The Measure of a Man: A Critical Methodology for Investigating Essentialist Beliefs about Sexual Orientation Categories in Japan and the United States

Methods for studying laypeople’s beliefs about sexual orientation categories have evolved in step with larger theoretical and epistemological shifts in the interdisciplinary study of sexuality. The dominant approach to measuring laypeople’s sexual orientation beliefs over the past decade was made possible through an epistemological shift from a nature vs. nurture paradigm to a social constructionist theoretical model of psychological essentialism (Medin, 1989; Medin & Ortony, 1989; Rothbart & Taylor, 1992). Despite this shift, I argue that the forced-response scale-based survey methodologies typically used to operationally define essentialist beliefs about sexual orientation at best only partially realize the social constructionist potential of this underlying theory. By critically reconstructing this theory of psychological essentialism from an epistemological stance rooted in discourse, I developed a methodology reliant not on investigators’ but rather laypeople’s own mobilization of culturally shared discourses of sexuality. In testing this methodology, I focus on one theoretical dimension of psychological essentialism—inductive potential, or the extent to which shared knowledge about category membership allows for inference of a wealth of associated information about specific category members. I explored this critical methodology through a mixed-method empirical investigation of laypeople’s beliefs in the inductive potential of sexual orientation categories in relation to two components of sexuality: sexual desire and romantic love. I sought to answer two research questions: To what extent, and in what ways, do laypeople discursively mobilize inductive potential beliefs about homosexual or heterosexual men’s sexual desire and romantic love? To what extent, and in what ways, is laypeople’s discursive mobilization of those inductive potential beliefs explained by their gendered and/or cultural contexts? In Study 1, I primed cultural discourses of sexual orientation categories prior to an impression formation task. Students from four-year public universities in the Tokyo (N = 197; ages 18-23) and New York City (N = 208; ages 18-25) metropolitan areas read a series of fictional diary entries featuring a male college student (the target) describing his attraction to either a female or male classmate. Each participant then manually drew a Euler diagram comprised of circles representing their impressions of the relative importance (circle size) and interrelationships between (circle overlap) six identities associated with the target. To the extent participants engaged in inductive potential beliefs, I predicted that: (H1) participants would perceive sexual desire as more centrally defining of a same-sex attracted male target relative to an other-sex attracted male target; and (H2) participants would perceive romantic love as less centrally defining of a same-sex attracted male target relative to an other-sex attracted male target. Fitting multiple circle size and overlap outcomes to separate generalized linear models, I found a consistent pattern of support for both predictions. Cultural and gendered differences added additional nuance to these experimental patterns: Japanese participants associated men with greater sexual desire and less romantic love relative to their US peers, regardless of perceived sexual orientation. Additionally, US and Japanese men, compared to women, appeared to associate these two components of sexuality more frequently with men’s social roles. As such, while these results strongly suggested the presence of participants’ inductive potential beliefs about sexual orientation categories, they also pointed to important variation across culture and gender. In an effort to discursively unpack the inductively rich meanings associated with these additional gendered and cultural patterns, as well as establish the cultural credibility of my interpretations of the results of this experimental manipulation, in a second study I engaged separate peer focus groups in New York City (N = 20; ages 19-25) and Tokyo (N = 21; ages 20- 24) in discursively interpreting the Euler diagrams produced in Study 1. Using thematic analysis, I identified three themes concerning the ways several distinct sexual orientation discourses were culturally understood in the US and Japan; the ways those discourses were imbricated with other distinct discourses of cultural identity; and the ways laypeople voiced resistance to these sexual orientation discourses. I concluded that the experimental pattern from Study 1 could be explained in part through US participants’ rejection of an essentialist discourse of binary sexual orientation in favor of a focus on sexual practices; Japanese participants’ responses marked instead a troubling of essentialist discourses of binary gender. Taken together, these findings from Study 1 and 2 implicate sexual orientation as an inductively potent discourse in laypeople’s construction of beliefs about male sexuality across cultural contexts and genders, albeit in cultural distinct ways. These results thus add to past research on essentialist beliefs while also highlighting a need for critical methodologies sensitive to the ways culturally embedded and multiply imbricated transnational discourses of sexuality inform beliefs about men

