trainees with a special interest and 11 paediatric sub-specialty trainees. All grades were represented from across the UK. Training in adolescent and young adult health and transition was rated as minimal or non-existent (65%); this was more marked in endocrinology (76%) than in diabetes (42%). The major barriers to achieving this experience and training were perceived to be limited clinic time and lack of training. Trainees reported unmet training needs, with paediatric trainees reporting higher learning needs despite reporting more exposure and training. Both seniority and number of clinics attended positively impacted on reported training experience. Conclusions: This survey has highlighted the need for improvements in training in adolescent and young adult health. Trainees from paediatric and adult backgrounds feel under-trained and under-prepared to deliver this care. Given the importance of improving outcomes in adolescents and emerging adults with long-term conditions, this issue merits urgent attention.

Moffat Nyirenda: investigating diabetes and other NCDs in Malawi

Moffat Nyirenda: investigating diabetes and other NCDs in Malawi

In Pursuit of Genes of Glucose Metabolism

If you don't know where you're going, you might wind up someplace else—Yogi Berra My professional journey, once I accepted the fact that I would not play first base for the Chicago Cubs, was not accomplished in a straight line. I entered medical school intending to become a family physician but soon became interested in research. I took an internal medicine residency at the University of California, San Francisco (UCSF), then a long research fellowship in the nascent field of molecular biology at the National Institutes of Health (NIH), and followed that with training in clinical endocrinology at the University of Wisconsin. I spent the next fifteen years dividing my time between the clinic and laboratory at the University of Iowa. Finally, I decided to concentrate on research and spent the next twenty-three years at Vanderbilt University. For the past eleven years, I have been at the University of Iowa, where I helped establish a new diabetes research center. My research journey also had several different directions. Upon reflection, I guess I ended up “someplace else” by choice, and it certainly has been an interesting trip. It is one I unreservedly recommend.

Editorial introductions

Current Opinion in Endocrinology and Diabetes was launched in 1994, with Obesity added to the title in 2007. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of endocrinology and diabetes are divided into 12 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce one of the Journal's Section Editors for this issue. SECTION EDITORS Peter A. GottliebPeter A. GottliebDr Peter A. Gottlieb was born in Havana, Cuba, but at age 2 moved to New Jersey, USA, where he grew up. After receiving his undergraduate degree from the University of Pennsylvania, USA, he attended UMDNJ-Robert Wood Johnson Medical School, USA from which he graduated in 1984. Dr Gottlieb completed his internship and residency in internal medicine at the University of Massachusetts Medical School, USA and then continued his fellowship training in endocrinology and metabolism there as well. In 1990, after completing his fellowship, he moved to the Weizmann Institute in Israel to do post-doctoral training in T cell immunology. After surviving the First Gulf War, he returned to UMass, USA and joined the staff as Clinical Director of Diabetes. He subsequently joined the Barbara Davis Center for Childhood Diabetes in 1995, USA where he is now a Professor of Pediatrics and Medicine and the Director of the Translational Research Unit at the Barbara Davis Center. He has authored, co-authored and collaborated on more than 110 publications in peer-reviewed journals, as well as several book chapters and served as section editor for several journal editions. His research areas of interest include the immunology of type 1 diabetes, intervention trials to prevent or reverse type 1 diabetes, islet transplantation and the genetics of autoimmune disease. He had led several multi-center trials in new onset type 1 diabetes and is an active member of the Steering Committee for Type 1 Diabetes TrialNet. Whitney WoodmanseeWhitney WoodmanseeDr Whitney Woodmansee is Director of the Clinical Neuroendocrine Program at Brigham and Women's Hospital and Assistant Professor of Medicine at Harvard Medical School in Boston, MA, USA. Dr Woodmansee received her medical degree and completed her clinical training in internal medicine and endocrinology at the University of Colorado Health Sciences Center (UCHSC) in Denver, CO, USA. After completing her training, she joined the faculty at UCHSC in 1999 where she performed basic science research in the neuroendocrine field, as well as directed the Pituitary Disorders Program. She currently manages an active clinical practice caring for patients with pituitary disorders as a member of the Brigham and Women's Hospital's multi-disciplinary Pituitary/Neuroendocrine Center. She also directs the Dynamic Endocrine Testing Unit at her hospital. Dr Woodmansee has more recently shifted her research efforts from understanding the molecular biology of the pituitary to more clinical studies, and has a particular interest in the management of hypopituitarism.

Diabetic Kidney Disease: A Call to Action: Preface.

As guest editor for this Diabetes Spectrum From Research to Practice section, I am pleased to introduce a tour de force on the theme topic of diabetic kidney disease (DKD). My journey in diabetes began as an observer. In youth, during the early 1970s, I watched my tennis partner, Cindy, struggle with the complexities of her blood glucose control, while still striving to play competitively. Her episodes of hypoglycemia were scary, and urine glucose testing just did not cut it. The era of self-monitoring of blood glucose was still years away, but eventually we got there. Fast forward to medical school days in the late 1970s. I remember what a breakthrough it was to have “chemsticks” to check blood glucose at the bedside of hospitalized patients. Diabetes educators appeared on the wards and taught the patients (and us) just how to do it. A new age in diabetes care had surely arrived. Throughout medical school, and then a residency in internal medicine, I was captivated by the physiology of metabolic disorders and the application of science to medicine. During this formative time, Dr. Mark E. Molitch was one of my inspirational mentors. I admired his commitment to advancing care for people with diabetes that has endured over the many years that followed our time together in the early 1980s. With his great wisdom and perception, he has penned a compelling editorial for the current issue titled, “Diabetic Kidney Disease: Much Progress, but Still More to Do” (p. 154). After residency, my next stop was fellowship training in endocrinology and metabolism. I was thrust into a world of insulin-glucose clamp studies with concurrent physiological assessments related to glucose counterregulation. And, we did these studies in real people with diabetes. I was amazed that they actually volunteered for such intensive, time-consuming, and …

Introduction: Training in reproductive endocrinology and infertility: meeting worldwide needs

Training in reproductive endocrinology (REI) and its male variant, andrology, has been profoundly influenced by the central role captured by assisted reproductive technologies (ART). The marked differences in financial, regulatory, and societal/ethical restrictions on ART in different countries of the world also prominently influence the clinical management of infertility. Training should strive for comprehensive teaching of all medically indicated procedures, even if only to optimize cross-border care. Better international standardization of infertility practices and training would benefit worldwide infertility care and should be promoted by international societies.