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If V. S. Naipaul’s late fiction demonstrates the crisis of narrative in the arrested dialectic of what I have called postcolonial naturalism, then the work of South African novelist, playwright, and critic Lewis Nkosi epitomizes the intersection of postcolonial naturalism with the double-voiced discourse of the hysteric. Situated between a post-independence melancholy and the registration of globalization’s volatile new dispensation and refracted through the racial politics of apartheid and its end as well as the lived experience of exile, Nkosi’s apartheid-era debut novelMating Birdsarticulates in both form and content the noble self-exemption of Hegel’s “Beautiful Soul” and the subversive anxiety of the hysteric, to whom no satisfaction can be given. Such an accounting helps to reframe split critical appraisal of the novel by reading its complex of form and content as the living crystallization of historical processes.

In this chapter, the authors examine the turnover of employees in Latin America, with a particular focus on Mexico. Employee turnover is important in Latin America and in Mexico, as it is in many other places, because the cost of labor typically accounts for 70% of a firm’s operating cost. When employees leave, it requires that the employer replaces the workers through human resource management processes that include recruiting, selection, orientation, and training. These costs are a significant expense to firms that they could avoid if turnover was lower. The authors identify cultural, economic, legal, and other factors that could influence employee turnover. The authors also summarize many managerial practices that can help employers to effectively manage employee turnover. Finally, the authors provide insights for future research on employee turnover in this important region of the world.

Students frequently request concept-list study guides prior to exams, but the benefits of instructors providing such resources are unclear. Research on memory and comprehension has suggested that some challenges in learning are associated with benefits to performance. In the context of an introductory psychology course, a study was conducted to investigate the impact of providing a concept-list study guide on exam performance, as opposed to having students create a study guide. Additionally, student preferences for various types of study guides were examined. Results indicated that although students greatly prefer that the instructors provide a study guide (as opposed to making their own), providing a concept-list study guide resulted in poorer exam performance. These results call for future research on the influence of study guides on student performance.

Background: Mutations in desmoplakin ( DSP ), the primary force transducer between cardiac desmosomes and intermediate filaments, cause an arrhythmogenic form of cardiomyopathy that has been variably associated with arrhythmogenic right ventricular cardiomyopathy. Clinical correlates of DSP cardiomyopathy have been limited to small case series. Methods: Clinical and genetic data were collected on 107 patients with pathogenic DSP mutations and 81 patients with pathogenic plakophilin 2 ( PKP2 ) mutations as a comparison cohort. A composite outcome of severe ventricular arrhythmia was assessed. Results: DSP and PKP2 cohorts included similar proportions of probands (41% versus 42%) and patients with truncating mutations (98% versus 100%). Left ventricular (LV) predominant cardiomyopathy was exclusively present among patients with DSP (55% versus 0% for PKP2 , P DSP versus 40% for PKP2 ( P DSP cardiomyopathy. LV late gadolinium enhancement was present in a primarily subepicardial distribution in 40% of patients with DSP (23/57 with magnetic resonance images). LV late gadolinium enhancement occurred with normal LV systolic function in 35% (8/23) of patients with DSP . Episodes of acute myocardial injury (chest pain with troponin elevation and normal coronary angiography) occurred in 15% of patients with DSP and were strongly associated with LV late gadolinium enhancement (90%), even in cases of acute myocardial injury with normal ventricular function (4/5, 80% with late gadolinium enhancement). In 4 DSP cases with 18F-fluorodeoxyglucose positron emission tomography scans, acute LV myocardial injury was associated with myocardial inflammation misdiagnosed initially as cardiac sarcoidosis or myocarditis. Left ventricle ejection fraction DSP cases ( P PKP2 cases ( P DSP cases ( P =0.8). Frequent premature ventricular contractions were common among patients with severe arrhythmias for both DSP (80%) and PKP2 (91%) groups ( P =non-significant). Conclusions: DSP cardiomyopathy is a distinct form of arrhythmogenic cardiomyopathy characterized by episodic myocardial injury, left ventricular fibrosis that precedes systolic dysfunction, and a high incidence of ventricular arrhythmias. A genotype-specific approach for diagnosis and risk stratification should be used.

