bluuebunny/crossref_metadata_2025 huggingface dataset:
B Cell Development and Maturation
Authors: Schultze Joachim L , Gribben John G
Published: November 2023

B-lymphopoiesis is a developmentally regulated process characterized by differential phenotypic expression of a number of cell-surface and intracytoplasmic markers, immunoglobulin (lg) gene rearrangement, and, subsequently, class switching. Dysregulation of this orderly process can result in humoral deficiency, autoimmunity, or B cell malignancy (Goodnow, 1996). Increasing evidence points to the importance of interactions between the developing B cell and its microenvironment. The development of B cell-specific lineage cells is bone marrow (BM) stromal-dependent. Stromal interactions are also important in the development of antigen-specific B cells in secondary lymphoid organs, with increasing evidence pointing to the interaction of CD40 ligand with CD40 on the B cell playing an essential role here. Broadly, the process of B cell development can be divided into two stages. First, development of B cell-specific lineage cells from co34+ uncommitted progenitors. This occurs in the BM and is associated with lg recombination events. Second, development from naive to memory B cells. This is an antigen-driven process that occurs in lymphoid tissue and is characterized by acquisition of somatic hypermutation.
Zebrafish Hematopoietic Mutants
Authors: Zon Leonard I
Published: November 2023

The elegant genetics of the zebrafish system has allowed for the isolation of many mutants affecting hematopoiesis (Ransom et al., 1996; Weinstein et al., 1996). There are over 26 complementation groups of such mutants, providing a collection that represents critical steps in vertebrate hematopoiesis and illustrates the multiple stages of differentiation (Brownlie et al., 1998; Orkin and Zon, 1997; Bahary and Zon, 1998). Recent advances in candidate and positional cloning in the zebrafish has allowed for the characterization of these mutant genes. Some mutant genes are novel and thus define new steps in the hematopoietic program, while other genes represent human disease models. The genetics of the zebrafish, coupled with its powerful developmental biology, will thus provide a plethora of information on vertebrate hematopoiesis.
Spontaneous and Targeted Mutations in Erythrocyte Membrane Skeleton Genes: Mouse Models of Hereditary Spherocytosis
Authors: Peters Luanne L , Barker Jane E
Published: November 2023

The red cell outer limiting membrane is critical to all aspects of red cell function. The membrane responds to extracellular signals during erythropoiesis, mediates iron uptake, facilitates carbon dioxide transport, regulates red cell cation and water content, and provides a negatively charged exterior that allows red cells to flow through the circulation without adhering to the endothelial layer of the vasculature. Evidence suggests that the red cell membrane also regulates energy metabolism by reversibly binding the glycolytic enzymes glyceraldehyde 3-phosphate dehydrogenase, aldolase, and phosphofructokinase (Harrison et al., 1991; Low et al., 1993).
Clitics: A Window Into The Null Subject Property
Authors: Barbosa Pilar
Published: November 2023

According to most analyses, (Rizzi 1982, 1990; Burzio 1986; Belletti 1990, among many others) the preverbal subject in (2a) has been A-moved to Spec, IP. It has been often noted (Brito and Duarte 1983; Brito 1984; Ambar 1988; Calabrese 1990; Saccon 1993; Pinto 1994, among many others) that the preverbal subject in (2a) has different discourse properties from the postverbal subject in (2b): preverbal subjects are topics, whereas postverbal subjects are foci. Based on this observation, Saccon (1993), Pinto (1994), Adger (1996), Grimshaw and Samek-Lodovici (1994), and Costa (1996) proposed that overt movement to Spec, IP in the NSLs is triggered by some “topic” feature. Under this approach, the NSLs differ from the non-NSLs in the possibility of leaving foci subjects in situ, but, from a strictly configurational point of view, subject initial constructions in the NSLs do not differ substantially from subject initial constructions in the non-NSLs: in both cases the subject is raised to Spec, IP, an A-position.
Romance Clitics and the Minimalist Program
Authors: Duarte Inês , Matos Gabriela
Published: November 2023

Since Kayne’s pioneering work on French clitic pronouns, two major questions have been asked with respect to the syntax of clitics: (i) What are the properties that force clitics to move differently from full DPs and regular affixes? (ii) Why is it that clitics do not surface at the same positions cross-linguistically and within the same language?
Leaders of Hot Groups II: Some Options for the Leader of a New Group
Authors: Lipman-Blumen Jean , Leavitt Harold.
Published: November 2023

Leading a hot group is more like leading a rough-and-tumble political campaign than working at a steady government job. It’s much more like leading a military squad in a tough combat situation than managing an ongoing operating unit of a large company. Hot groups, that is, are hot. They are here, and they are now, vitally, intensely, actively involved in pursuing their task. So, to lead them, a leader must think more like a campaign manager than a civil servant, more like an infantry officer than an accountant. Treat your group as what it is: a small enclave of dedicated human beings in a hurry to do an important job. Don’t view it as a system, or a set of job descriptions, or a hierarchy of authority.
The Organizational Surround I: “Where and “When Do Hot Groups Thrive?
Authors: Lipman-Blumen Jean , Leavitt Harold.
Published: November 2023