Gastrointestinal Stromal Tumor (GIST) in Long Standing Crohn’s disease on Anti-TNF Therapy

Introduction Patients suffering from inflammatory bowel disease (IBD) are at increased risk for developing cancer. Adenocarcinomas are the most commonly observed tumors of the gastrointestinal tract whereas data on gastrointestinal stromal tumor (GIST) in IBD patients is limited. GIST is a neoplasm that originates from the interstitial cells of Cajal in the smooth muscle layers of the gastrointestinal tract. [1] The association between GIST and Crohn’s disease (CD) is debated, as the tumor inconsistently present in areas of inflammatory activity. We report an interesting case of CD maintained on Infliximab, who presented with a flare that revealed GIST in the stomach. To our knowledge, this is the first reported occurrence of GIST in stomach in a patient with CD maintained on anti-TNF therapy. Case Report A 40-year-old Caucasian man with a history of small bowel Crohn’s disease on infliximab therapy presented with a two-day history of abdominal pain, hematochezia, and diffuse joint pain. Upon admission, the patient was hemodynamically stable and afebrile, with a blood pressure of 140/70 mmHg, heart rate of 90 beats per minute, and respiratory rate of 14 per minute. Physical exam was remarkable for abdominal distension and diffuse abdominal tenderness. Complete blood count, comprehensive metabolic panel, and C-reactive protein were within normal range. The patient reported no history of alcohol abuse, smoking, recent abdominal procedures, or trauma. The patient had computed tomography (CT) of the abdomen done that revealed a 2.5-centimeter exophytic mass in the stomach with possible liver metastases (Fig. 1). Endoscopic ultrasound (EUS) guided biopsies of the exophytic mass confirmed gastrointestinal stromal tumor (GIST) on fine needle aspiration and flow cytometry results (Fig. 2,3). The patient underwent surgical resection without complication and is back to his usual state of health. Discussion GIST is the most common mesenchymal neoplasm in the gastrointestinal tract [1,2]. The annual incidence of GIST has been reported as 11-19.6 per million [3,4], however a more recent analysis in 2015 estimates the annual incidence to be 6.8 per million with a 53% predominance in males and 73% predominance in Caucasians [5]. Individuals are typically diagnosed with GIST in their seventh decade of life [5]. Immunologically, it is reported that 70-80% of GIST have a mutation in the KIT gene, leading to a continuously active KIT receptor, independent of its activating ligand [1]. KIT activation leads to overexpression of the protein CD117. In KIT-negative GIST, a small number are observed to have a mutation in platelet-derived growth factor receptor-a (PDGFRA). Dysregulated activation of either of these genes results in uncontrolled cell growth and survival. It is estimated that 10-15% of GIST do not have mutations in either KIT or PDGRFA, and while they are considered wild-type, they are shown to express high levels of KIT [1]. More recently, Novelli et al. found that the presence of proteins CD117 and DOG1 had the highest sensitivity and specificity for GIST [6]. The majority of GIST develop in the stomach (60%), with the jejunum and ileum representing the next most common site of involvement (30%) [7]. Several prognostic factors have been researched, most notably tumor location and mitotic index. Emory et al. found that GIST originating from the esophagus had the highest survival rate, followed by those that arose from the stomach, small bowel, colon/rectum, and omentum/mesentery in decreasing order [8]. Additionally, mitotic index, defined as the number of mitotic figures per high-power field (HPF), is reported an independent prognostic factor, with greater than 10 mitotic figures per 50 HPF showing the largest difference in survival in gastric GIST [8]. Small bowel GIST exhibited minimally different survival curves with respect to mitotic index. Age was also found to be an independent prognostic factor of survival in GIST [8]. Later research by Miettinen demonstrated that larger gastric GIST with a diameter of 10cm and 5 mitotic figures per 50 HPF carried a lower metastatic risk in comparison