To determine whether abnormal blood pressure response (ABPR), with or without left ventricular outflow tract obstruction (LVOTO), is associated with adverse heart failure and arrhythmia outcomes in hypertrophic cardiomyopathy (HCM).A retrospective, single-center analysis was performed for adult HCM patients who underwent exercise stress testing.Of 589 patients included in the study, 192 (33%) demonstrated ABPR. A similar proportion of patients with ABPR had LVOTO compared to those without ABPR (56% vs 63%, p = 0.11). Patients with ABPR demonstrated lower percent predicted VO2 and METs achieved than those with LVOTO (16.9 ± 6.8 vs 21.6 ± 7.9, p = 0.002 and 5.3 ± 2.4 vs 7.4 ± 3.1, p 0.001). In a subgroup of 17 patients with LVOTO and ABPR who subsequently underwent successful myectomy, 5 (30%) demonstrated persistent ABPR. 23 patients (3.8%) experienced sudden cardiac death or ventricular arrhythmias, which were not associated with ABPR, regardless of age group. In multivariable analysis, syncope (p = 0.04), left ventricular hypertrophy (p = 0.02) and left atrial diameter (p = 0.006) were significantly associated with the composite outcome of sudden death or severe ventricular arrhythmia, whereas ABPR was not (p = 0.38). In contrast, ABPR was associated with subsequent heart failure hospitalization (p = 0.002), regardless of presence or absence of LVOTO (p = 0.04, p = 0.02).ABPR is associated with reduced functional capacity in HCM regardless of the presence of LVOTO but is not associated with adverse arrhythmia outcomes. Patients with ABPR have a higher incidence of subsequent heart failure hospitalization.

Central to the polarizing discussions of the late-period work of V. S. Naipaul has been the author’s apparent faithfulness to methods—and political presuppositions—derived from nineteenth-century British models of literary realism. This essay explores Naipaul’s pivotal late-period work Guerrillas as marking a shift toward what it terms postcolonial naturalism as a way of both distancing the author’s aesthetic from the realism of a depleted romantic nationalism and anticipating, through its own codification of affect, an as yet unnamable globalization.

Mutations in cardiac myosin binding protein C (MyBP-C, encoded by MYBPC3) are the most common cause of hypertrophic cardiomyopathy (HCM). Most MYBPC3 mutations result in premature termination codons (PTCs) that cause RNA degradation and a reduction of MyBP-C in HCM patient hearts. However, a reduction in MyBP-C has not been consistently observed in MYBPC3-mutant induced pluripotent stem cell cardiomyocytes (iPSCMs). To determine early MYBPC3 mutation effects, we used patient and genome-engineered iPSCMs. iPSCMs with frameshift mutations were compared with iPSCMs with MYBPC3 promoter and translational start site deletions, revealing that allelic loss of function is the primary inciting consequence of mutations causing PTCs. Despite a reduction in wild-type mRNA in all heterozygous iPSCMs, no reduction in MyBP-C protein was observed, indicating protein-level compensation through what we believe is a previously uncharacterized mechanism. Although homozygous mutant iPSCMs exhibited contractile dysregulation, heterozygous mutant iPSCMs had normal contractile function in the context of compensated MyBP-C levels. Agnostic RNA-Seq analysis revealed differential expression in genes involved in protein folding as the only dysregulated gene set. To determine how MYBPC3-mutant iPSCMs achieve compensated MyBP-C levels, sarcomeric protein synthesis and degradation were measured with stable isotope labeling. Heterozygous mutant iPSCMs showed reduced MyBP-C synthesis rates but a slower rate of MyBP-C degradation. These findings indicate that cardiomyocytes have an innate capacity to attain normal MyBP-C stoichiometry despite MYBPC3 allelic loss of function due to truncating mutations. Modulating MyBP-C degradation to maintain MyBP-C protein levels may be a novel treatment approach upstream of contractile dysfunction for HCM.

