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   Background The American Association of Medical Colleges trialed residency application initiatives including geographic preferences and preference signals in 2022. Objective To assess the impact of geographic preferences on application outcomes during the 2022 residency match year. Design Cross-sectional. Participants Applicants to categorical and preliminary internal medicine during the 2022 application cycle who completed the Texas Seeking Transparency in Applications to Residency survey. Main Measures The primary outcome was interview rate (interview offers/total applications) and whether an application resulted in a match. The key dependent variables were geographic preferences and program-specific preference signals. We also assessed differences in utilization of geographic preferences between specialties. Key Results A total of 970 applicants into categorical ( n  = 884) and preliminary ( n  = 86) internal medicine were included in our study. A total of 704 (72.6%) applicants submitted at least one geographic preference and 424 (43.7%) submitted three preferences. On average, applicants who submitted a geographic preference had a higher interview rate than those who did not (46.0% vs. 41.8%). Applications submitted with both a preference signal and geographic preference were significantly more likely to receive an interview offer (OR: 3.2, p  < 0.01) and match (OR: 6.4, p  < 0.01) than applications with neither a preference signal nor a geographic preference. Geographic preferences were associated with an increase in the odds of an application receiving an interview offer, even in the setting of a preference signal (OR: 1.4, p  < 0.01). Conclusions Both preference signals and geographic preferences have significant associations with odds of an application receiving an interview and matching for both categorical and preliminary internal medicine applicants. This study can be used to inform applicants, advisors, and programs how novel application strategies can affect important application outcomes for US medical school graduates. As more specialties pilot alternative processes, it will be important to study all application outcomes among varying applicant populations.

Purpose This manuscript summarizes the introduction, evolution and current outcomes for preference signaling in Urology as well as its use in other medical specialties. Overapplication plagues the residency recruitment process and PS has emerged as a process to improve the bottleneck of the interview selection process. Recent Findings PS has been shown to be associated with a higher likelihood of interview among many subspecialties. Applicants and programs report satisfaction with the process. Summary Further solutions are needed to increase transparency of program information and selection criteria to applicants so that critical decisions on which programs an applicant should apply to can be data driven.

Objective Signaling was introduced to the otolaryngology match in 2021, with 5 signals allotted to applicants in 2021, 4 in 2022, 7 in 2023, and 25 in 2024. This study investigated the modifying effect of signaling volume on the relationship between away rotations and matching in otolaryngology from 2018 to 2024. Study Design Cross‐sectional. Setting National survey of US medical students. Methods We used the Texas Seeking Transparency in Application to Residency (STAR) survey responses of otolaryngology applicants from 2018 to 2024. Using multivariate logistic regression, we determined the odds of matching where away rotations were performed and how these odds varied across the pre‐volume (2018‐2020), low‐volume (2021‐2023), and high‐volume (2024) signaling eras. Results In total, 28.3% (n = 855) of otolaryngology applicants from 2018 to 2024 completed the Texas STAR survey. Using multivariate logistic regression, adjusting for applicant characteristics, and including an interaction term between performing away rotations and signaling time period, applicants in the high‐volume signaling era were found to be significantly less likely to match at programs where away rotations were performed (odds ratio [OR]: 0.56, 95% CI: 0.33‐0.95; P < .05) compared to the pre‐signaling era. The same trend was seen in the low‐volume signaling era, though not statistically significant (OR: 0.76, 95% CI: 0.47‐1.22, P = .24). The most impactful factor on matching across all study years was performing an away rotation (OR: 12.1, 95% CI: 9.0‐16.5, P < .001). Conclusion The introduction of signaling and the recent increase in signal number are associated with decreased likelihood of matching at a program where an away rotation was performed compared to the pre‐signaling era. Level of Evidence V.