to gastric GIST with diameter of \u3e 5cm but with \u3e 5 mitotic figures per 50 HPF [9]. This may suggest that in gastric GIST, mitotic index carries the most prognostic value. Miettinen found that in intestinal GIST, a diameter of \u3e 5cm and \u3e 5 mitotic figures per HPF each independently carried a moderate or high risk of metastasis, respectively. Intestinal GIST carried a 39% tumor-related mortality rate, compared to 17% for gastric GIST [10,11]. Currently, surgery is the primary treatment modality for nonmetastatic GIST that is technically amenable to resection. Imatinib, a tyrosine kinase inhibitor (TKI), may be used as neoadjuvant therapy or as initial therapy for nonresectable disease [12]. Imatinib directly binds to the KIT protein and prevents further signaling [1]. This medication first demonstrated favorable treatment effects in 2002, with over 50% of the 147 patients showing at least a partial response to therapy [13]. Some patients develop resistance to Imatinib, prompting the development of alternative TKI therapy. Currently, Sunitinib is FDA approved for Imatinib-resistant GIST [14], with a host of other TKI’s and alternative therapies under investigation [1]. In 2012, Körner examined glucagon-like peptide-2 receptor (GLP-2) expression in a variety of neoplasm and found that 68% of the GISTs expressed this receptor in the intestinal myenteric plexus [15]. Additionally, this receptor was expressed in high density in patients with Crohn’s disease. Interestingly, this expression was absent in active or inactive ulcerative colitis as well as Hirschsprung’s disease [15]. Table 1: GIST with concurrent IBD. Author (ref) Age, Sex IBD Symptoms Location of GIST Imaging or operative findings Pfeffela, 1999 [16] 51, M CD Weight loss, Abdominal pain, Fever, Fatigue Ileum Large tumorous lesions in the right lower abdomen (terminal ileum) measuring 8 × 5 × 6 cm Grieco, 2002 [17] 57, F UC Melena, progressive anemia Ileum Solid mass in the left pelvic cavity with a diameter of 7 cm Mijandrusić Sincić, 2005 [18] 81, M CD Ileus Meckel’s diverticulum Dilated loops of intestine with large packets of gas and anti-peristalsis Kaiser, 2006 [19] 64, M UC Severe bleeding, abdominal distension Omentum 8 cm mass attached to greater omentum Ruffolo, 2010 [20] 59, M UC Rectal bleeding Rectum 0.5 cm GIST located 20 cm from anal adenocarcinoma Theodoropoulos, 2009 [21] 45, M CD Abdominal pain, vomiting, constipation, bloating Jejunum and Ileum 6 mm GIST within jejunoileal intussusception Bocker U, 2008 [22] 26, F CD Abdominal cramping, gastrointestinal bleeding Duodenum Ulcerated lesion noted 140 cm past proximal duodenum on enteroscopy Gianluca, 2016 [7] 38, M CD Asymptomatic Small bowel A mass found along the small bowel Gianluca, 2016 [7] 53, M UC Abrupt postoperative bleeding Stomach No evidences of masses at surgery. Gastric bleeding at endoscopy Present paper 40, M CD Abdominal pain, hematochezia Stomach 2.5 cm exophytic mass in the stomach with possible liver metastases CONCLUSION Our case of Crohn’s disease diagnosed with gastric GIST sheds light on a rare link between two separate disease entities native to the gastrointestinal system. While there exists a well-known association between inflammatory bowel disease and colon cancer, other malignancies are described much less frequently in the literature. The development of gastric GIST with underlying Crohn’s disease is a rare occurrence, but is one that should be kept in mind when evaluating patients with inflammatory bowel disease found to have new masses on imaging. References: 1. Corless CL, Barnett CM, Heinrich MC. Gastrointestinal stromal tumours: Origin and molecular oncology. Nat Rev Cancer. 2011;11(12):865-878. doi:10.1038/nrc3143 2. Katzka DA, Loftus E V., Camilleri M. Evolving molecular targets in the treatment of nonmalignant gastrointestinal diseases. Clin Pharmacol Ther. 2012;92(3):306-320. doi:10.1038/clpt.2012.77 3. Nilsson B, Bümming P, Meis-Kindblom JM, et al. Gastrointestinal stromal tumors: The incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era - A population-based study in western Sweden. Cancer. 