Hot groups go blah in the dull, dog-days of regularity and routine. They flourish amid atmospheric Sturm und Drang. Paradoxically, that statement may appear to contradict some advice offered in an earlier chapter. There, we proposed that one way to encourage hot groups was via relaxation, by loosening organizational rules. There’s no conflict though. First step: Relax constraints. Second step: Agitate the organization, so it will utilize its new freedom. Stir it up. Instill a sense of urgent purpose. Open its doors and windows, so its occupants can hear, see, and feel the turbulent winds of change blowing out there. Entice the organization’s people out of their offices, into the storm. Get them out where the action is, among customers, suppliers, potential allies, and competitors. Then, things will happen. Ideas will generate and so will hot groups. That’s what this chapter is about, the organizational conditions that make hot groups flourish―and those that don’t. We’ll start with those that don’
Pricing Human Life Getting Beyond Tragic Choices
Authors: Fleck Leonard M
Published: November 2023

The conductor of a trolley has suddenly dropped over dead and the brakes have failed. You are one of a few passengers on the trolley, and you are nearest to the conductor. The trolley is running downhill. You can see far enough ahead that you know the trolley will stop safely eventually. However, you also see five workers on the track ahead. If you simply allow the trolley to follow its present course, those five workers will be killed. You have a choice—you can grab the steering mechanism and direct the trolley down a spur where it will again come to a safe stop—but a small child is playing on the tracks. That child will be killed if you choose to steer the trolley down that spur. What should you do?
Elements of Health Care Justice
Authors: Fleck Leonard M
Published: November 2023

If an individual has advanced colorectal cancer, and if current chemotherapeutic regimens are no longer capable of stopping tumor progression, and if cetuximab (Erbitux) is the only remaining intervention that has proven effective in stopping tumor progression for an additional period of time, and if that individual ‘s insurance company refuses to pay the $12,000 per month cost of the drug because it only increases median survival by 1.5 months (compared to palliative care only [Jonker et al., 2007]), then has that individual been treated unjustly? If an individual has total cholesterol of 200 but he wishes to achieve an additional margin of safe health by driving that number down to 160 through the use of statins, and if his insurance company refuses to cover the $1,100 per year cost of that drug because their judgment is that the additional gains are too marginal relative to cost, has that individual been treated unjustly? Should our answer to our questions matter whether we are talking about a working-class individual earning $35,000 per year or an upper middle-class individual earning $20,000 per year?
Rationing, Catastrophic Illness, and Disabled Patients
Authors: Fleck Leonard M
Published: November 2023

The average cost for each of these patients then was more than . Mr. Diaz from our first chapter would be a perfect example of one sort of patient who would generate these results—he spent more than days in the ICU. He entered the ICU as a patient with advanced dementia and a bleeding problem of unknown origin that precipitated that hospitalization; the cost of his care was about.
Transforming Retail Banking
Authors: Hunter Larry W
Published: November 2023

A substantial segment of the American work force may be facing a future of “lousy jobs.” The essays collected in Burt less (1990), for example, suggest that workers with high levels of education and sought-after skills face excellent opportunities, but that prospects for workers with high school educations or less are bleak. Employers seem increasingly to be constructing jobs for low-skilled workers that offer low wages and benefits, minimal training, and little opportunity for advancement.
What If the Rest of the World Looked Like Trucking’?
Authors: Belzer Michael H
Published: November 2023

Has the restructuring of the trucking industry been a success or a failure? The answer depends to some extent on your perspective. Each constituency is a” special interest” when it comes to public policies that regulate motor carriers. The task of public policy is to balance those interests and maximize social welfare.
Deregulation as Public Policy
Authors: Belzer Michael H
Published: November 2023

Over the last 25 years, arguments for economic deregulation have dominated the policy debate. While it is true that our nation continues to enact certain types of regulations-primarily social regulations, such as the Americans with Disabilities Act and the Family and Medical Leave Act-the primary goal of legislators in the last two decades has been to increase competition by lifting many of the economic regulations that have long governed U.S. industry. Less and less of an institutional framework exists for markets as markets operate more freely. The general trend has been to eliminate economic regulation and allow markets to allocate resources and prescribe winners and losers.
Introduction
Authors: Rivero María Luisa , Ralli Angela
Published: November 2023

This volume grew out of the workshop on the syntax of Balkan languages, organized by Angela Ralli and Irene Philippaki-Warburton, held in Athens in 1996 in connection with the Glow Colloquium The idea behind this workshop which featured Brian D. Joseph and María Luisa Rivero as invited speakers, was to provide a forum where comparative work related to the syntax of Balkan languages could be presented. This is also the basic goal of the present collection. The volume brings together seven papers on syntactic topics in which leading and new researchers in Balkan syntax examine aspects of the grammar of mainly Albanian, Bulgarian, Greek, and Romanian.
Conversation Analysis and Communication Disorders
Authors: Schegloff Emanuel A
Published: November 2023