Background The residency matching process has become increasingly competitive across surgical subspecialties, with \"interview hoarding\" exacerbating resource inefficiencies and systemic inefficiencies in candidate selection. Traditional reliance on non-standardized metrics—particularly USMLE Step 1 scores, institutional prestige, and geographic connections—has further compounded equity concerns in the matching ecosystem. Preference signaling mechanisms have emerged as a standardized solution to enhance both matching efficiency and fairness, though current evidence remains limited by single-specialty studies and insufficient examination of long-term match outcomes. Methods Studies on the preference signaling mechanism in surgical subspecialties published after 2020 were retrieved from PubMed, Embase, and CENTRAL databases. Eleven high-quality retrospective cohort studies involving 10,448 applicants were included. Meta-analysis was performed to compare interview and match rates between signal and non-signal groups, with subgroup analyses assessing the impacts of specialty, data source, and other factors. Results Totally, eleven studies with 10,488 patients were included for meta-analyses. The interview rate in the signal group was 9.30 times higher than that in the non-signal group (95% CI 7.72–10.89), though substantial heterogeneity was observed across specialties ( I 2  = 96.5%). Orthopedics demonstrated the strongest signaling effect (OR = 18.05), while general surgery showed the weakest (OR = 4.53). Studies based on program directors’ data revealed a larger effect size (OR = 34.74). Pooled analysis of four studies showed the match rate in the signal group was 6.76 times higher than that in the non-signal group (95% CI 2.88–10.65), with moderate heterogeneity ( I 2  = 65%). Conclusions This meta-analysis confirms that the preference signaling mechanism significantly enhances interview rates and match rates in resident matching, demonstrating dual value in optimizing efficiency and promoting equity across surgical specialties. By providing cross-specialty evidence for system optimization, this study advances the preference signaling system toward greater efficiency and fairness in the residency matching process.

Objectives To assess the impact of applicant and program characteristics on preference signaling outcomes during the 2021 and 2022 application cycles in otolaryngology. Methods The Texas Seeking Transparency in Applications to Residency survey was used for otolaryngology applicants during the 2021 and 2022 match years. The primary outcome of interest was signal yield, defined as the number of interviews at signaled programs divided by the total number of signals sent. Associations with applicant‐reported characteristics, geographic connections to programs, and program reputation were assessed. Results On average 59.5% of signals resulted in an interview (signal yield). There was a positive correlation between the number of signals sent to a program with a reported geographic connection and signal yield, with each additional signal resulting in a 3.4% increase in signal yield (p = .03). Signal yield was positively associated with number of publications (p < .001); number of s, posters, and presentations (p = .04); and whether the applicant took a research year (p = .003). Applicants with higher USMLE Step 1 (p = .01) and Step 2 (p = .003) scores, publications (p = .03), volunteer (p = .008) and leadership (p = .001) experiences received a lower percentage of their total interviews from signaled programs whereas applicants from the 3rd (p < .001) and 4th (p = .03) cumulative class ranked quartiles received a higher percentage of their total interviews from signaled programs. Conclusions Signal yield appears to have a significant association with geographic connections to programs and applicant competitiveness. This study may help applicants, advisors, and programs maximize the benefit of the preference signaling system. Levels of evidence: Level 4.

A growing number of papers theoretically study the effects of introducing a preference signaling mechanism. However, the empirical literature has had difficulty proving a basic tenet, namely that an agent has more success when the agent uses a signal. This paper provides evidence based on a field experiment in an online dating market. Participants are randomly endowed with two or eight “virtual roses” that a participant can use for free to signal special interest when asking for a date. Our results show that, by sending a rose, a person can substantially increase the chance of the offer being accepted, and this positive effect is neither because the rose attracts attention from recipients nor because the rose is associated with unobserved quality. Furthermore, we find evidence that roses increase the total number of dates, instead of crowding out offers without roses attached. Despite the positive effect of sending roses, a substantial fraction of participants do not fully utilize their endowment of roses and even those who exhaust their endowment on average do not properly use their roses to maximize their dating success.

