The surprising underperformance of East Asians in US law and business schools: The liability of low assertiveness and the ameliorative potential of online classrooms.

SignificanceTo date, researchers and practitioners have focused on the academic challenges of underrepresented ethnic groups in the United States. In comparison, Asians have received limited attention, as they are commonly assumed to excel across all educational stages. Six large studies challenge this assumption by revealing that East Asians (but not South Asians) underperform in US law schools and business schools. This is not because East Asians are less academically motivated or less proficient in English but because their low verbal assertiveness is culturally incongruent with the assertiveness prized by US law and business schools. Online classes (via Zoom) mitigated East Asians' underperformance in courses emphasizing assertiveness and class participation. Educators should reexamine pedagogical practices to create a culturally inclusive classroom.

Why East Asians but not South Asians are underrepresented in leadership positions in the United States.

Well-educated and prosperous, Asians are called the "model minority" in the United States. However, they appear disproportionately underrepresented in leadership positions, a problem known as the "bamboo ceiling." It remains unclear why this problem exists and whether it applies to all Asians or only particular Asian subgroups. To investigate the mechanisms and scope of the problem, we compared the leadership attainment of the two largest Asian subgroups in the United States: East Asians (e.g., Chinese) and South Asians (e.g., Indians). Across nine studies (n = 11,030) using mixed methods (archival analyses of chief executive officers, field surveys in large US companies, student leader nominations and elections, and experiments), East Asians were less likely than South Asians and whites to attain leadership positions, whereas South Asians were more likely than whites to do so. To understand why the bamboo ceiling exists for East Asians but not South Asians, we examined three categories of mechanisms-prejudice (intergroup), motivation (intrapersonal), and assertiveness (interpersonal)-while controlling for demographics (e.g., birth country, English fluency, education, socioeconomic status). Analyses revealed that East Asians faced less prejudice than South Asians and were equally motivated by work and leadership as South Asians. However, East Asians were lower in assertiveness, which consistently mediated the leadership attainment gap between East Asians and South Asians. These results suggest that East Asians hit the bamboo ceiling because their low assertiveness is incongruent with American norms concerning how leaders should communicate. The bamboo ceiling is not an Asian issue, but an issue of cultural fit.

Ingroup vigilance in collectivistic cultures.

Collectivistic cultures have been characterized as having harmonious, cooperative ingroup relationships. However, we find evidence that people in collectivistic cultures are more vigilant toward ingroup members, mindful of their possible unethical intentions. Study 1 found that Chinese participants were more vigilant than Americans in within-group competitions, anticipating more unethical behaviors from their peers. Study 2 replicated this finding by comparing areas within China, finding that people from China's collectivistic rice-farming regions exhibit greater ingroup vigilance than people from the less collectivistic wheat-farming regions. The rice/wheat difference was mediated by greater perceived within-group competition. Study 3 found that Chinese participants were more likely than Americans to interpret a peer's friendly behavior as sabotage in disguise. We also manipulated within-group competition and found that it increased ingroup vigilance in both cultures. Finally, study 3 identified two boundary conditions where cultural differences in ingroup vigilance decrease: an unambiguously competitive win-lose situation where Americans also exhibit vigilance, and an unambiguously cooperative win-win situation where Chinese participants relax their vigilance. This research contributes to a more balanced view of collectivism, revealing its interpersonal tensions in the forms of within-group competition and ingroup vigilance.

Pediatric Appendicitis-Factors Associated With Surgical Approach, Complications, and Readmission.