My own interest in the possible bearing of conversation-analytic work on talk vernacularly taken to be problematic or odd or compromised and professionally understood to be pathological in some respect, whether psychiatric or neurological, goes back quite a long time, to before a distinct field recognizable as conversation analysis began. So did Sacks’s. Both of us worked very early—in the early 1960s—on materials with an overtly psychiatric pedigree—he on calls to a suicide prevention center and recordings of group therapy sessions with adolescents, I with psychiatric and neurologic assessments of state detainees both criminal (persons pleading insanity as a defense to criminal charges) and civil (persons held for psychiatric examination to see if they should be committed to a mental hospital because they constituted a threat to themselves or others). Both of us worked as well on the psychiatric theorizing that was brought to bear by professionals in the field on those materials, taking it as additional grist for our mill, rather than as a collegial resource.
Neuromyotonia and Antiganglioside-associated Neuropathies
Authors: Hart Ian , Vincent Angela , Willison Hugh
Published: November 2023

The neuromuscular junction (NMJ) is not only the site of myasthenia gravis, the main topic of this book, but also of the LambertEaton myasthenic syndrome (LEMS), which is caused by autoantibodies against the voltage-gated calcium channels on the presynaptic nerve terminal that are involved in neurotransmitter release (see Chapter 9). The pathophysiology of these disorders and the ability to study them by injecting immunoglobulins into mice or rats indicate that the motor nerve terminal and neuromuscular junction are extremely vulnerable to circulating antibodies. The approaches learned by studying myasthenia gravis and LEMS have now been applied to other disorders. In this chapter we shall concentrate on acquired neuromyotonia (NMT), which is caused by increased excitability of the nerve, here shown to be associated with autoantibod-ies to potassium channels. In addition, we shall summarize recent findings on the effects of sera and monoclonal antibodies from patients with antiganglioside-associated neuropathies on the function of the motor nerve and nerve terminal.
Instituting an Organization Ethics Program
Authors: Spencer Edward M , Mills Ann E , Rorty Mary V , Werhane Patricia H
Published: November 2023

In chapter 8 we discussed the role of the mission statement, value statement, or ethical code in the HCO. These represent the vehicle for introducing central ethical content into the HCO. Long-and short-term organizational strategies and structures need to be formulated with these values in mind. It is the ethical standards expressed in the mission statement that the organization ethics program aims to implement throughout the institution.

But merely to state ethical values is not sufficient. As we concluded in Chapters 1 through 5, the HCO itself is best understood as a dynamic set of structures, processes, and activities in constant interaction with its internal and external environment. Maintaining positive ethical standards in such an open system is itself a task that requires a flexible, informed, activeongoing implementation and oversight process. It is the details of setting up such a process through the development of an organization ethics committee that this chapter addresses.
Female Opposition: The Anti-Suffrage Campaign
Authors: Jablonsky Thomas
Published: November 2023

It may be difficult for Americans in the twenty-first century to comprehend how a sizable group of women could spend a half century in organized opposition to the right of women to vote. The notion of refusing to embrace political equality is the antithesis of history’s direction since the American and French Revolutions. Yet the saga of America’s female antisuffragists reveals not only the subtleties of our political tradition but also the evolution of women’s place in U.S. society.
The Next Generation: Harriot Stanton Blatch and Grassroots Politics
Authors: DuBois Ellen Carol
Published: November 2023

By the late nineteenth and early twentieth century, a second-generation of suffrage women were replacing the early pioneers of the movement, bringing to the struggle new arguments for the necessity of the vote as well as innovative tactics and strategies. All were virtual daughters of the pioneers; some were literal descendants. Among them were Alice Stone Blackwell, the daughter of Lucy Stone and Henry Blackwell, and Lucy Anthony, the niece of Susan B. Anthony, who with Blackwell engineered the merging in 1890 of the two national suffrage organizations into the National American Woman Suffrage Association. This chapter tells the story of a crusade by one of these women of the second generation.
Natural Suppression of Menstruation
Authors: Coutinho Elsimar M , Segal Sheldon J
Published: November 2023

Menstrual cycles enter the lives of most women when they are about thirteen, as they reach the menarche, and end when the menopause is complete, around forty-five to fifty years of age. At the beginning and end of the span they may experience irregular cycles (oligomenorrhea). During the reproductive years, usually considered to be fifteen to forty-five, they often stop menstruating naturally, due to pregnancy and breast-feeding. With high fertility and long periods of lactation, therefore, the number of times that a woman actually experiences menstrual cycles can be dramatically curtailed. For many women in developing countries where most of the world’s population lives, this pattern of frequent and long periods of menstrual suppression accurately describes their menstruation history. In any given month around the globe, because of the natura circumstances of age, pregnancy, and breast-feeding, there are certainly more women not menstruating than there are menstruating. Moreover, there is substantial evidence that exercise and diet can further reduce the number of menstrual periods a woman has in her lifetime.
Sentencing and Punishment in Finland
Authors: ä Tapio Lappi-Sepp äl
Published: November 2023