This chapter examines how employers can better manage the risks for expatriates working in danger zones. It highlights the need for a better understanding of the risks that expatriates face while working abroad. However, past research has tended to focus primarily on the psychological adjustment of expatriates and their families, with very little attention towards expatriate risk management. The dominant theme in prior research about expatriates has focused on the predictors and outcomes of expatriate adjustment to work in foreign countries. Expatriate risk management research has identified several risks that expatriates face, as well as several methods for managing risk in countries with elevated levels of risk. The risks to expatriates can include terrorism, kidnapping, crime. The risk management practices for nurses should be tailored to match the severity and frequency of the risks that they face. Risk management for expatriate civil engineers will be very different from positions that inherently engender contacts with locals such as foreign correspondents.

Adults adopt the traits of characters in narratives, but little is known about whether children do so. In Study 1, 7- and 10-year-olds (N=96) heard a 2.5-minute recording about a professor or cheerleader. Reporting higher engagement in the professor narrative related to more time playing with an analytical toy (a Rubik’s cube), whereas reporting higher engagement in the cheerleader narrative related to less time playing with Rubik’s cube. However, although children were randomly assigned to a narrative, within condition children may have had preexisting personality differences causing them both to become more engaged in that narrative and also to behave more like that character afterwards. To control for this possibility, in Study 2 children (N=104) were given perspective-taking or objective instructions. Interestingly, both instructions created higher engagement than in Study 1, resulting in main effects of narrative. Children in the professor condition, compared to those in the cheerleader condition, spent more time playing with Rubik’s cube and self-reported higher levels of professor-relevant characteristics (e.g., smart, good at teaching). These studies show that, by the elementary school years and particularly when highly engaged in a narrative, children adopt the traits of a narrative’s central character.

Following Paul Buhle's claims about the inherent utopianism of horror, this essay examines the popular film Daybreakers (2009) as a cultural response to the economic and biopolitical crises of the Great Recession. Ultimately retreating from the dark mirror of its compelling dystopian critique, the film executes its social crisis through the logic of vampiric speciology, immunizing the present against the threat of radical transformation and restoring a “natural” social order. However, the biopolitical writings of Roberto Esposito offer us a way to discern the ineradicable utopian horizon in even this strategy of containment and neutralization.

Background: The choice of bioprosthesis versus mechanical prosthesis in patients aged less than 70 years undergoing aortic valve replacement (AVR) remains controversial, with guidelines disparate in their recommendations. The objective of this study was to explore outcomes after AVR for various age ranges based on type of prosthesis. Methods: A systematic review was undertaken according to the Preferred Reporting Instructions for Systematic Reviews and Meta-Analyses (PRISMA) guidelines by using Medline (PubMed), Cochrane, Web of Science, Embase, and Scopus databases. Rates of long-term survival (primary outcome), reoperation, major bleeding, thromboembolism, stroke, structural valve deterioration, and endocarditis were compared between subjects receiving biologic and mechanical prostheses. Findings were grouped into patients aged

Substitute object pretense is one of the earliest-developing forms of pretense, and yet it changes considerably across the preschool years. By 3.5 years of age, children can pretend with substitutes that are highly dissimilar from their intended referents (Elder & Pederson, 1978), but even older children have difficulty understanding such pretense in others (Bigham & Bourchier-Sutton, 2007). The present studies had 3 aims: 1) to examine the relative influence of the form and function of substitute objects; 2) to replicate the age gap between pretense production and comprehension using a tightly controlled procedure; and 3) to investigate whether preschoolers’ comprehension of substitute object pretense is predicted by a) theory of mind (ToM), because it involves reading pretender intent, and (b) executive function (EF), because it involves inhibiting the substitute object’s identity. In Study 1, 3- to 5-year-old children performed at ceiling on a test of substitute object pretense production, whereas pret...

