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Immune suppressive factors of the tumor microenvironment (TME) undermine viability and exhaust the activities of the intratumoral cytotoxic CD8 + T lymphocytes (CTL) thereby evading anti-tumor immunity and decreasing the benefits of immune therapies. To counteract this suppression and improve the efficacy of therapeutic regimens, it is important to identify and understand the critical regulators within CD8 + T cells that respond to TME stress and tumor-derived factors. Here we investigated the regulation and importance of activating transcription factor-4 (ATF4) in CTL using a novel Atf4ΔCD8 mouse model lacking ATF4 specifically in CD8 + cells. Induction of ATF4 in CD8 + T cells occurred in response to antigenic stimulation and was further increased by exposure to tumor-derived factors and TME conditions. Under these conditions, ATF4 played a critical role in the maintenance of survival and activities of CD8 + T cells. Conversely, selective ablation of ATF4 in CD8 + T cells in mice rendered these Atf4ΔCD8 hosts prone to accelerated growth of implanted tumors. Intratumoral ATF4-deficient CD8 + T cells were under-represented compared to wild-type counterparts and exhibited impaired activation and increased apoptosis. These findings identify ATF4 as an important regulator of viability and activity of CD8 + T cells in the TME and argue for caution in using agents that could undermine these functions of ATF4 for anti-cancer therapies. [ABSTRACT FROM AUTHOR]

Learning the language is crucial to be included in a new society. For migrants, the smartphone is a commonly used device for staying connected, which could also be used for language learning purposes. This research concerns mobile literacy with newly arrived Arabic speaking migrants to Sweden and the use of mobile learning as a means for integration. The purpose is to investigate how mobile technology can be designed to support migrants' language learning process. The research concerns technology development where versions of a mobile application (app) are explored from a bottom-up perspective with Arabic speaking migrants. A qualitative method approach is applied, built on design principles focusing on the construction of situated artefacts and evaluation of performance. The results show that intuitive design and engaging content with connections to everyday social situations play important parts in sustaining motivation to engage with an app. [ABSTRACT FROM AUTHOR]

The mobile phone has become an indispensable device for communication and managing everyday life among newly arrived migrants. Learning a new language is a crucial aspect of integration and professionalization in a foreign country, and the phone is a tool that is also used by migrants also for language learning. The purpose of this study is to investigate how mobile-assisted language learning (MALL) is situated in the context of newly arrived migrants from the Middle East in Sweden as a means to learn a new language. The designs and context of MALL apps used with migrants are explored from a pedagogical perspective and investigated by means of observations and interviews with migrants. The results show that there are difficulties with how MALL apps are used by migrants, as the apps are built on individualised drilling activities with vocabulary training which are neither motivating nor immediately connected to the everyday language learning needs of the migrants. However, gamification aspects built into the apps together with push notifications attract most of the users who do engage with the apps, and these aspects are incentives for building a routine around MALL app usage. The design around the content and functionality plays an important role in how learners make use of mobile applications. [ABSTRACT FROM AUTHOR]

Objective: To assess outcomes of women with uterine fibroids (UFs) and heavy menstrual bleeding (HMB) treated with 300 mg elagolix twice daily plus add-back therapy (E2 1 mg/NETA 0.5 mg once daily) or placebo who were not considered responders in pooled analysis of two phase 3, 6-month randomized clinical trials (Elaris UF-1 and UF-2). Methods: Responders were defined as women who met both primary end point bleeding criteria (<80 mL menstrual blood loss [MBL] during the final month and ≥50% reduction in MBL from baseline to the final month) and either completed the study or discontinued due to predefined reasons. Thus, women termed nonresponders who were analyzed in this study who met neither or one bleeding end point or met both criteria but prematurely discontinued treatment because of adverse events, perceived lack of efficacy, or required surgical or interventional treatment for UFs were analyzed in this study. This post hoc analysis assessed mean changes from baseline in MBL, as well as adverse events. Results: Among 367 women receiving elagolix with add-back with observed data, 89 (24%) were not considered responders. Within this subset, 17 (19%) women met both bleeding criteria but prematurely discontinued treatment for the reasons mentioned above, while 23 (26%) met one bleeding criterion and 49 (55%) met neither bleeding criteria, regardless of discontinuation status. Among all nonresponders, a numerical trend toward greater mean reductions in MBL was observed in those receiving elagolix with add-back, compared with placebo group nonresponders. No differences in adverse events were observed between responders and nonresponders. Conclusion: Forty of 89 (45%) women with HMB and UFs who were classified as nonresponders in the UF-1 or UF-2 trials may have had a clinically meaningful response to elagolix with add-back therapy because they met at least one of the objective bleeding criteria. Clinical Trial Registration: Clinicaltrials.gov, NCT02654054 and NCT02691494. (NEJM 2020; 382:328–340) DOI: 10.1056/NEJMoa1904351 [ABSTRACT FROM AUTHOR]