The Nordic countries share a long legal and cultural history. The connection between Finland and Sweden has been exceptionally close. For centuries, the same laws were in force in both because Finland was part of Sweden up to 1809. Between 1809 and 1917 Finland remained an autonomous grand duchy of the Russian Empire (but still maintaining its own laws). Finland declared independence from Russia in 1917. During the twentieth century, Finland experienced three wars (the 1918 Civil War and the two wars against Russia between 1939 and 1944). The exceptional wartime and postwar conditions made their mark on Finnish criminal policy. For instance, dire economic circumstances were reflected in the prison administration of the time. There was little scope for the treatment ideology, so prevalent in Denmark and Sweden, to catch on in Finnish policy at mid-century. Instead, the postwar crime increases led to stiffer criminal legislation in the 1950s. In general terms, the criminal justice system of Finland in the 1950s and 1960s was less resourceful, less flexible, and more repressive than those of its Nordic counterparts.
Multinational Enterprises and Cross-Border Knowledge Creation
Authors: Westney D Eleanor
Published: November 2023

Over the last two decades, the model of the multinational enterprise (MNE) has changed dramatically, especially in terms of the nature and role of knowledge creation. From the 1960s into the early 1980s, the dominant perspective in international business viewed the MNE as developing a knowledge-based advantage in its home country and then exploiting it by extending its production system into geographically dispersed markets (see, for example, Vernon, 1966; Buckley and Casson, 1976; Dunning, 1981; Rugman, 1981).
Knowledge Creation and the Internationalization of Japanese Companies: Front-Line Management Across Borders
Authors: Yasumuro Kenichi , Westney D Eleanor
Published: November 2023

The distinctive patterns of knowledge creation in Japanese firms and their enormous contribution to the competitiveness of Japan’ s leading companies has been one of the central themes of Ikujiro Nonaka’ s work for over a decade (Nonaka, 1985). To oversimplify his argument considerably, he sees Japanese companies as both excel- ling in and heavily dependent on creating and enhancing tacit knowledge, in contrast to Western companies’ reliance on explicit knowledge. There is a growing body of work illuminating Japanese knowledge-creation processes, including many of the essays in this book. However, relatively little of the work on Japanese knowledge creation explicitly addresses the implications for the internationalization processes of Japanese firms. What happens when firms whose patterns of knowledge creation have been generated in the tacit-knowledge-valuing Japanese context set up subsidiaries in an explicit-knowledge-valuing society like the United States?
“Co-opetition” in the Japanese Aircraft Industry
Authors: Caspary Sigrun , Nishiguchi Toshihiro
Published: November 2023

Knowledge creation is the key to Japanese entrepreneurial innovation (Nonaka and Takeuchi, 1995:3). It takes place on various organizational levels: within one company, between companies of one industry, and between companies of various industries. In cases where the development of an industry is thought to require government support, there is additional knowledge creation through the exchange between government and private industry. Strategic industries are one example of industries with massive governmental intervention.
Endowments and Opportunities
Authors: Bhide Amar V
Published: November 2023

Most new businesses lack any ideas or assets that differentiate them from their competitors. They don’t really earn a profit; they merely provide a wage to their proprietors that is set by a competitive market for the proprietors’ labor. For many individuals this wage turns out to be lower than what they could make working for someone else, so they have a powerful incentive to shut down.
Change: The Name of the Game
Authors: Altier William J
Published: November 2023

By definition, you could open the door, turn on the lights, and walk away and the plant would do its thing perfectly. But that isn’t the real world; in the real world we are continually confronted with that thing called change. And we’ve invented a special breed to deal with this thing called change; we call him or her a manager and expect this manager to use information effectively in the conduct of his or her job. But there’s an important caveat about this raw material called information.
Situation Assessment
Authors: Altier William J
Published: November 2023

Situation Assessment is a tool for evaluating all the thinking projects, the unresolved concerns, that are gathering dust on your desk. Its use is akin to spreading the problems out on top of your desk; then dusting each one off and deciding what needs to be done to it-what thinking tool needs to be applied to it; then making sure that no concerns are stuck together; and finally deciding in what order you’re going to analyze and resolve them.
What is your Retirement Annuity?
Authors: Schloss Irving S , Abildsoe Deborah V
Published: November 2023

Like the peculiar behavior of the dog in the night in the Sherlock Holmes story “Silver Blaze;• one of the obvious but overlooked clues about the insurance orientation of TIAA-CREF appears in the names of the accounts that are given to the various accumulation alternatives available to you. Each account is labeled an “annuity,” and each contribution is called a ‘‘premium.” To avoid confusion you should note that what TIAA-CREF labels as an “account,” you probably would call an investment choice or fund.
What is your Supplemental Retirement Annuity Account?
Authors: Schloss Irving S , Abildsoe Deborah V
Published: November 2023

As the name indicates, a Supplemental Retirement Annuity (the “SRA”) operates as an adjunct to your Retirement Annuity. If your employer offers an SRA, you have the opportunity to augment your retirement stash on a tax-deferred basis through a salary deferral agreement, provided you are within the contribution limitations stipulated by law. Again, your benefits office will be able to advise you as to how large a percentage of your salary you may contribute to your SRA. Not all institutions offer the SRA. If your employer is one who does, try your hardest to take advantage of this feature of your employer’s plan. It typically allows you to contribute the gap between the maximum contribution you can make under the Code and the permissible deferral of salary under the employers plan. If you have the funds, for obvious reasons you want to save as much as possible in the tax-favored setting of a qualified plan. Let’s look at the other characteristics of an SRA.
What are a Group Retirement Account and a Group Supplemental Retirement Account?
Authors: Schloss Irving S , Abildsoe Deborah V
Published: November 2023