Three studies explored the abilities of 205 children (5-11 years) and 74 adults (18-72 years) to distinguish directly versus indirectly acquired information in a scenario where an individual grew up in isolation from human culture. Directly acquired information is knowledge acquired through firsthand experience. Indirectly acquired information is knowledge that requires input from others. All children distinguished directly from indirectly acquired knowledge (Studies 1-3), even when the indirectly acquired knowledge was highly familiar (Study 2). All children also distinguished difficult-to-acquire direct knowledge from simple-to-acquire direct knowledge (Study 3). The major developmental change was the increasing ability to completely rule out indirect knowledge as possible for an isolated individual to acquire.

We greatly appreciate the astute comments on Lillard et al. (2013) and the opportunity to reply. Here we point out the importance of keeping conceptual distinctions clear regarding play, pretend play, and exploration. We also discuss methodological issues with play research. We end with speculation that if pretend play did not emerge because it was naturally selected (due to helping causal reasoning or some other developmentally important skill), perhaps it emerged as a by-product of 2 other selected behaviors: play fighting and language.

Piaget (1962) asserted that children stop engaging in pretend play when they enter the concrete operational stage because they become able to accommodate reality and no longer need to assimilate it to their wishes. Consistent also with the views of Vygotsky, discussion of pretend play in developmental psychology is typically confined to early childhood, yet the activity itself does not seem to be so confined. As a preliminary investigation of pretend play in middle childhood, undergraduates were asked to complete a retrospective questionnaire about their childhood pretend play. The questionnaire items queried them about the content and context of their prior pretense engagements, when and why they stopped pretending, and personality characteristics relevant to pretense and fantasy. On average, respondents reported ceasing to pretend around 11 years of age. Among the statistically significant predictors of participants’ reported ages of ceasing to pretend were gender, childhood environs, siblings’ ages, be...

Read against the industry-inspiring success of his better-known works, Rushdie's debut novel Grimus (1975) is often regarded as the artistically tentative effort of the author who would, in his maturity, go on to write Midnight's Children (1981). The relative dearth of critical responses to Grimus in the thirty-five years since its publication seems to indicate a scholarly consensus, though one which, given the recently recognized emergence of the genre of postcolonial science fiction, invites renewed consideration. In the essay that follows, I resist this broadly dismissive critical approach by suggesting that the novel's appropriation of utopian and science fictional resources provides for both a critical/aesthetic intervention--among the very first--into the global order just making itself visible in the mid-1970s and, perhaps more important, for the utopian neutralization of that order. To reposition Grimus within the rich tradition. of utopia/SF, (1) I argue, is to overcome the ideological limits of previous scholarly appraisals, restoring a properly historical context against which the novel's deep political and pedagogical tendencies--as well as its considerable aesthetic accomplishments--may be more fully understood. A common justification for the critical neglect of Griffins is its apparent obliviousness to the disciplinary shibboleths of what was, throughout the 1980s, the developing field of postcolonial studies. From the vantage of the early 1990s institutionalization of the discipline, Griffins is not a successful novel because it is not yet an identifiably postcolonial one. Mujeebuddin Syed writes in 1994 that "in spite of its brilliant attempt at creating an ironic meta-histoire, a sardonic philosophia perennis, Grimus falters in its failure to countenance postcolonial concerns." Rushdie's Joycean narrative experiments, Syed further argues, "prove inadequate in providing Grimus with a mooring, an anchor that can provide its high profile a well-defined identity" (148). Similarly, Catherine Cundy suggests in 1992 that the true value of Grimus is simply that it "offers an important insight into the stylistic and thematic preoccupations developed more fully in the author's later work," thus allowing us to see in embryo the "areas of debate which are handled with greater depth and maturity in Rushdie's later work" (128). At this apprentice stage, she suggests, the thematic concerns that will inform subsequent novels (hybridity, the emigre experience, the quest for postcolonial identity, and the ambivalent cultural legacies of imperialism) appear as yet frustratingly inchoate: "the diversity remains just that; the elements insufficiently blended to make the novel appear a skillfully amalgamated whole." Griffins is, Cundy contends, "clearly a novel from a period when Rushdie had not yet achieved the synthesis of diverse cultural strands and narrative forms" (137), and it takes only "tentative steps towards an examination of post-coloniality," a subject that she describes as "submerged" in the novel's mercurial structure (129). (2) But what if such readings judge Rushdie's debut novel according to the wrong criteria, by standards derived from the disciplinary habits of thought that his later work helped to instantiate? Indeed, these critical approaches. consider Griffins in the light of both Midnights Children and a poststructuralist-inflected postcolonial hermeneutic. If, however, we disregard this interpretive consensus and its fundamental narrative of authorial entelechy, we might read the novel's unapologetic rejection of a national-cultural habitus not as a failing--as a failure to situate the book's multiple dislocations within the ambit of the postcolonial nation state--but rather as the register of an altogether different creative aim. At least one recent critical response to Grimus has taken important steps toward such a reconsideration and provides its a useful point of departure. …