BACKGROUND: Laparoscopic appendectomy is a preferred approach in children with appendicitis. Patient characteristics associated with open appendectomy are poorly characterized, although such information can help optimize the care. MATERIAL AND METHODS: To characterize the factors associated with open appendectomy, we performed a retrospective analysis using the 2014 Nationwide Readmissions Database, capturing 49.3% of US hospitalizations. We identified surgically managed appendicitis using International Classification of Diseases, Ninth Revision, Clinical Modification among patients aged 18 or younger. Factors associated with open appendectomy, 30-d readmission rate, and hospitalization length were assessed using logistic regression, Cox proportional hazards regression, and Poisson regression, respectively. RESULTS: Of 46,147 children with surgically managed appendicitis, 85.2% had laparoscopic appendectomy. Low-volume hospitals (odds ratio, OR: 3.01 [95% confidence interval, CI: 1.81-5.01]), rural hospitals (OR: 2.36 [95%CI: 1.63-3.40]), public insurance (OR: 1.19 [95%CI: 1.03-1.36]), lower-income neighborhood residence (OR: 1.40 [95%CI: 1.06-1.86]), younger age (OR: 5.00 [95%CI: 3.64-6.86] in <5 year-old), and abscess complicating appendicitis (OR: 1.91 [95%CI: 1.58-2.31]) were associated with open appendectomy. Laparoscopic appendectomy was associated with shorter hospitalization (incidence rate ratio: 0.77 [95%CI: 0.69-0.87]) and less readmission with wound infection, but not with 30-d readmission, or readmission with intraabdominal abscess. CONCLUSIONS: Along with clinical factors, non-clinical factors including appendicitis volume and rural/teaching status of the treating hospitals play a role in the choice of surgical approach. Awareness of the patient- and hospital-level factors associated with open appendectomy may allow for future resource distribution or improvement in access to care, resulting in population-level impact.

Polycultural psychology.

We review limitations of the traditional paradigm for cultural research and propose an alternative framework, polyculturalism. Polyculturalism assumes that individuals' relationships to cultures are not categorical but rather are partial and plural; it also assumes that cultural traditions are not independent, sui generis lineages but rather are interacting systems. Individuals take influences from multiple cultures and thereby become conduits through which cultures can affect each other. Past literatures on the influence of multiple cultural identities and cultural knowledge legacies can be better understood within a polyculturalist rubric. Likewise, the concept elucidates how cultures are changed by contact with other cultures, enabling richer psychological theories of intercultural influence. Different scientific paradigms about culture imply different ideologies and policies; polyculturalism's implied policy of interculturalism provides a valuable complement to the traditional policy frames of multiculturalism and colorblindness.

Heritage-culture images disrupt immigrants' second-language processing through triggering first-language interference.

For bicultural individuals, visual cues of a setting's cultural expectations can activate associated representations, switching the frames that guide their judgments. Research suggests that cultural cues may affect judgments through automatic priming, but has yet to investigate consequences for linguistic performance. The present studies investigate the proposal that heritage-culture cues hinder immigrants' second-language processing by priming first-language structures. For Chinese immigrants in the United States, speaking to a Chinese (vs. Caucasian) face reduced their English fluency, but at the same time increased their social comfort, effects that did not occur for a comparison group of European Americans (study 1). Similarly, exposure to iconic symbols of Chinese (vs. American) culture hindered Chinese immigrants' English fluency, when speaking about both culture-laden and culture-neutral topics (study 2). Finally, in both recognition (study 3) and naming tasks (study 4), Chinese icon priming increased accessibility of anomalous literal translations, indicating the intrusion of Chinese lexical structures into English processing. We discuss conceptual implications for the automaticity and adaptiveness of cultural priming and practical implications for immigrant acculturation and second-language learning.

Hepatocyte autophagy is linked to C/EBP-homologous protein, Bcl2-interacting mediator of cell death, and BH3-interacting domain death agonist gene expression.

BACKGROUND: Endoplasmic reticulum (ER) stress and autophagy each play important roles in hepatocyte cell injury. We hypothesized that gene expression of C/EBP-homologous protein (CHOP) and the BH3 proteins Bcl2-interacting mediator of cell death (BIM) and BH3-interacting domain death agonist (BID) are involved in a complex interplay that regulates ER stress-induced autophagy and cell death. MATERIALS AND METHODS: Hepatocytes were cultured from lean Zucker rats. Confluent hepatocytes were incubated with single or combined small interfering RNA for CHOP, BIM, and/or BID for 24 h providing gene inhibition. Incubation with tunicamycin (TM) for another 24 h stimulated ER stress. Quantitative real-time polymerase chain reaction determined the expression levels of CHOP, BIM, and BID. Immunostaining with microtubule-associated protein 1 light chain 3 measured autophagy activity. Trypan blue exclusion determined the cell viability. RESULTS: TM treatment increased the messenger RNA levels of CHOP and BIM but decreased the messenger RNA levels of BID. TM increased autophagy and decreased cell viability. Individual inhibition of CHOP, BIM, or BID protected against autophagy and cell death. However, simultaneous treatment with any combination of CHOP, BIM, and BID small interfering RNAs reduced autophagy activity but increased cell death independent of ER stress induction. CONCLUSIONS: Autophagy in hepatocytes results from acute ER stress and involves interplay, at the gene expression level, of CHOP, BIM, and BID. Inhibition of any one of these individual genes during acute ER stress is protective against cell death. Conversely, inhibition of any two of the three genes results in increased nonautophagic cell death independent of ER stress induction. This study suggests interplay between CHOP, BIM, and BID expression that can be leveraged for protection against ER stress-related cell death. However, disruption of the CHOP/BH3 gene expression homeostasis is detrimental to cell survival independent of other cellular stress.