The Group Retirement Account (or “GRA”) and the Group Supplemental Retirement Account (or “GSRA”) resemble the Retirement Annuity account and the Supplemental Retirement Annuity account in many respects. There are, however, some fundamental differences between the group accounts and their nongroup counterparts.
How do TIAA-CREF Plans Differ from Employer to Employer?
Authors: Schloss Irving S , Abildsoe Deborah V
Published: November 2023

As we indicated in the previous chapters, plans provided by TIAACREF can differ substantially from one employer to another. We have noted that some employers offer an Retirement Annuity account, others the Group Retirement Account. Contribution percentages will vary from one employer to another. Perhaps the most striking structural difference lies in the extent to which employers will give their employees options at retirement to withdraw funds from TIAA-CREF and take their futures into their own hands.
How can you Learn how your Employer’s Plan Works?
Authors: Schloss Irving S , Abildsoe Deborah V
Published: November 2023

As the text thus far has broadly and frequently stated, you need to know the details of your employer’s plan. Generally, you have two routes to follow.
How Should You Go About Your Retirement Planning?
Authors: Schloss Irving S , Abildsoe Deborah V
Published: November 2023

For some, retirement comes as a wrenching experience, although this occurs less frequently due to the flexibility most participants enjoy as to when they begin their retirement. For most, retirement appears as a welcome relief, in part because they can design their retirement with more individual control than formerly. You can work part-time or on a reduced schedule.
The Heart of the Matter What Sorts of Annuities Does TIAA-CREF Offer?
Authors: Schloss Irving S , Abildsoe Deborah V
Published: November 2023

For those of you who are considering annuitizing all or part of your account, this chapter and the next may prove to be the most critical and, we hope, helpful. We will lay out the different options available, the implications for each choice, and the issues that you need to consider in picking an annuity.
What are the Pros and Cons of the Minimum Distribution Option?
Authors: Schloss Irving S , Abildsoe Deborah V
Published: November 2023

We now need to look at the implications that the choice of the MDO will have upon you and your Designated Beneficiary. To start with the obvious negatives, the MDO does not offer the security of an annuity. You do not obtain the assurance of a lifetime stream of income, and everything depends on the size of your account and how you manage it. If your accumulation is large you may have to live to 100 and a little bit longer to reduce the MDO to a pittance; or if your account is not large, you may find yourself in trouble at 80 using the MDO. Most of us would take our chances if confronted with the former because so few human beings live to be 100. If the latter seems likely rather than remotely improbable, it strongly suggests that, other things being equal, you should not elect the MDO.
How Do You Pay for Second-to-Die Life Insurance?
Authors: Schloss Irving S , Abildsoe Deborah V
Published: November 2023

The issue of affordability, especially after one’s income declines after retirement, constantly arises. It probably represents the largest barrier to purchasing second-to-die life insurance that we have encountered. For starters, the premiums represent an unanticipated and unwanted expense, in much the same way that the estate tax problems inherent in having an estate consisting primarily of retirement assets come as a shock and a surprise.
Overview: Methods for Process Research
Authors: Poole Marshall Scott , Van de Ven Andrew H , Dooley Kevin , Holmes Michael E
Published: November 2023

We have made some progress on our journey to understanding change and development processes. The first part of our itinerary has been devoted to exploring the conceptual and theoretical grounding of organizational processes. The remainder of the excursion will be devoted to methods that put the concepts of Part I to work.
Stochastic Modeling
Authors: Poole Marshall Scott , Van de Ven Andrew H , Dooley Kevin , Holmes Michael E
Published: November 2023

We noted in chapter 2 that among the basic requirements of process research are the ability to identify and characterize event sequences and the capacity to identify temporal dependencies in event sequences. Stochastic modeling of event sequences is directly applicable to both tasks, because it captures dependencies among sequential observations. Stochastic modeling can also contribute to the evaluation of developmental models based on formal and final causality and to the identification of macrolevel narrative structures.
Epidemiology of Ischemic Stroke
Authors: Adams Harold P , Bachinski Vladimir , Norris John W
Published: November 2023

Although ischemic stroke can affect men and women of any age, some patient populations are at higher risk. Several conditions or factors can be used to identify these individuals. Some risk factors are modifiable, and others are not (Table 2-1.) In reality, many risk factors predispose to stroke because of their influence on the evolution of atherosclerosis. The relationships between some risk factors and ischemic stroke may not be as strong as are those for coronary artery disease because stroke can be secondary to conditions, such as trauma or infection, that are independent of traditional atherosclerotic risk factors. Some physicians consider transient ischemic attack (TIA) to be a risk factor for stroke, but it is not included in this chapter.
Cardiac Sources of Embolism
Authors: Adams Harold P , Bachinski Vladimir , Norris John W
Published: November 2023