Coastal, port, and waterway projects often require an understanding of the waterborne traffic in the site vicinity. Knowledge of what types of vessels transit near a project site, along with the vessel speeds and typical transit times/paths, can be valuable information to an engineer. Often the best available information for vessel traffic can be obtained from Automatic Identification System (AIS) data. AIS data includes information about the vessel type, position, course, and speed (IMO, 2014). Historic AIS data is available from a variety of free and commercial sources. Inside the United States, a large quantity of AIS data is available freely to the public from the United States’ Coast Guard datasets. AIS data can be summarized in a variety of tabular and graphic formats. For spatial planning and visualization, an intuitive format for communicating vessel traffic to non-technical audiences is a vessel density map. Straightforward methods are available (BOEM/NOAA, 2015) for producing vessel density maps in relatively open water and away from sharp channel bends. This paper addresses challenges with preparing vessel maps in areas with narrow channels and around bends.

Real time vessel simulation has become an integral part of design of navigation channels, harbor geometries, and marine terminals. Generalized guidance for channel width, bend radii, and turning basin dimensions is documented in numerous sources (e.g. PIANC, ASCE) based on typical environmental parameters of current magnitude, wind speed, and wave height. Common to all the guidance is to confirm and finalize geometry and operability based on vessel simulation studies. A real time vessel simulator incorporates various data to represent the response of a vessel to helm controls of the pilot such as water depth, currents, waves, winds, drag, rudder force, and tug boat power. A key component of the simulation is that the computations occur in real time such that the pilot does not notice any lag due to computer processing. As such the fidelity of environmental input to the simulation has often been limited to avoid congestion. Furthermore, vessel simulation software was designed for quick modification in training simulations with simple parameters to apply the conditions uniformly over the model domain. As a result, the implementation of metocean conditions in real time simulation is often truncated based on a simple characterization of sea state and currents to a snap shot of time, represented by a static current field representing peak and ebb or flood tide or by simple representative vectors. However, there are aspects of assessing channel design which benefit from simulating the changing of metocean conditions simultaneously with vessel maneuvering. With improving processing power of simulators, it is possible to incorporate time-varying numerical modeling results directly with fine resolution. This paper presents applications of coastal engineering tools and techniques for real time vessel simulation in conjunction with high resolution coastal hydrodynamic modeling for waterway design.