2005;103(4):821-829. doi:10.1002/cncr.20862 4. Goettsch WG, Bos SD, Breekveldt-Postma N, Casparie M, Herings RMC, Hogendoorn PCW. Incidence of gastrointestinal stromal tumours is underestimated: Results of a nation-wide study. Eur J Cancer. 2005;41(18):2868-2872. doi:10.1016/j.ejca.2005.09.009 5. Ma GL, Murphy JD, Martinez ME, Sicklick JK. Epidemiology of gastrointestinal stromal tumors in the era of histology codes: Results of a population-based study. Cancer Epidemiol Biomarkers Prev. 2015;24(1):298-302. doi:10.1158/1055-9965.EPI-14-1002 6. Novelli M, Rossi S, Rodriguez-Justo M, et al. DOG1 and CD117 are the antibodies of choice in the diagnosis of gastrointestinal stromal tumours. Histopathology. 2010;57(2):259-270. doi:10.1111/j.1365-2559.2010.03624.x 7. Pellino G, Marcellinaro R, Candilio G, et al. The experience of a referral centre and literature overview of GIST and carcinoid tumours in inflammatory bowel diseases. Int J Surg. 2016;28:S133-S141. doi:10.1016/j.ijsu.2015.12.051 8. Emory TS, Sobin LH, Lukes L, Lee DH, O’Leary TJ. Prognosis of gastrointestinal smooth-muscle (stromal) tumors: Dependence on anatomic site. Am J Surg Pathol. 1999;23(1):82-87. doi:10.1097/00000478-199901000-00009 9. Miettinen M, Lasota J. Gastrointestinal stromal tumors: Pathology and prognosis at different sites. Semin Diagn Pathol. 2006. doi:10.1053/j.semdp.2006.09.001 10. Miettinen M, Sobin LH, Lasota J. Gastrointestinal stromal tumors of the stomach: A clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up. Am J Surg Pathol. 2005;29(1):52-68. doi:10.1097/01.pas.0000146010.92933.de 11. Miettinen M, Makhlouf H, Sobin LH, Lasota J. Gastrointestinal stromal tumors of the jejunum and ileum: A clinicopathologic, immunohistochemical, and molecular genetic study of 906 cases before imatinib with long-term follow-up. Am J Surg Pathol. 2006;30(4):477-489. doi:10.1097/00000478-200604000-00008 12. Demetri GD, Benjamin R, Blanke CD, et al. NCCN Task Force Report: Optimal Management of Patients with Gastrointestinal Stromal Tumor (GIST)--Expansion and Update of NCCN Clinical Practice Guidelines. Vol 2 Suppl 1.; 2004. 13. Eorge D Emetri GD, Argaret Von Ehren MM, Harles B Lanke CD, et al. The New Eng Land Jour Nal of Medicine EFFICACY AND SAFETY OF IMATINIB MESYLATE IN ADVANCED GASTROINTESTINAL STROMAL TUMORS A BSTRACT Background Constitutive Activation of KIT Receptor. Vol 347.; 2002. www.nejm.org. Accessed January 29, 2020. 14. Demetri GD, van Oosterom AT, Garrett CR, et al. Efficacy and safety of sunitinib in patients with advanced gastrointestinal stromal tumour after failure of imatinib: a randomised controlled trial. Lancet. 2006;368(9544):1329-1338. doi:10.1016/S0140-6736(06)69446-4 15. Körner M, Rehmann R, Reubi JC. GLP-2 receptors in human disease: High expression in gastrointestinal stromal tumors and Crohn’s disease. Mol Cell Endocrinol. 2012;364(1-2):46-53. doi:10.1016/j.mce.2012.08.008 16. Pfeffel F, Stiglbauer W, Depisch D, Oberhuber G, Raderer M, Scheithauer W. Coincidence of Crohn’s disease and a high-risk gastrointestinal stromal tumor of the terminal ileum. Digestion. 1999. doi:10.1159/000007684 17. Grieco A, Cavallaro A, Potenza AE, et al. Gastrointestinal stromal tumor (GIST) and ulcerative colitis. J Exp Clin Cancer Res. 2002. 18. Mijandrusic Sincic BM, Kovać D, Jašić M, Grbas H, Uravić M, Depolo A. Crohn’s disease and a gastrointestinal stromal tumor in an 81-year-old man - A rare coincidence. Zentralbl Chir. 2005. doi:10.1055/s-2005-918206 19. Kaiser AM, Kang JC, Tolazzi AR, Sherrod AE, Beart RW. Primary solitary extragastrointestinal stromal tumor of the greater omentum coexisting with ulcerative colitis. Dig Dis Sci. 2006;51(10):1850-1852. doi:10.1007/s10620-006-9217-y 20. Ruffolo C, Massani M, Rossi S, Caratozzolo E, Antoniutti M, Bassi N. Adenocarcinoma and GIST in ulcerative colitis. Int J Colorectal Dis. 2010;25(8):1027-1028. doi:10.1007/s00384-010-0905-x 21. Theodoropoulos GE, Linardoutsos D, Tsamis D, et al. Gastrointestinal stromal tumor causing small bowel intussusception in a patient with Crohn’s disease. World J Gastroenterol. 2009;15(41):5224-5227. doi:10.3748/wjg.15.5224 22. Böcker U, Löhr JM, Marx A. Twenty-six-year-old female with assumed Crohn’s disease and a gastrointestinal stromal tumor: Response. Inflamm Bowel Dis. 2009;15(4):489-490. doi:10.1002/ibd.2065