Symptoms including wooziness, dizziness, or syncope often are secondary to heart diseases that lead to transient declines in cardiac output. Intermittent cardiac arrhythmias, most commonly intermittent complete heart block or the bradycardia-tachycardia (sick sinus syndrome), are frequent cardiac causes of recurrent syncope in the elderly. Although these cardiac rhythm disturbances are important markers of severe heart disease that lead to transient episodes of loss of consciousness, they generally do not lead to embolism to the brain. Despite the relatively low risk of stroke directly related to these cardiac arrhythmias, they are associated with high risk of cardiac death.
Neuropathies Associated with Monoclonal Gammopathies
Authors: Kissel John T , Mendell Jerry R
Published: November 2023

Searching for the presence of a monoclonal protein (also called paraprotein, monoclonal gammopathy, or M-protein) has become an important part of evaluating patients with chronic peripheral neuropathies of unknown cause. Approximately 10% of idiopathic neuropathy patients have an associated monoclonal gammopathy. Most of these patients do not have an identifiable underlying plasma cell disorder, instead they have a so-called monoclonal gammopathy of undetermined significance (MGUS) (Table 15-1). The pathophysiological relationship of the monoclonal protein to the neuropathy is often obscure, even for those patients with a defined hematologic disorder. The clinical spectrum, pathologic features, and methods of treatment of these disorders are the subjects of this chapter.
Romance Infinitives with Specified Subjects: The State of the Art
Authors: Mensching Guido
Published: November 2023

In this chapter I discuss existing generative accounts of specified subjects in Romance infinitive constructions. After a brief summary, each proposal will be explored in the light of the data presented in chapter 2 and the theoretical framework outlined in chapter 3. It will become evident from this chapter that although there has been a considerable number of attempts to explain some of the relevant data for individual languages, no unified solution applicable to all Romance languages has been given so far, particularly for nominative subjects.

The chapter is organized as follows. In section 4.1, I discuss infinitive subjects in the accusative case, which have been explained by exceptional case marking and in which the infinitive construction is selected by perceptional, causative, and permissive verbs. Section 4.2 is dedicated to an outline of some basic approaches toward infinitive subjects that appear in the main clause, both in raising and in wh contexts. These two sections include some additional data that have not yet been introduced.
The Position of Subjects in Romance Infinitive Clauses
Authors: Mensching Guido
Published: November 2023

In this chapter, I analyze the data presented so far to establish the structural position of the constituents in the infinitive constructions under discussion. As suggested by its title, the main aim of this chapter is to identify the different subject positions. Since the analysis of other constituents is involved in determining the location of subjects, I also examine the position of verbs, adverbs, negation, and clitics so that this chapter will contribute to understanding the structure of old and modem Romance infinitive clauses in general. As for the subject positions, I reject some of the proposals presented in chapter 4, whereas others tum out to be compatible with the Split-Intl hypothesis and with the assumption that SpecVP is the base position of subjects.

As I explained in chapter 1, causative and similar constructions are not discussed because the analyses reviewed in section 4.1.1 are sufficient to account for those structures. Moreover, in this chapter, the difference between accusative and nominative subjects is ignored because the issue of case assignment is discussed at length in chapter 6. Thus, I now explore the question of where the subjects are located in the clause, and in the next chapter I examine what licenses these positions and the movements involved.
Win All Without Fighting
Authors: McNeilly Mark
Published: November 2023

At 2:45 in the morning of January 30, 1968, all hell broke loose at the United States embassy in Saigon, the capital city of what was then South Viet Nam. On Tet, the Vietnamese New Year, nineteen Viet Cong guerilla commandos shot their way into the embassy. Simultaneously, in the largest offensive of the war, eighty-four thousand Viet Cong and North Vietnamese troops threw themselves against the major towns and cities in South Viet Nam, using human wave tactics to overwhelm defenders and incite terror in the populace.

After overcoming their initial shock, the U.S. forces and the South Vietnamese troops recovered well, delivering major blows to the communists and retaking all captured cities and towns. The commando force that entered the embassy compound was wiped out. Overall, the communists suffered the loss of roughly forty thousand troops (almost half of the forces engaged) while the U.S. and AR VN (Army of the Republic of Viet Nam) forces losses amounted to only 3,400 men dead. If judged by a “body count” criteria, this was a major success for the U.S. and its ally. However, in warfare, body counts and casualty ratios do not determine success or failure. This war was not only being fought in the jungles and villages of Southeast Asia but also in the living rooms and student unions in the United States. More important than the reality on the Asian battlefields was the perception in American minds.
Deception and Foreknowledge
Authors: McNeilly Mark
Published: November 2023

Now the reason the enlightened prince and the wise general conquer the enemy whenever they move and their achievements surpass those of ordinary men is foreknowledge. (XIII.3)

As Sun Tzu states, to defeat the enemy and achieve the nation’s goals, one must have “foreknowledge.” Sun Tzu then explains exactly what foreknowledge is:

What is called “foreknowledge” cannot be elicited from spirits, nor from gods, nor by analogy with past events, nor from calculations. It must be obtained from men who know the enemy situation. (XIII.4)