Elaborating Nina Auerbach's marvelous description of the novel as a "compendium of fin-de-siecle phobias,"3 criticism of the last two decades has sought to address lacunae in Draculas long critical tradition by com plicating the conventional doxa of psychosexual analyses and grounding the novel's social anxieties in material history. Perhaps the most conspicu ous omission in previous readings of the novel, as many of these scholars have observed, is a consideration of its preoccupation with class conflict at the turn of the century. This essay builds upon the foundational work of recent material historicist readings like those of Laura Sagolla Croley, Eric Kwan-Wai Yu, Stephen Arata, Carol Senf, and Franco Moretti4 by suggesting that one as yet unacknowledged source of the novel's deep so cial distress is the 1871 Paris Commune, the unsettling political possibili ties of which were still haunting the English cultural imaginary at the turn of the century in the form of what Matthew Beaumont names the cacotopian novel.

Characterization of signaling pathways in embryonic stem cells is a prerequisite for future application of these cells to treat human disease and other disorders. Identification of tyrosine signaling cascades is of particular interest but is complicated by the relatively low levels of tyrosine phosphorylation in embryonic stem cells. These hurdles correlate with the primary limitations of mass spectrometry-based proteomics; namely, poor detection limit and dynamic range. To overcome these obstacles, we fabricated miniaturized LC-electrospray assemblies that provided approximately 15-fold improvement in LC-MS performance. Significantly, our characterization data demonstrate that electrospray ionization efficiency compensates for diminished chromatographic performance at effluent flow rates below Van Deemter minima. Use of these assemblies facilitated quantitative proteomics-based analysis of tyrosine signaling cascades in embryonic stem cells. Our results suggest that a renewed focus on miniaturized LC coupled to ultralow flow electrospray will provide a viable path for proteomic analysis of primary cells and rare post-translational modifications.

Whereas past research has demonstrated that children's beliefs about the real world can influence their memory for events, the role of fantasy beliefs in children's recall remains largely unexplored. We examine this topic in 5- and 6-year-olds by focusing on how belief in a familiar fantasy figure, namely the Tooth Fairy, is related to children's memory for their most recent primary tooth loss. Although children who fully believed in the reality of the Tooth Fairy provided more voluminous and complex accounts than those with less strong beliefs, they also provided the most fictitious reports, frequently characterized by claims of hearing or seeing the Tooth Fairy. Belief in the Tooth Fairy did not affect the accuracy of children's reports of the mundane elements of their tooth loss, and many fantastic claims were linked to real events. Exposure to seemingly tangible evidence of the Tooth Fairy's existence was associated with the provision of fantastic claims. This research was supported by a grant from Ur...

To examine how children's fantasy beliefs can affect memory for their experiences, 5- and 6-year-olds with differing levels of belief in the reality of the Tooth Fairy were prompted to recall their most recent primary tooth loss in either a truthful or fun manner. Many of the children who fully believed in the existence of the Tooth Fairy reported supernatural experiences consistent with the myth under both sets of recall instructions, whereas those who realized the fictionality of the myth recalled mainly realistic experiences. However, those children with equivocal beliefs evidenced a different pattern under each set of instructions, recalling mainly realistic experiences when asked to be truthful and reporting many fantastical experiences when prompted to relate the tooth loss in a fun manner. These findings suggest that children's beliefs in the reality of fantastic phenomena can give rise to genuine constructive memory errors in line with their fantasies. Copyright © 2007 John Wiley & Sons, Ltd.

This chapter is a close analysis of the representation of post-apocalyptic North America (Panem) in the three novels comprising Suzanne Collins’s blockbuster The Hunger Games trilogy: The Hunger Games (2008), Catching Fire (2009), and Mockingjay (2010). Smith and Korsnack argue that scholars have yet to consider the trilogy’s uneasy relation to the dystopian genre with which it is universally identified. Instead, they propose that a close consideration of the relationship between setting and genre in the series reveals points at which its dystopian critique lapses into other varieties of utopian form, specifically the anti-utopia and the conservative utopia.

