What Do Program and Geographic Preference Signals Signal? A Survey of Diagnostic Radiology and Integrated Interventional Radiology Residency Applicants.

RATIONALE AND OBJECTIVES: As part of the 2022-2023 Diagnostic/Interventional Radiology residency application process, applicants could participate in the ERAS supplemental application, including sending up to six preference signals and three geographic signals. Our goal was to survey Diagnostic Radiology and Integrated Interventional Radiology applicants at two large academic institutions in different geographic locations regarding their perceived impact of program and geographic preference signaling on the application process. METHODS: An anonymous survey was sent to 282 applicants between two academic medical centers asking about their participation in program and geographic preference signaling as well as their perception on its impact on the application process. RESULTS: 105 applicants responded to the survey (37.2% [105/282]). Most applicants (26% [27/102]) received four interviews from signaled programs. When prompted to best describe their sentiments with respect to program signaling (one being most negative and five being most positive), the plurality of applicants reported a positive sentiment of four (36% [37/103]). Applicants that received four to six interviews from signaled programs were significantly more likely to feel positively towards program signaling than those that received one to three interviews (p = 0.01). Geography was the most important deciding factor on which programs to signal for applicants (57% [58/101]). DISCUSSION: Our survey results demonstrate that most applicants felt positively towards program signaling and it increased their odds of receiving interviews from preferred programs, which is consistent with the current literature. CONCLUSION: Program and geographic signaling are relatively new features of the ERAS residency application process and therefore, their effects on the match outcome are still in question. However, our study results indicate that they are perceived positively by most applicants and that they boost their chances in finding their ideal match.

Dorsal hippocampus to nucleus accumbens projections drive reinforcement via activation of accumbal dynorphin neurons.

The hippocampus is pivotal in integrating emotional processing, learning, memory, and reward-related behaviors. The dorsal hippocampus (dHPC) is particularly crucial for episodic, spatial, and associative memory, and has been shown to be necessary for context- and cue-associated reward behaviors. The nucleus accumbens (NAc), a central structure in the mesolimbic reward pathway, integrates the salience of aversive and rewarding stimuli. Despite extensive research on dHPC→NAc direct projections, their sufficiency in driving reinforcement and reward-related behavior remains to be determined. Our study establishes that activating excitatory neurons in the dHPC is sufficient to induce reinforcing behaviors through its direct projections to the dorso-medial subregion of the NAc shell (dmNAcSh). Notably, dynorphin-containing neurons specifically contribute to dHPC-driven reinforcing behavior, even though both dmNAcSh dynorphin- and enkephalin-containing neurons are activated with dHPC stimulation. Our findings unveil a pathway governing reinforcement, advancing our understanding of the hippocampal circuity's role in reward-seeking behaviors.

The protocol for an observational Australian cohort study of CADASIL: The AusCADASIL study.

Introduction: Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a rare genetic condition with a broad phenotypic presentation. This study aims to establish the first Australian cohort of individuals affected by CADASIL (AusCADASIL) and examine its clinical features and longitudinal course, and to investigate neuroimaging and blood biomarkers to assist in early diagnosis and identify disease progression. Methods: Participants will be recruited from six study centres across Australia for an observational study of CADASIL. We aim to recruit 150 participants with diagnosed CADASIL, family history of CADASIL or suspected CADASIL symptoms, and 150 cognitively normal NOTCH3 negative individuals as controls. Participants will complete: 1) online questionnaires on medical and family history, mental health, and wellbeing; 2) neuropsychological evaluation; 3) neurological examination and brain MRI; 4) ocular examination and 5) blood sample donation. Participants will have annual follow-up for 4 years to assess their progression and will be asked to invite a study partner to corroborate their self-reported cognitive and functional abilities.Primary outcomes include cognitive function and neuroimaging abnormalities. Secondary outcomes include investigation of genetics and blood and ocular biomarkers. Data from the cohort will contribute to an international consortium, and cohort participants will be invited to access future treatment/health intervention trials. Discussion: AusCADASIL will be the first study of an Australian cohort of individuals with CADASIL. The study will identify common pathogenic variants in this cohort, and characterise the pattern of clinical presentation and longitudinal progression, including imaging features, blood and ocular biomarkers and cognitive profile.