A blinded determination of H0H_0 from low-redshift Type Ia supernovae, calibrated by Cepheid variables

Presently a ${>}3\sigma$ tension exists between values of the Hubble constant $H_0$ derived from analysis of fluctuations in the Cosmic Microwave Background by Planck, and local measurements of the expansion using calibrators of type Ia supernovae (SNe Ia). We perform a blinded reanalysis of Riess et al. 2011 to measure $H_0$ from low-redshift SNe Ia, calibrated by Cepheid variables and geometric distances including to NGC 4258. This paper is a demonstration of techniques to be applied to the Riess et at. 2016 data. Our end-to-end analysis starts from available CfA3 and LOSS photometry, providing an independent validation of Riess et al. 2011. We obscure the value of $H_0$ throughout our analysis and the first stage of the referee process, because calibration of SNe Ia requires a series of often subtle choices, and the potential for results to be affected by human bias is significant. Our analysis departs from that of Riess et al. 2011 by incorporating the covariance matrix method adopted in SNLS and JLA to quantify SN Ia systematics, and by including a simultaneous fit of all SN Ia and Cepheid data. We find $H_0 = 72.5 \pm 3.1$ (stat) $\pm 0.77$ (sys) km s$^{-1}$ Mpc$^{-1}$ with a three-galaxy (NGC 4258+LMC+MW) anchor. The relative uncertainties are 4.3% statistical, 1.1% systematic, and 4.4% total, larger than in Riess et al. 2011 (3.3% total) and the Efstathiou 2014 reanalysis (3.4% total). Our error budget for $H_0$ is dominated by statistical errors due to the small size of the supernova sample, whilst the systematic contribution is dominated by variation in the Cepheid fits, and for the SNe Ia, uncertainties in the host galaxy mass dependence and Malmquist bias.Comment: 38 pages, 13 figures, 13 tables; accepted for publication in MNRA