Shoulder pain and injuries are common in athletes. Overhead athletes, in particular, place great demands on the shoulder and supporting structures. Magnetic resonance (MR) imaging is well suited to evaluation of the osseous structures and soft tissues of the shoulder and plays an important role in evaluation of shoulder pain in athletes. Primary extrinsic impingement is well evaluated on MR imaging as are the less common posterior superior glenoid impingement and subcoracoid impingement. Rotator cuff tendinosis as well as partial- and full-thickness tears are frequently encountered in the athletic shoulder. The biceps tendon and rotator interval capsular structures are important sources of shoulder pain. Glenohumeral instability that results from a traumatic event or atraumatic multidirectional recurrent instability is assessed. The biceps labral complex is a source of considerable anatomic variability and pathology.

Three studies examined the short-term impact of television (TV) on children's executive function (EF). Study 1 (N = 160) showed that 4- and 6-year-olds' EF is impaired after watching 2 different fast and fantastical shows, relative to that of children who watched a slow, realistic show or played. In Study 2 (N = 60), 4-year-olds' EF was as depleted after watching a fast and fantastical educational show as it was after a fast and fantastical entertainment 1, relative to that of children who read a book based on the educational show. Study 3 (N = 80) examined whether show pacing or fantasy was more influential, and found that only fantastical shows, regardless of their pacing, disrupted 4-year-olds' EF. Taken together, these studies show that 10-20 min watching televised fantastical events, relative to other experiences, results in lower EF in young children.

Despite the popularity of Bakhtinian approaches to Joyce’s works in the 1980s and early ’90s, there has been in recent years an increasing dissatisfaction with what is often perceived as the privileging of social and political relativity within Bakhtin’s body of theory that allegedly elides questions of class, race, and history with celebratory notions of the inherently dialogized utterance and the impossibility of true monologism. The putative ahistoricism of Bakhtinian theory has led, predictably, to a criticism of its popular application in Joyce studies. As M. Keith Booker has it in his “Ulysses,” Capitalism, and Colonialism: Reading Joyce After the Cold War, many recent “political” readings of Joyce which deploy Bakhtin as a point of departure are concerned with revealing Joyce’s interest in and engagement with popular culture in an effort to dismantle the formerly dominant critical view of Joyce characterized by an “elitist and aestheticist hermeticism” (35). While the best of these “liberal” Bakhtinian readings are commendable for their recuperation of Joyce as a functioning member of his society, indeed as a political writer, Booker suggests that in focusing their analyses exclusively upon the heteroglossic nature of Joyce’s work, they may also inadvertently assume a position which is “suspiciously close to the liberal humanist notion that variety is inherently good and that good things will automatically happen when multiple voices are allowed to sound” (35). In short, some argue that Bakhtinian analyses of Joyce often come dangerously close to positing a closed system of universal (read western) aesthetics—which disregards political realities—much like the New Critical regime which they sought to displace. Peter Hitchcock warns those who invoke

Background: Carney complex (CNC) is a multiple neoplasia syndrome caused by PRKAR1A-inactivating mutations. One-third of the patients, however, have no detectable PRKAR1A coding sequence defects. Small deletions of the gene were previously reported in few patients, but large deletions of the chromosomal PRKAR1A locus have not been studied systematically in a large cohort of patients with CNC. Setting: A tertiary care referral center was the setting for analysis of an international cohort of patients with CNC. Methods: Methods included genome-wide array analysis followed by fluorescent in situ hybridization, mRNA, and other studies as well as a retrospective analysis of clinical information and phenotype-genotype correlation. Results: We detected 17q24.2-q24.3 deletions of varying size that included the PRKAR1A gene in 11 CNC patients (of 51 tested). Quantitative PCR showed that these patients had significantly lower PRKAR1A mRNA levels. Phenotype varied but was generally severe and included manifestations that are not commonly associated with CNC, presumably due to haploinsufficiency of other genes in addition to PRKAR1A. Conclusions: A significant number (21.6%) of patients with CNC that are negative in currently available testing may have PRKAR1A haploinsufficiency due to genomic defects that are not detected by Sanger sequencing. Array-based studies are necessary for diagnostic confirmation of these defects and should be done in patients with unusual and severe phenotypes who are PRKAR1A mutation-negative.