The Hrd1 ubiquitin ligase plays a role in quality control of two substrates associated with the Sec61 translocon.

Background: Duodenal cancer is the leading cause of cancer death in familial adenomatous polyposis after colorectal cancer. The lifetime risk for developing duodenal cancer is 4% to 10%. Current treatment guidelines recommend endoscopic surveillance with a prophylactic pancreaticoduodenectomy in advanced duodenal polyposis, defined using the Spigelman staging system. Because no clinical trials have assessed this recommendation, a modeling approach was used to evaluate the cost-effectiveness of various treatment strategies. Methods: A Markov model was constructed to estimate the life expectancy and cost of three different strategies: pancreaticoduodenectomy at Spigelman stage III, pancreaticoduodenectomy at Spigelman stage IV, and pancreaticoduodenectomy at cancer diagnosis. A cohort of 30-year-old familial adenomatous polyposis patients with total colectomies was simulated until age 80. The

In the late 1960s, the federal government was looking for young, healthy men to enlist in the military to help ensure success in the Vietnam War. Not enough men were voluntarily choosing to enlist. In 1969, the federal government implemented a lottery draft. Recruiters traveled the U.S. encouraging enlistment and explaining the draft requirements. They made visits to medical schools explaining options to newly minted MDs. Those options included: (1) be drafted and (possibly) go to war or (2) enlist in the Public Health Service (PHS) using the skills learned in their medical profession in the U.S. The PHS included an option to travel to Bethesda, Maryland and enlist as a Training Associate (TA) at the National Institutes of Health (NIH) to work in one of the scientific intramural labs on campus and receive training by some of the top medical research scientists in the nation. For this study, we searched the National Archives for the physical paper applications of those individuals who applied to the NIH Intramural Training Associates program before, during, and after the lottery draft. We digitalized their applications, combed public documents in search of up-to-date career information, and linked them to their publications and patents to-date. We created a rich linked dataset of administrative records from which we examine the impact of early career, high intensity research training on the probability of staying in research and the overall impact on advancing science. This paper describes our results evaluating the impact of this federal program.

IMPORTANCEAlthough there have been signs of increasing interest in entrepreneurship among physicians as well as claims of a paucity of entrepreneurial activity in health care in general, there is little systematic evidence of the extent, type, and characteristics of entrepreneurship by physicians.Physician involvement in entrepreneurship may result in more innovative and financially successful health care companies. OBJECTIVE To evaluate the proportion and characteristics of physicians who founded new businesses and the types of businesses that they started. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study was conducted by matching all 33 770 physicians holding a Massachusetts medical license in 2017 with the Massachusetts new business registration records from 1960 to 2017 to identify companies founded by physicians. Data were analyzed from September 2017 to December 2019. MAIN OUTCOMES AND MEASURES The number of physician-founded companies inMassachusetts and the types of businesses as characterized by the stated purpose at the time of founding.

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Can a relatively short but intense exposure to frontier research alter the career trajectories of potential innovators? To answer this question, we study the careers and productivity of 3,075 medical school graduates who applied to the Associate Training Programs (ATP) of the National Institutes of Health (NIH) during the turbulent period of the Vietnam War, 1965War, -1975. Carefully selecting on observables, we compare physicians who attended the program to those who passed a first admission screen but were ultimately not selected. We find that program participants were twice as likely to choose a research-focused position after training, and considerably less likely to switch to purely clinical endeavors as their careers unfolded. Over the life cycle, NIH trainees also garnered publications, citations, and grant funding at a much higher rate than synthetic controls. The direction of their research efforts was also durably imprinted by their training experience. In particular, NIH trainees appear to have acquired a distinct "translational" style of biomedical research which became an implicit training model for physician-scientists as ATP alumni came to occupy the commanding heights of academic medicine throughout the United States.

Can a relatively short but intense exposure to frontier research alter the career trajectories of potential innovators? To answer this question, we study the careers and productivity of 3,075 medical school graduates who applied to the Associate Training Programs (ATP) of the National Institutes of Health (NIH) during the turbulent period of the Vietnam War, 1965War, -1975. Carefully selecting on observables, we compare physicians who attended the program to those who passed a first admission screen but were ultimately not selected. We find that program participants were twice as likely to choose a research-focused position after training, and considerably less likely to switch to purely clinical endeavors as their careers unfolded. Over the life cycle, NIH trainees also garnered publications, citations, and grant funding at a much higher rate than synthetic controls, and went on to mentor more trainees who them-selves became successful researchers. The direction of their research efforts was durably imprinted by their training experience. In particular, NIH trainees appear to have acquired a distinct "translational" style of biomedical research which became an implicit training model for physician-scientists as ATP alumni came to occupy the commanding heights of academic medicine throughout the United States.

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