Modulation of the inflammatory response by increasing fetal wound size or interleukin-10 overexpression determines wound phenotype and scar formation.

Wound size impacts the threshold between scarless regeneration and reparative healing in the fetus with increased inflammation showed in fetal scar formation. We hypothesized that increased fetal wound size increases pro-inflammatory and fibrotic genes with resultant inflammation and fibroplasia and that transition to scar formation could be reversed by overexpression of interleukin-10 (IL-10). To test this hypothesis, 2-mm and 8-mm dermal wounds were created in mid-gestation fetal sheep. A subset of 8-mm wounds were injected with a lentiviral vector containing the IL-10 transgene (n = 4) or vehicle (n = 4). Wounds were harvested at 3 or 30 days for histology, immunohistochemistry, analysis of gene expression by microarray, and validation with real-time polymerase chain reaction. In contrast to the scarless 2-mm wounds, 8-mm wounds showed scar formation with a differential gene expression profile, increased inflammatory cytokines, decreased CD45+ cells, and subsequent inflammation. Lentiviral-mediated overexpression of the IL-10 gene resulted in conversion to a regenerative phenotype with decreased inflammatory cytokines and regeneration of dermal architecture. In conclusion, increased fetal wounds size leads to a unique gene expression profile that promotes inflammation and leads to scar formation and furthermore, these results show the significance of attenuated inflammation and IL-10 in the transition from fibroplasia to fetal regenerative healing.

When the one true faith trumps all: Low religious diversity, religious intolerance, and science denial.

Past theories have linked science denial to religiosity but have not explained its geographic variability. We hypothesize that it springs not only from religious intensity but also from religious intolerance, which depends greatly on the experience of religious diversity and hence on geography. The belief that one's religion trumps other faiths precipitates the stance that it trumps science too. This psychological process is most likely to operate in regions or countries with low religious heterogeneity. We measure the rejection of science not only in people's refusal to follow specific health recommendations, such as taking COVID-19 vaccines, but also in general measures of scientific engagement and attainment. We rule out alternative explanations, including reverse causality and spurious correlations, by conducting controlled experiments and running robustness checks on our statistical models.

The effect of configural processing on mentalization.

Eight studies (N = 2,561) reveal that how we perceptually process a person's face affects our capacity to understand their mind. Studies 1A and B indicate this relationship functions via two separate pathways: (a) indirectly by increasing our sensitivity to the cues of a mind in a face and (b) directly by changing the way we relate to the mind behind the face. Six additional studies adopt perspective taking paradigms to provide further support for a direct effect of configural processing on mentalization. Studies 2 and 3 find that processing faces configurally increases perspective taking on spatial tasks compared to processing faces featurally. Study 4 demonstrates configural face processing gives rise to inferences about the target's mental states such as beliefs and desires. Study 5 finds manipulation of a target's face that heightens configural processing increases perspective taking. Using a positive control, Study 6 demonstrates real-world consequences. Taken together, these findings document that the multiple and complex consequences of configural processing are critical to the social function of mentalization. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Inflammatory Myofibroblastic Tumor of the Esophagus and Stomach Successfully Treated With ALK Inhibitor in a Pediatric Patient: A Case Report and Concise Review of Literature.

An inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal neoplasm of borderline malignant potential. Nearly half of all IMTs have rearrangement of anaplastic lymphoma kinase (ALK) locus on chromosome 2p23 which can be treated with targeted therapy. Herein, we describe an unusual presentation of IMT involving an anatomical region rarely implicated in this disease process. A 15-year-old male patient came to the ER with dysphagia and coffee ground emesis. On esophagogastroscopy, a nodular luminal obstructing 30 × 50 mm mass in the lower esophagus was found, which was continuous with a large, partially circumferential gastric mass extending from the mid-body to the proximal antrum. Biopsies from esophageal and gastric masses revealed submucosal lesions composed of cytologically bland spindle and epithelioid cells, intermingled with inflammatory infiltrate, for which several immunohistochemical (IHC) stains were performed. The molecular study demonstrated ATIC::ALK fusion. Based on morphological, IHC, and molecular study findings, the diagnosis of ALK-positive IMT was rendered. Because surgical excision was deemed infeasible, the patient was started on ALK-inhibiting therapy with crizotinib. The patient responded well with no evidence of residual or recurrent disease on follow-up imaging or surveillance esophagogastroduodenoscopy. Crizotinib was ultimately discontinued after 10 months of therapy, and the patient continues to undergo surveillance imaging for monitoring of disease burden.

