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Background and Objectives This study investigated the impact of treating facility type on guideline‐concordant sentinel lymph node biopsy (SLNB) management in T1a* (defined as a Breslow depth <0.76 mm without ulceration or mitoses) and T2/T3 melanoma. Methods This was a retrospective cohort study utilizing the National Cancer Database from 2012 to 2016. Results Our cohort included 109,432 patients. For T1a* melanomas, 85% of patients received guideline‐concordant SLNB management at community and academic facilities versus 75% of patients at integrated network facilities (p < .001). Over 83% of patients with T2/T3 melanoma treated at an academic facility received guideline‐concordant SLNB management versus 77% treated at a community facility (p < .001). Adjusting for demographic and clinical factors, integrated (adjusted odds ratio, aOR = 0.54), and comprehensive community (aOR = 0.74) facilities were less likely to provide guideline‐concordant SLNB management in patients with T1a* melanoma compared to academic facilities. Community facilities (aOR = 0.72) were less likely to provide guideline‐concordant SLNB management in patients with T2/T3 melanoma compared to academic facilities. Conclusion Academic facilities provide the highest rate of guideline‐concordant sentinel lymph node management. Comparatively, community programs may underutilize SLNB in T2/T3 disease, while integrated and comprehensive community facilities may over‐utilize SLNB in T1a* disease.

IMPORTANCE According to the National Residency Matching Program's biennial Charting Outcomes in the Match (NRMP ChOM) reports, the mean number of research items of matched allopathic dermatology applicants has nearly tripled since 2007, rising from 5.7 to 14.7. Research items are self-reported by applicants and serve as an approximation of research output. Because the NRMP research items field is unverified and reported as an aggregate of several different research pursuits, it may not be an accurate representation of applicant research output. OBJECTIVE To determine if the rise in NRMP-reported data is associated with a rise in verifiable, indexed publications from matched allopathic dermatology applicants from 2007 to 2018. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study including a bibliometric analysis on accepted applicant research output among 2234 matched allopathic dermatology applicants, with a total of 6229 publications, in dermatology residency programs for the years

The human chaperonin complex is a ~ 1 MDa nanomachine composed of two octameric rings formed from eight similar but non-identical subunits called CCT. Here, we are elucidating the mechanism of a heritable CCT5 subunit mutation that causes profound neuropathy in humans. In previous work, we introduced an equivalent mutation in an archaeal chaperonin that assembles into two octameric rings like in humans but in which all subunits are identical. We reported that the hexadecamer formed by the mutant subunit is unstable with impaired chaperoning functions. This study quantifies the loss of structural stability in the hexadecamer due to the pathogenic mutation, using differential scanning calorimetry (DSC) and isothermal titration calorimetry (ITC). The disassembly of the wild type complex, which is tightly coupled with subunit denaturation, was decoupled by the mutation without affecting the stability of individual subunits. Our results verify the effectiveness of the homo-hexadecameric archaeal chaperonin as a proxy to assess the impact of subtle defects in heterologous systems with mutations in a single subunit.