Squamous Cell Transformation of Primary Lung Adenocarcinoma in a Patient With EML4-ALK Fusion Variant 5 Refractory to ALK Inhibitors.

Histologic transformation from adenocarcinoma to squamous cell carcinoma in lung cancer has not been reported as a mechanism of resistance to ALK inhibition. This report describes the clinical course of a female former light smoker with metastatic lung adenocarcinoma whose tumor underwent histologic transformation from a well-differentiated lung adenocarcinoma to a well-differentiated lung squamous cell carcinoma in the same location at the left mainstem bronchus while maintaining the ALK fusion oncogene without any resistance mutations. After experiencing disease progression while on crizotinib, the patient participated in clinical trials that provided early access to the novel ALK inhibitors ceritinib and alectinib before they were commercially available. Tumor recurrence occurred at the primary and metastatic central nervous system sites (ie, brain and spine). At tumor progression, liquid biopsy and tumor genomic profiling of plasma cell-free DNA next-generation sequencing (NGS) provided an accurate diagnosis with a short turnaround time compared with the tissue-based targeted capture NGS. The patient received several courses of radiation primarily to the brain and spine during her disease course. Her disease did not respond to the immune checkpoint inhibitor nivolumab, and she died on home hospice approximately 4 years after diagnosis. This case supports the importance of both histopathologic assessment and comprehensive genomic profiling in selecting appropriate treatment for patients with refractory, metastatic, ALK oncogene-driven non-small cell lung cancer. Use of symptom-directed radiation in tandem with ALK inhibitors contributed to the disease and symptomatic control and prolonged survival in this patient.

Looking the Part: Stereotypicality in Appearance Among White Professionals Predicts Leadership Attainment and Perceived Leadership Suitability.

This project explores the effects of racial phenotypic stereotypicality, or the degree to which a person's appearance is perceived as typical of their racial group, on leadership outcomes. Building on research showing that people hold an image of the ideal leader as a White person, we propose that looking more typically White may facilitate leadership attainment. In Study 1, which used a sample of American college football coaches (N = 1,106), White (vs. Black) coaches were more likely to occupy leadership roles. Furthermore, within race, stereotypicality positively predicted occupying a leadership or head-coach role among White professionals (and negatively predicted occupying a head-coach role among Black professionals). Study 2 elucidated a possible mechanism by showing a causal effect of stereotypicality on perceived suitability for leadership among Whites. These findings advance theorizing on the White-leader link and have implications for the ability of people of color to access lucrative professional roles.

The face of STEM: Racial phenotypic stereotypicality predicts STEM persistence by-and ability attributions about-students of color.

[Correction Notice: An Erratum for this article was reported in Vol 116(3) of Journal of Personality and Social Psychology (see record 2019-08943-003). In the article "The Face of STEM: Racial Phenotypic Stereotypicality Predicts STEM Persistence by-and Ability Attributions About-Students of Color" by Melissa J. Williams, Julia George- Jones, and Mikki Hebl (Journal of Personality and Social Psychology. Advance online publication. October 15, 2018. http://dx.doi.org/10.1037/pspi0000153), the Editor' Note acknowledging Toni Schmader as the action editor for this article was omitted. All versions of this article have been corrected.] Despite strong initial interest, college students-especially those from underrepresented minority (URM) backgrounds-leave STEM majors at high rates. Here, we explore the role of racial phenotypic stereotypicality, or how typical one's physical appearance is of one's racial group, in STEM persistence. In a longitudinal study, URM students were especially likely to leave STEM to the extent that they looked more stereotypical of their group; Asian American students were especially likely to leave STEM to the extent that they looked less stereotypical. Three experiments documented a possible mechanism; participants (Studies 2-4), including college advisors (Study 3), attributed greater STEM ability to more-stereotypical Asian Americans and to less-stereotypical Black women (not men), than to same-race peers. Study 4 showed that prejudice concerns, activated in interactions with Black men (not women), account for this gender difference; more-stereotypical Black men (like women) were negatively evaluated when prejudice concerns were not salient. This work has important implications for ongoing efforts to achieve diversity in STEM. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Biological conceptions of race and the motivation to cross racial boundaries.

The present studies demonstrate that conceiving of racial group membership as biologically determined increases acceptance of racial inequities (Studies 1 and 2) and cools interest in interacting with racial outgroup members (Studies 3-5). These effects were generally independent of racial prejudice. It is argued that when race is cast as a biological marker of individuals, people perceive racial outgroup members as unrelated to the self and therefore unworthy of attention and affiliation. Biological conceptions of race therefore provide justification for a racially inequitable status quo and for the continued social marginalization of historically disadvantaged groups.

Not yet human: implicit knowledge, historical dehumanization, and contemporary consequences.

Historical representations explicitly depicting Blacks as apelike have largely disappeared in the United States, yet a mental association between Blacks and apes remains. Here, the authors demonstrate that U.S. citizens implicitly associate Blacks and apes. In a series of laboratory studies, the authors reveal how this association influences study participants' basic cognitive processes and significantly alters their judgments in criminal justice contexts. Specifically, this Black-ape association alters visual perception and attention, and it increases endorsement of violence against Black suspects. In an archival study of actual criminal cases, the authors show that news articles written about Blacks who are convicted of capital crimes are more likely to contain ape-relevant language than news articles written about White convicts. Moreover, those who are implicitly portrayed as more apelike in these articles are more likely to be executed by the state than those who are not. The authors argue that examining the subtle persistence of specific historical representations such as these may not only enhance contemporary research on dehumanization, stereotyping, and implicit processes but also highlight common forms of discrimination that previously have gone unrecognized.