Uterine fibroids are common benign tumors that occur in up to 80% of women. Approximately half of the women affected experience considerable physical, psychological, and economic burdens and impact on quality of life due to symptoms such as heavy menstrual bleeding, pelvic pain, and infertility. Several medical and surgical options are available to treat uterine fibroids; however, healthcare providers may benefit from practical guidance in the development of individualized treatment plans based on a personalized approach. Medical treatments and minimally invasive procedures are generally preferred by most patients before considering more invasive, higher risk surgical interventions. In general, patient-centered, uterine-preserving procedures may be prioritized based on the patient's goals and the clinical scenario. Occasionally, hysterectomy may be the preferred treatment option for some patients who require definitive treatment. This call-to-action highlights recent challenges to patient care, including radical shifts in physician–patient interactions due to the COVID-19 pandemic and recent changes to evidence-based, clinically approved therapies. This report also reviews contemporary recommendations for women's health providers in the diagnosis and medical and surgical management of uterine fibroids. This call-to-action aims to empower healthcare providers to optimize the quality of care for women with uterine fibroids utilizing the best available evidence and best practices. [ABSTRACT FROM AUTHOR]

Background: The disease and treatment burden of uterine fibroids (UF) in Black women is substantially greater compared with other racial groups, with higher rates of complications and poorer outcomes with both hysterectomy and myomectomy. The inequities in the access Black women have to minimally invasive routes of surgery contribute to their burden of illness. Laparoscopic radiofrequency ablation (LAP-RFA) is a minimally invasive, safe, and effective uterine-sparing treatment option. Methods: This subgroup analysis of the LAP-RFA Pivotal Trial stratified outcomes by race comparing White women (n = 28, 21%) versus Black women (n = 46, 34%). Results: At baseline, Black women had more fibroids on average (7.3 vs. 3.7; P ≤ 0.001), a greater symptom severity score (SSS) (P ≤ 0.001), and a lower health-related quality of life (HRQoL) score (P = 0.005) than White women. At 36 months post-treatment with LAP-RFA, the statistical differences that existed with baseline SSS and HRQoL score were eliminated between Black and White women. Menstrual blood loss (140.1 mL vs. 127.02 mL; P = 0.44) and mean fibroid volume reduction (47.5 cm3 vs. 36.0 cm3; P = 0.17) were similar between Black and White women at 12 months. Although not statistically significant, the intraoperative total blood loss and uterine blood loss was lower in Black women than White women, despite greater operative time (160 minutes vs. 137 minutes; P = 0.09). Conclusions: These results are promising in providing an alternative uterine-sparing option for Black women and may help to provide a minimally invasive option that can address some of the racial inequities in care for Black women with UF. [ABSTRACT FROM AUTHOR]

This research investigates professional development with Syrian refugee women teachers settled in Lebanon and Sweden. Both countries offer professional training programmes for migrant teachers, enabling them to proceed with their careers. The purpose is to investigate how moving to a new country calls for an opportunity to engage in practice development and the role digital literacy plays in the refugees' lives. We conducted interviews with twenty women in Lebanon and Sweden. The outcomes show that engaging in further career development is empowering and beneficial for strengthening and developing teaching and learning skills, and mobile literacy plays a role in overcoming the language barrier. [ABSTRACT FROM AUTHOR]

Effective T cell differentiation during acute virus infections leads to the generation of effector T cells that mediate viral clearance, as well as memory T cells that confer protection against subsequent reinfection. While inhibitory immune checkpoints have been shown to promote T cell dysfunction during chronic virus infections and in tumors, their roles in fine tuning the differentiation and responses of effector and memory T cells are only just beginning to be appreciated. We previously identified PSGL-1 as a fundamental regulator of T cell exhaustion that sustains expression of several inhibitory receptors, including PD-1. We now show that PSGL-1 can restrict the magnitude of effector T cell responses and memory T cell development to acute LCMV virus infection by limiting survival, sustaining PD-1 expression, and reducing effector responses. After infection, PSGL-1-deficient effector T cells accumulated to a greater extent than wild type T cells, and preferentially generated memory precursor cells that displayed enhanced accumulation and functional capacity in response to TCR stimulation as persisting memory cells. Although, PSGL-1-deficient memory cells did not exhibit inherent greater sensitivity to cell death, they failed to respond to a homologous virus challenge after adoptive transfer into naïve hosts indicating an impaired capacity to generate memory effector T cell responses in the context of viral infection. These studies underscore the function of PSGL-1 as a key negative regulator of effector and memory T cell differentiation and suggest that PSGL-1 may limit excessive stimulation of memory T cells during acute viral infection. [ABSTRACT FROM AUTHOR]