What Sun Tzu is saying is that foreknowledge is not simply projecting the future based on the past, nor is it simple analysis of the enemy’s order of battle. Foreknowledge is firsthand insight and a deep understanding of three things—the enemy, one’s own strengths and weaknesses, and the environment. The first of these is the enemy.
The War on Terrorism
Authors: McNeilly Mark
Published: November 2023

And therefore the general who understands war is the minister of the people’s fate and arbiter of the nation’s destiny. (11.21)

I completed the previous chapter in early 2001 with the above quotation and submitted the manuscript that would become this book before the events of September I I, 2001. Once the terrorist attacks occurred and their magnitude became apparent, it was clear that a chapter addressing the application of Sun Tzu’s principles to the war on terrorism was needed. The significance and meaning of the above quotation became even more important and twenty-five centuries later Sun Tzu’s words still ring true: how U.S. leaders carry out the war on terrorism will, to a large extent, determine America’s fate and Western civilization’s destiny.
Epidemiological Principles for the Study of Gastrointestinal Cancers
Authors: Amos Christopher I , Spitz Margaret R
Published: November 2023

This chapter discusses some of the general principles and designs used in epidemiological studies of gastrointestinal cancers, with an emphasis on molecular and genetic epidemiological methods. These newer methods have come to play an important role in understanding the etiology of gastrointestinal cancers, yet textbook discussions of these methods are limited. Also, because of the importance and difficulty of measuring dietary intake, we shall include a short section describing some of the major dietary assessment tools. We close the chapter with a section discussing informed consent for epidemiological studies.
Developmental Biology of the Gastrointestinal Tract
Authors: Babyatsky Mark W
Published: November 2023

Advances in molecular techniques have provided tremendous insights into the complex sequence of events that occur during the maturation of an initial hollow tube to the specialized multifunctional gastrointestinal (GI) tract and its appendages. Unique developmental pathways particular to the functional characteristics of the individual digestive organ or set of organs have emerged, particularly through recent gene deletion models of specific developmental factors in mice.
Therapeutic Principles of Gastrointestinal Neoplasia: Chemotherapy
Authors: Xiong Henry Q , Abbruzzese James L
Published: November 2023

Cytotoxic chemotherapy has constituted a major modality in the treatment of cancer since its first use for cancer patients five decades ago. The clinical use of chemotherapy continues to expand as a result of the continuous discovery of new agents and their increasingly rational use. Chemotherapy can be given as a single agent or in combination with different cytotoxic agents or different treatment modalities, including radiation, vaccines, and novel targeted therapeutics. Chemotherapy is clearly part of the mainstream of treatment for metastatic and recurrent gastrointestinal malignancies.
Pathology and Natural History of Esophageal Cancer
Authors: Glickman Jonathan N , Odze Robert D
Published: November 2023

Esophageal cancer accounts for about 5%–6% of all malignant tumors of the gastrointestinal tract. Worldwide, squamous cell carcinoma is the most common, although the incidence of adenocarcinoma has increased dramatically in recent years. Esophageal cancers are categorized primarily by their cell of origin (Table 14–1). However, in some tumors (e.g., adenoid cystic carcinoma), the origin is not always known conclusively. The histologic classification used in this chapter is a variation of the one proposed by the World Health Organization (WHO).
Clinical Aspects and Management of Metastatic Carcinoma of the Esophagus and Gastroesophageal Junction
Authors: Ajani Jaffer A , Blumenschein George R
Published: November 2023

Proper selection of patients for palliation by chemotherapy is of paramount importance. The likelihood of achieving a response and a positive palliative effect is higher among patients with a better performance status (2 or less) than among those with a poor performance status. Patients with a performance status of 3 or more should not be considered for chemotherapy, as it often results in severe and occasionally fatal toxic effects. In addition, before instituting even a moderately toxic chemotherapy, adequate nutritional support and pain control should be established.
Barrett’s Esophagus: Clinical Aspects and Management
Authors: Spechler Stuart Jon
Published: November 2023

In Barrett’s esophagus, an abnormal, intestinal-type epithelium replaces the stratified squamous epithelium that normally lines the distal esophagus.1 This condition develops as a consequence of chronic gastroesophageal reflux disease (GERD). The precise mechanisms that effect the intestinal metaplasia are not clear, however, and it is not known why only a minority of patients with GERD ever develop Barrett’s esophagus.
Epidemiology and Molecular Epidemiology of Hepatocellular Cancer
Authors: Hassan Manal M , Patt Yehuda Z
Published: November 2023

Hepatocellular carcinoma (HCC), a common cancer worldwide, causes more than 250,000 deaths annually,1 including more than 5000 deaths per year in the United States.2 A recently published study reported a statistically significant increase in the incidence of HCC in the United States over the past two decades.3 The incidence rose from 1.4 per 100,000 from 1976 to 1980 to 2.4 per 100,000 from 1991 to 1995. With respect to gender and race, the same report showed that in the United States, HCC occurs three times more often in men than in women and twice as often in African Americans than in whites.
Pathology and Natural History of Hepatocellular Carcinoma
Authors: Balis Ulysses J , Lauwers Gregory Y
Published: November 2023