Culture and group perception: dispositional and stereotypic inferences about novel and national groups.

In 3 studies, the authors tested the hypothesis that Chinese participants would view social groups as more entitative than would Americans and, as a result, would be more likely to infer personality traits on the basis of group membership--that is, to stereotype. In Study 1, Chinese participants made stronger stereotypic trait inferences than Americans did on the basis of a target's membership in a fictitious group. Studies 2 and 3 showed that Chinese participants perceived diverse groups as more entitative and attributed more internally consistent dispositions to groups and their members. Guided by culturally based lay theories about the entitative nature of groups, Chinese participants may stereotype more readily than do Americans when group membership is available as a source of dispositional inference.

Sexual aggression when power is new: Effects of acute high power on chronically low-power individuals.

Previous theorists have characterized sexually aggressive behavior as an expression of power, yet evidence that power causes sexual aggression is mixed. We hypothesize that power can indeed create opportunities for sexual aggression-but that it is those who chronically experience low power who will choose to exploit such opportunities. Here, low-power men placed in a high-power role showed the most hostility in response to a denied opportunity with an attractive woman (Studies 1 and 2). Chronically low-power men and women given acute power were the most likely to say they would inappropriately pursue an unrequited workplace attraction (Studies 3 and 4). Finally, having power over an attractive woman increased harassment behavior among men with chronic low, but not high, power (Study 5). People who see themselves as chronically denied power appear to have a stronger desire to feel powerful and are more likely to use sexual aggression toward that end. (PsycINFO Database Record

The physician-hospital team: a successful approach to improving care in a large academic medical center.

Initiatives to improve the quality and efficiency of care in academic medical centers (AMCs, teaching hospitals) can benefit the performance of academic departments as well as the hospital. However, the value of performance improvement programs in an AMC is often challenging. At Jefferson Medical College, clinical efficiency and bed availability are important priorities to the Department of Medicine. To this end, a multidisciplinary program was designed to (1) improve the quality and consistency of care by adapting and adopting national guidelines for patients with heart failure and acute coronary syndrome; (2) identify and improve hospital operational supports and maximize resource utilization; (3) increase hospital functional capacity to make way for increased volume; and (4) improve housestaff education and practice by using evidence-based approaches and by optimizing teaching relationships between housestaff and attending faculty. The eight-month project (November 2002 to July 2003) resulted in improvement in several quality measures including increased use of beta blockers and angiotensin converting enzyme inhibitors for heart failure patients, reduced length of stay for heart failure and acute coronary syndrome patients, and increased satisfaction of the clinicians involved in caring for these patients. However, the project was not without barriers including individual physician's unwillingness to embrace change and an inability to incentivize change. Development of faculty leadership skills and enhanced physician accountability helped in overcoming the challenges of change.

The subtle suspension of backlash: A meta-analysis of penalties for women's implicit and explicit dominance behavior.

Previous research suggests that women, more than men, experience negative outcomes when they display dominance. A closer look, however, reveals ambiguity about the specific forms of dominance proscribed for women. Here, we suggest that negative reactions to women's dominance, a counter-stereotypical behavior, may require that the behavior be clearly encoded as counter-stereotypical-which is less likely when the behavior is expressed implicitly. This hypothesis was tested with a meta-analysis of studies on the evaluation of individuals behaving dominantly, including articles not directly investigating gender. Results revealed that dominance indeed hurts women's, relative to men's, likability (although the overall effect is small, d = -0.19, k = 63), as well as more downstream outcomes such as hireability (d = -0.58, k = 20). More important, however, dominance expressed explicitly (e.g., direct demands) affected women's likability (d = -0.28) whereas implicit forms of dominance (e.g., eye contact) did not (d = 0.03). Finally, the effect of dominance on men's and women's perceived competence did not differ (d = 0.02, k = 31), consistent with the idea that it is interpersonal (rather than instrumental) evaluations that obstruct women leaders. Implications for theory, and for the success of male and female leaders, are discussed.

Fundamental(ist) attribution error: Protestants are dispositionally focused.

Attribution theory has long enjoyed a prominent role in social psychological research, yet religious influences on attribution have not been well studied. We theorized and tested the hypothesis that Protestants would endorse internal attributions to a greater extent than would Catholics, because Protestantism focuses on the inward condition of the soul. In Study 1, Protestants made more internal, but not external, attributions than did Catholics. This effect survived controlling for Protestant work ethic, need for structure, and intrinsic and extrinsic religiosity. Study 2 showed that the Protestant-Catholic difference in internal attributions was significantly mediated by Protestants' greater belief in a soul. In Study 3, priming religion increased belief in a soul for Protestants but not for Catholics. Finally, Study 4 found that experimentally strengthening belief in a soul increased dispositional attributions among Protestants but did not change situational attributions. These studies expand the understanding of cultural differences in attributions by demonstrating a distinct effect of religion on dispositional attributions.

Cultural differences in expectations of change and tolerance for contradiction: a decade of empirical research.

Since the publication of Peng and Nisbett's seminal paper on dialectical thinking, a substantial amount of empirical research has replicated and expanded on the core finding that people differ in the degree to which they view the world as inherently contradictory and in constant flux. Dialectical thinkers (who are more often members of East Asian than Western cultures) show greater expectation of change in tasks related to explanation and prediction and greater tolerance of contradiction in tasks involving the reconciliation of contradictory information. The authors show how these effects are manifested in the domains of the self, emotional experience, psychological well-being, attitudes and evaluations, social categorization and perception, and judgment and decision making. They note important topics in need of further investigation and offer predictions concerning possible cultural differences in unexplored domains as a function of the presence or absence of naïve dialecticism.