Improved Classification Using Hidden Markov Averaging From Multiple Observation Sequences

The enormous popularity of Hidden Markov models (HMMs) in spatio-temporal pattern recognition is largely due to the ability to 'learn' model parameters from observation sequences through the Baum-Welch and other re-estimation procedures. In this study, HMM parameters are estimated from an ensemble of models trained on individual observation sequences. The proposed methods are shown to provide superior classification performance to competing methods

New Study Underway to Estimate the Impact of Lesser Scaup on Arkansas’ Baitfish Industry

The baitfish industry is an important economic enterprise for many aquaculture producers in Arkansas. The industry generates approximately $30 million annually in farm-gate sales of these small fish that include fathead minnows, goldfish and golden shiners. Diving ducks known as scaup, or “Bluebills,” spend late fall through early spring in Arkansas and Mississippi on deep water wetlands, rivers, and aquaculture ponds. The notion that scaup are consuming an abundance of baitfish in Arkansas ponds has concerned commercial growers for several years

New Study Underway to Estimate the Impact of Lesser Scaup on Arkansas’ Baitfish Industry

The baitfish industry is an important economic enterprise for many aquaculture producers in Arkansas. The industry generates approximately $30 million annually in farm-gate sales of these small fish that include fathead minnows, goldfish and golden shiners. Diving ducks known as scaup, or “Bluebills,” spend late fall through early spring in Arkansas and Mississippi on deep water wetlands, rivers, and aquaculture ponds. The notion that scaup are consuming an abundance of baitfish in Arkansas ponds has concerned commercial growers for several years

Do Antibiotic Intramedullary Dowels Assist in Eradicating Infection in Two-Stage Resection for Septic Total Knee Arthroplasty?

Background Evidence suggests approximately 40% of intramedullary (IM) canals are culture positive at resection for infected knee arthroplasty. While commonly utilized, no clinical data on the efficacy of antibiotic-eluding IM dowels exist. We quantified treatment success with and without the use of antibiotic-eluding IM dowels in two-stage treatment of periprosthetic knee infection using static and articulating antibiotic cement spacers. Methods 109 consecutive patients who underwent two-stage treatment for periprosthetic knee infection were reviewed. Treatment failure, defined as repeat resection before reimplantation or recurrent infection within 6 months of reimplantation, was evaluated based on spacer type and use of IM dowels, accounting for infection type and systemic host and local extremity grade. Results After exclusions for confounds, articulating spacers without IM dowels were used in 49 (57.7%) cases, articulating spacers with IM dowels in 14 cases (16.5%), and static spacers with IM dowels in 22 (25.9%) cases. Treatment success regardless of infection classification was 85.7% for articulating spacers with IM dowels, 89.8% for articulating spacers without IM dowels, and 68.2% for static spacers with IM dowels (P = .074). In chronically infected poor hosts with compromised extremities, treatment success remained highest in patients with articulating spacers with (90.9%) or without (92.9%) IM dowels compared with static spacers with IM dowels (68.4%) (P = .061). Conclusion Findings suggest that the use of IM dowels did not enhance infection eradication above and beyond that observed for articulating spacers alone, including in the worst cases involving chronically infected poor hosts with compromised extremities

Petition for a Writ of Certiorari. Opp v. Office of the State\u27s Attorney of Cook County, 565 U.S. 815 (2011) (No. 10-1163), 2011 U.S. LEXIS 6893

QUESTION PRESENTED Five major federal employment statutes, including in this case the Age Discrimination in Employment Act, exclude certain government workers at the policymaking level from the definition of employees protected by those laws. The question presented is: who is a worker on the policymaking level