Participants in dictator games frequently avoid learning whether their choice to maximize their own earnings will help or hurt the recipient and then choose selfishly, exploiting the “moral wiggle room” provided by their ignorance. However, this is found in an environment in which the dictator must actively learn the true payoffs, so inaction means ignorance. Does this effect persist when one must actively choose either to be ignorant or to be informed or when one must actively choose to remain ignorant? In fact, whereas 45% of dictators remain ignorant when one must click to become informed, this drops to 25% when one must click in either case and to 3% when one must click to remain ignorant. Although the exploitation of moral wiggle room is not merely an artifact, it is, much like social behavior itself, subject to environmental and psychological factors that may reinforce or undermine its impact. Data, as supplemental material, are available at http://dx.doi.org/10.1287/mnsc.2014.1989 . This paper was accepted by Uri Gneezy, behavioral economics .

This research studies the product line design problem when consumers are subject to perceptual errors in assessing their intrinsic preferences. This research studies the product line design problem when consumers are subject to perceptual errors in assessing their intrinsic preferences. If perceptual errors are driven by common variables, then a firm may use aggregate consumer data (e.g., conjoint studies or anonymous usage data) to deduce the errors and infer the consumer preferences. In this way, we develop microfoundations necessary to show when and how the firm can understand consumer preferences better than consumers themselves, a situation we call superior knowledge . But is superior knowledge ever unprofitable? How should the firm with superior knowledge design its product line? Do consumers receive more-relevant products or simply have more surplus extracted? Can data collection help consumers make better choices? Our results suggest that consumers’ rational suspicions may prevent the firm from exploiting its superior knowledge. In addition, the burden of signaling may force the firm to offer efficient quality for its products. Therefore, allowing the firm to collect aggregate consumer data may be strictly Pareto improving.

Signaling pathways allow cells to detect and respond to a wide variety of chemical (e.g. Ca 2+ or chemokine proteins) and physical stimuli (e.g., sheer stress, light). Together, these pathways form an extensive communication network that regulates basic cell activities and coordinates the function of multiple cells or tissues. The process of cell signaling imposes many demands on the proteins that comprise these pathways, including the abilities to form active and inactive states, and to engage in multiple protein interactions. Furthermore, successful signaling often requires amplifying the signal, regulating or tuning the response to the signal, combining information sourced from multiple pathways, all while ensuring fidelity of the process. This sensitivity, adaptability, and tunability are possible, in part, due to the inclusion of intrinsically disordered regions in many proteins involved in cell signaling. The goal of this collection is to highlight the many roles of intrinsic disorder in cell signaling. Following an overview of resources that can be used to study intrinsically disordered proteins, this review highlights the critical role of intrinsically disordered proteins for signaling in widely diverse organisms (animals, plants, bacteria, fungi), in every category of cell signaling pathway (autocrine, juxtacrine, intracrine, paracrine, and endocrine) and at each stage (ligand, receptor, transducer, effector, terminator) in the cell signaling process. Thus, a cell signaling pathway cannot be fully described without understanding how intrinsically disordered protein regions contribute to its function. The ubiquitous presence of intrinsic disorder in different stages of diverse cell signaling pathways suggest that more mechanisms by which disorder modulates intra- and inter-cell signals remain to be discovered. Graphical abstract

Whether it is clothing, meals or an exercise regimen, consumers purchase a wide range of goods on a recurring basis using a subscription model. While past research indicates that people continue to subscribe to these services even when they rarely use them, no work to date has examined how identity considerations affect preferences in this domain. Building on research on signaling and self-concept structure, we propose that quitting an ongoing subscription can threaten the stability of the self-concept by signaling a change in identity. Consumers who are uncertain about their self-concept (i.e., low self-concept clarity) and motivated to maintain a stable self-concept are thus more likely to keep unused subscriptions than those who are more certain. In support of the underlying mechanism, we demonstrate that self-concept clarity affects choices only for identity-relevant subscription choices, and that it affects choices for subscriptions, but not one-shot product choices that are a weaker signal of identity. Finally, because signing up for a new subscription also signals an identity change that can threaten the stability of the self, consumers with low self-concept clarity are also less likely to subscribe to a new service compared to those with more certain self-concepts.