Autophagy is involved in endoplasmic reticulum stress-induced cell death of rat hepatocytes.

BACKGROUND: Both endoplasmic reticulum (ER) stress and autophagy have been shown to display dual roles in cell survival in multiple cell lines. There is a reported but poorly understood link between ER stress, autophagy, and cell death. We hypothesized that autophagy plays a role in ER stress-dependent cell death in rat hepatocytes. MATERIALS AND METHODS: Primary hepatocytes isolated from both lean and obese male Zucker rats were cultured and treated with tunicamycin (TM), tauroursodeoxycholic acid, 3-methyladenine, and wortmannin for 12 h. The ER stress-associated genes glucose-regulated protein 78 and C/EBP homologous protein were examined via quantitative real time polymerase chain reaction. Immunostaining with microtubule-associated protein 1 light chain 3 as well as electron microscopy were used to evaluate autophagy activity. Trypan blue exclusion was used to determine hepatocyte cell viability. RESULTS: In both lean and steatotic hepatocytes, we found that TM induced both C/EBP homologous protein and glucose-regulated protein 78 messenger RNA expression. Cells with increased ER stress were undergoing increased autophagy and had a significant decrease in cell viability. Both tauroursodeoxycholic acid and 3-methyladenine treatments attenuated TM induced ER stress, autophagy, and cell death, whereas wortmannin treatment reduced autophagy and cell death but without changing ER stress. CONCLUSIONS: These data suggest that autophagy is a likely downstream mediator of ER stress-induced cell death in rat hepatocytes. Further exploration of the link between autophagy and ER stress in hepatocyte injury will yield important information that may be leveraged for treatment of liver injuries such as ischemia/reperfusion.

Cicatrical cecal volvulus following laparoscopic cholecystectomy.

Laparoscopic cholecystectomy is the procedure of choice for the treatment of symptomatic biliary disease. There is currently no agreement on the management of spilled gallstones, which commonly occurs during laparoscopic cholecystectomy and may produce significant morbidity. We present a case of spilled gallstones causing cicatrical cecal volvulus and also provide a review of pertinent literature.

A Case of Malignant Brenner Tumor of the Ovary Incidentally Found in a Patient with Deep Vein Thrombosis.

We present the case of a 73-year-old woman who was incidentally found to have a malignant Brenner tumor (MBT) of the ovary during an evaluation for deep vein thrombosis (DVT). The patient presented with swelling in her left leg, non-healing ulcers, weakness, and numbness in her lower limbs. Imaging studies revealed a large multiloculated cystic mass with areas of calcification in the left adnexa extending to the upper abdomen toward the gallbladder fossa. The patient underwent exploratory laparotomy with removal of the ovarian cyst, later diagnosed as a focal MBT in a background of borderline Brenner tumor. Brenner tumors of the ovary are a rare subtype of ovarian neoplasm that accounts for less than 2% of all ovarian tumors. MBTs are even rarer, comprising less than 5% of all Brenner tumors. To our knowledge, this is the first reported case of an MBT incidentally found in a patient with DVT.

Population Density and Triage of Pediatric Firearm Injuries in a Rural Trauma System.

