Objectives Otolaryngology applicants routinely decry conflicting interview dates because this limits the number of interviews that one can attend, despite being offered an interview. Conversely, applicants also perceive that a large number of interviews are offered to a minority of applicants. We sought to verify and quantify the inequality in distribution of interviews attended. Study Design Retrospective analysis of the National Resident Matching Program (NRMP) 2016 Charting Outcomes in the Match and Electronic Residency Application Service (ERAS) historic specialty data. Methods The Gini coefficient, a commonly used indicator of economic inequality, was calculated using data from the 2016 Charting Outcomes in the Match to estimate the distribution of interviews attended. This data was compared to nine other specialties, comprising a wide range of competitiveness and specialty size. Results 26% (110 of 416) of otolaryngology applicants accounted for half (1,721 of 3,426) of all possible interview positions. The Gini coefficient ranged from 0.43 to 0.84 across 10 specialties, with a higher coefficient indicating higher inequality. The Gini coefficient among otolaryngology applicants was 0.43, indicating lower inequality than most other specialties. When including only applicants who interviewed, the Gini coefficient was 0.23. Conclusion There is an unequal distribution of interview invitations, which likely reflects the reality of asymmetry in applicant competitiveness. Otolaryngology demonstrates the greatest equality in distribution, which may stem from a greater burden of hoarding. The specialty's perceived competitiveness mitigates factors such as cost and time, essentially encouraging more people to take as many interviews as they can. Level of Evidence NA Laryngoscope, 129:627–633, 2019

Androgen receptor (AR) transcriptional activity contributes to prostate cancer development and castration resistance. The growth and survival pathways driven by AR remain incompletely defined. Here, we found PDCD4 to be a new target of AR signaling and a potent regulator of prostate cancer cell growth, survival, and castration resistance. The 3 0 untranslated region of PDCD4 is directly targeted by the androgen-induced miRNA, miR-21. Androgen treatment suppressed PDCD4 expression in a dose responsive and miR-21-dependent manner. Correspondingly, AR inhibition dose-responsively induced PDCD4 expression. Using data from prostate cancer tissue samples in The Cancer Genome Atlas (TCGA), we found a significant and inverse correlation between miR-21 and PDCD4 mRNA and protein levels. Higher Gleason grade tumors exhibited significantly higher levels of miR-21 and significantly lower levels of PDCD4 mRNA and protein.PDCD4 knockdown enhanced androgen-dependent cell proliferation and cell-cycle progression, inhibited apoptosis, and was sufficient to drive androgen-independent growth. On the other hand, PDCD4 overexpression inhibited miR-21mediated growth and androgen independence. The stable knockdown of PDCD4 in androgen-dependent prostate cancer cells enhanced subcutaneous tumor take rate in vivo, accelerated tumor growth, and was sufficient for castrationresistant tumor growth.Implications: This study provides the first evidence that PDCD4 is an androgen-suppressed protein capable of regulating prostate cancer cell proliferation, apoptosis, and castration resistance. These results uncover miR-21 and PDCD4-regulated pathways as potential new targets for castration-resistant prostate cancer.

Patients with high risk upper tract urothelial carcinoma treated with neoadjuvant chemotherapy were noted to have a lower pathological stage distribution than patients treated with radical nephroureterectomy alone.

Objectives/Hypothesis Scheduling otolaryngology interviews may be a challenge for residency applicants due to overlapping interview dates. Our objective was to identify otolaryngology interview date patterns and scheduling conflicts over the past six application cycles. Study Design Retrospective review of otolaryngology online forums (http://Otomatch.com and Student Doctor Network). Methods Online threads related to residency interview dates posted during the 2012 to 2013 through 2017 to 2018 interview seasons on http://Otomatch.com were reviewed. Program directors were contacted to complete any missing data. The χ‐ goodness‐of‐fit test and the χ2 test of independence was used to compare proportions. Analysis of variance was used to compare values across years. Results Data from an average of 98 programs (99%) per year were obtained. The majority of invitations arrived late October (49%), followed by early November (37.1%). Interviews occurred primarily in December (48.4%) and January (37.5%). Programs on average scheduled 2.47 (range, 0–4) interview dates. Most interviews fell on Fridays (28.7%) and Saturdays (22.7%) (P < .0001), with an increasing trend toward interviewing on consecutive days. There was substantial overlap in interview dates, with six dates alone accounting for an average of 31.3% of all interviews in a given interview cycle. Conclusions The majority of otolaryngology interviews occur in December or January and fall on a Friday or Saturday. There is considerable overlap with the potential for scheduling conflicts. Our findings can help set expectations for applicants regarding interview invitations, as well as a strategy for scheduling interviews. Level of Evidence NA Laryngoscope, 129:2280–2285, 2019