Hepatocellular carcinoma (HCC) is heterogeneous in both its gross and microscopic features. Importantly, an increasing number of its characteristics are being demonstrably associated with tumor progression and outcome. Thus, a broad-based understanding of the pathology of HCC is of particular importance to the clinician charged with the management of patients afflicted with this disease.
Clinical Aspects and Management of Small Bowel and Appendiceal Cancers: Management Options: Unresectable, Locally Advanced, and Metastatic Small Bowel and Appendiceal Carcinomas
Authors: Kulke Matthew H , Fuchs Charles S
Published: November 2023

In contrast to that of other gastrointestinal malignancies, our knowledge of the natural history, prognosis, and treatment of small bowel and appendiceal cancers is limited because of their rarity and heterogeneous histology. In this chapter, we will review the various therapeutic options available to patients with advanced cancer of the small bowel or appendix.
Epidemiology and Prevention of Colorectal Cancer
Authors: Hawk Ernest T , Viner Jaye L , Limburg Paul J
Published: November 2023

Colorectal cancer (CRC) is the fourth most frequently diagnosed cancer in the United States and has the second highest cancerrelated mortality rate after lung cancer.1 While the incidence of CRC has declined over recent years, the disease remains a major public health burden in the United States. Advanced CRC is largely refractory to conventional therapeutics and is one of the least curable malignancies. Despite continuing advances in cancer therapy, long-term survival has not improved significantly over the last four decades, a situation that mandates improvements in early detection of this surgically curable disease and preventive interventions to reduce the incidence of the disease and its downstream morbidities and mortality.
Familial Colorectal Cancer Syndromes
Authors: Smyrk Thomas C , Lynch Henry T
Published: November 2023

Is cancer hereditary? This question has been asked by physicians and patients for hundreds of years. Molecular genetic research demonstrates that the answer is unequivocally yes for a subset of cancers. Indeed, more than 40 germline mutations have been identified as etiologic for cancer susceptibility, and new links between mutations and cancer syndromes are made almost monthly. Colorectal cancer (CRC) has been a particularly fruitful area of study for molecular geneticists, and we now enter an era during which CRC patients and the clinicians who care for them will harvest the benefits of molecular research.
Pathology and Natural History of Colorectal Cancer
Authors: Stemmermann Grant , Fenoglio-Preiser Cecilia
Published: November 2023

Sporadic carcinoma of the large bowel is commonly encountered among individuals in prosperous, industrialized countries. It is the second most common cancer in American women, after breast cancer; and the third most common cancer in American men, following cancer of the prostate and lung. 1,2 Only lung cancer surpasses it as a cause of cancer death in the United States. In contrast, colorectal cancer is much less common in undeveloped countries, either as an incident event or as a cause of death.
Management of Neuroendocrine Cancers of the Gastrointestinal Tract: Carcinoid Tumors
Authors: Yao James C , Ajani Jaffer A
Published: November 2023

Moertel once described the effort to treat neuroendocrine tumors as an “odyssey in the land of small tumors.”1 Although relatively rare, carcinoid tumors are the most common neuroendocrine tumor of the gastrointestinal tract and often present with dramatic manifestations that range from asymptomatic hepatomegaly to flushing, diarrhea, asthma, pellagra, and carcinoid heart disease. These tumors are often indolent but resistant to chemotherapy. Successful treatment of these tumors requires an understanding of their natural history and biology and of the impact of the available treatments.
Management of Neuroendocrine Cancers of the Gastrointestinal Tract: Islet Cell Carcinoma of the Pancreas and Other Neuroendocrine Carcinomas
Authors: Hoff Ana Oliveira , Cote Gilbert J , Gagel Robert F
Published: November 2023

The neuroendocrine tumors of the gastrointestinal tract are arbitrarily divided into carcinoid and islet cell neoplasms. Carcinoid tumors are discussed in Chapter 64 and will not be considered further here except as they relate to multiple endocrine neoplasia type 1 (MEN-1). Islet cell tumors are rare tumors derived from the discrete neuroendocrine epithelium of the pancreas.
Nutritional Support of Patients with Gastrointestinal Malignancies
Authors: Strasser Florian , Bruera Eduardo
Published: November 2023

Malnutrition is a frequent problem in patients with gastrointestinal malignancies and is distressing for both the patients and their families. Because many malnutrition-associated symptoms, such as anorexia and asthenia, are silent symptoms, unlike pain or shortness of breath, the importance of malnutrition is often underestimated, and malnutrition is underdiagnosed. Malnutrition can be categorized as primary (metabolic) or secondary (starvation) cachexia, which often occur together.
Pain Management
Authors: Elsayem Ahmed , Bruera Eduardo
Published: November 2023

Each year more than one million Americans are diagnosed with cancer, and approximately half of them die of their disease. Pain is one of the most common symptoms associated with cancer, affecting an estimated 50% of all cancer patients and approximately 70% of those with advanced disease. The prevalence of pain in patients with common gastrointestinal malignancies is outlined in Table 74–1.