BACKGROUND: Rural pediatric firearm injuries require regional pediatric and trauma expertise. We evaluated county-level population density associations with transport, hospital interventions, and patient outcomes at a Level I pediatric trauma center serving a rural, statewide catchment area. MATERIAL AND METHODS: The trauma registry of the only in-state pediatric trauma center was reviewed for firearm injuries in patients < 18 between 1/2013 and 3/2020. County-level population density was classified according to the United States Office of Management and Budget definitions for rural, micropolitan, and metropolitan areas. RESULTS: 364 patients were identified, including 7 patients who were re-injured. Mean age was 11.3 ± 4.5 y and patients were 79.4% male. 59.3% were transferred from a referring hospital. Median injury severity score was 5 (IQR 1-10); 88.0% required trauma center admission, and 48.2% required operative intervention. 7.4% were injured in a rural county, 46.4% in a micropolitan county, and 46.2% in a metropolitan county. Patients from rural counties were more likely to be unintentionally injured (72.0%) than those from micropolitan (54.4%) or metropolitan counties (44.0%, P = .04). While need for inpatient admission and length of stay were similar, those transported from rural counties had significantly longer transport times (P < .01) and less frequent need for operative intervention (P = .03), as well as trends toward lower injury severity (P = .08) and mortality (P = .06). CONCLUSION: Management of pediatric firearm injury is a unique challenge with significant regional variability. Opportunities exist for outreach, telehealth, and decision support to ensure equitable distribution of resources in rural trauma systems. LEVEL OF EVIDENCE: Epidemiological, Level III.

Assistive/rehabilitation technology, disability, and service delivery models.

The United Nation's Millennium Development Goals do not explicitly articulate a focus on disability; similar failures in the past resulted in research, policy, and practice that are not generalizable and did not meet the needs of persons with disabilities since they were developed for an "average" population. Academics and professionals in health and other disciplines should have a knowledge base in evidence-based practices that improve well-being and participation of people with disabilities through effective service delivery of assistive technology. Grounded by a theoretical framework that incorporates a multivariate perspective of disability that is acknowledged in the convention on the rights of persons with disabilities and the World Health Organization's International Classification of Functioning, Disability and Health, we present a review of models of assistive technology service delivery and call for future syntheses of the fragmented evidence base that would permit a comparative effectiveness approach to evaluation.

Closed Gastroschisis: A Rare Abdominal Wall Defect.

Gastroschisis is a rare congenital abdominal wall defect characterized by intestinal evisceration to the right of the umbilical stalk. In less than 6% of cases, the fascial defect closes around the herniated viscera in utero. The mechanism of fascial closure in these cases is unknown; however, the tourniquet effect on the mesenteric vasculature is thought to lead to intestinal atresia and midgut infarction. We report a case of a female neonate with a prenatal diagnosis of gastroschisis who was found to have a closed defect at the time of delivery. She required emergent operation for symptoms of intestinal obstruction and bowel ischemia.

Left-Sided Amyand Hernia.

An Amyand's hernia is defined by the presence of the vermiform appendix in the inguinal hernia sac. Most cases of Amyand's hernia are incidentally diagnosed intraoperatively while surgically reducing a right inguinal hernia. Right-sided Amyand's hernias are more common than left-sided Amyand's hernias for two reasons: the appendix is naturally located on the right side and right inguinal hernias are more common. The prevalence of an Amyand's hernia has been reported as 1%, but the true prevalence is much lower than that. We report a particularly rare case of a 5-month-old boy with a left-sided Amyand's hernia surgically repaired without appendectomy.

Experiential learning of cultural norms: The role of implicit and explicit aptitudes.

How should I greet her? Should I do what he requests? Newcomers to a culture learn its interpersonal norms at varying rates, largely through trial-and-error experience. Given that the culturally correct response often depends on conditions that are subtle and complex, we propose that newcomers' rate of acculturation depends on not only their explicit aptitude (e.g., reasoning ability) but also their implicit aptitude (e.g., pattern recognition ability). In Studies 1-3, participants experienced a range of influence situations sourced from a foreign culture. Across many trials, they decided whether or not to comply and then received accuracy feedback (based on what a majority of locals indicated to be the appropriate action in each situation). Across the 3 studies, stronger implicit aptitude was associated with greater improvement from trial-and-error experience, whereas stronger explicit aptitude was not. In Studies 4-6, participants experienced a range of greeting situations from a foreign culture. Across many trials, implicit aptitude predicted experiential learning, especially under conditions that impede reasoning: multiple cues, subliminal feedback, or inconsistent feedback. Study 7 found that the predictiveness of implicit aptitude was weaker under a condition that impedes associative processing: delayed feedback. These findings highlight the important role of implicit aptitude in helping people learn interpersonal norms from trial-and-error experience, particularly because in real-life intercultural interactions, the relevant cues are often complex, and the feedback is often fleeting and inconsistent but immediate. (PsycInfo Database Record (c) 2022 APA, all rights reserved).