The immune system, and in particular, cytotoxic CD8+ T cells (CTLs), plays a vital part in the prevention and elimination of tumors. In many patients, however, CTL-mediated tumor killing ultimately fails in the clearance of cancer cells resulting in disease progression, in large part due to the progression of effector CTL into exhausted CTL. While there have been major breakthroughs in the development of CTL-mediated "reinvigoration"-driven immunotherapies such as checkpoint blockade therapy, there remains a need to better understand the drivers behind the development of T cell exhaustion. Our study highlights the unique differences in T cell exhaustion development in tumor-specific CTL which arises over time in a mouse model of mesothelioma. Importantly, we also show that peripheral tumor-specific T cells have a unique expression profile compared to exhausted tumor-infiltrating CTL at a late-stage of tumor progression in mice. Together, these data suggest that greater emphasis should be placed on understanding contributions of individual microenvironments in the development of T cell exhaustion. [ABSTRACT FROM AUTHOR]

Understanding the mechanisms underlying anti-tumor immunity is pivotal for improving immune-based cancer therapies. Here, we report that growth of BRAF-mutant melanoma cells is inhibited, up to complete rejection, in Siah2−/− mice. Growth-inhibited tumors exhibit increased numbers of intra-tumoral activated T cells and decreased expression of Ccl17,Ccl22, and Foxp3. Marked reduction in Treg proliferation and tumor infiltration coincide with G1 arrest in tumor infiltrated Siah2−/− Tregs in vivo or following T cell stimulation in culture, attributed to elevated expression of the cyclin-dependent kinase inhibitor p27, a Siah2 substrate. Growth of anti-PD-1 therapy resistant melanoma is effectively inhibited in Siah2−/− mice subjected to PD-1 blockade, indicating synergy between PD-1 blockade and Siah2 loss. Low SIAH2 and FOXP3 expression is identified in immune responsive human melanoma tumors. Overall, Siah2 regulation of Treg recruitment and cell cycle progression effectively controls melanoma development and Siah2 loss in the host sensitizes melanoma to anti-PD-1 therapy. The ubiquitin ligase Siah2 has been implicated in immune responses. Here, the authors show that Siah2 null immune cells have an increased inflammatory response to inoculated melanoma cells, along with a reduced number of infiltrating immunosuppressive regulatory T cells, resulting in inhibition of tumour growth. [ABSTRACT FROM AUTHOR]

Background: Radiofrequency ablation (RFA) has emerged as a safe and effective treatment option for women with symptomatic uterine fibroids and can be delivered by laparoscopic, transvaginal, or transcervical approaches. The evidence regarding typical patient outcomes with RFA has not previously been examined in a comprehensive fashion. Materials and Methods: We performed a systematic review of prospective studies for treatment of uterine fibroids with RFA. Main outcomes were procedure time, patient recovery metrics, change in fibroid volume, symptom severity score (SSS), health-related quality of life (HRQL), and reinterventions. Data were analyzed with random effects meta-analysis and metaregression. Results: We identified 32 articles of 1283 unique patients (median age: 42 years) treated with laparoscopic RFA (19 articles), transvaginal RFA (8 articles), or transcervical fibroid ablation (5 articles). Mean procedure time was 49 minutes, time to discharge was 8.2 hours, time to normal activities was 5.2 days, and time to return to work was 5.1 days. At 12 months follow-up, fibroid volume decreased by 66%, HRQL increased by 39 points, and SSS decreased by 42 points (all P < .001 versus baseline). The annual cumulative rate of reinterventions due to fibroid-related symptoms was 4.2%, 8.2%, and 11.5% through 3 years. Conclusions: RFA of uterine fibroids significantly reduces fibroid volume, provides significant durable improvements in fibroid-related quality of life, and is associated with favorable reintervention rates. [ABSTRACT FROM AUTHOR]

Effective adaptive immune responses are characterized by stages of development and maturation of T and B cell populations that respond to disturbances in the host homeostasis in cases of both infections and cancer. For the T cell compartment, this begins with recognition of specific peptides by naïve, antigen-inexperienced T cells that results in their activation, proliferation, and differentiation, which generates an effector population that clears the antigen. Loss of stimulation eventually returns the host to a homeostatic state, with a heterogeneous memory T cell population that persists in the absence of antigen and is primed for rapid responses to a repeat antigen exposure. However, in chronic infections and cancers, continued antigen persistence impedes a successful adaptive immune response and the formation of a stereotypical memory population of T cells is compromised. With repeated antigen stimulation, responding T cells proceed down an altered path of differentiation that allows for antigen persistence, but much less is known regarding the heterogeneity of these cells and the extent to which they can become "memory-like," with a capacity for self-renewal and recall responses that are characteristic of bona fide memory cells. This review focuses on the differentiation of CD4+ and CD8+ T cells in the context of chronic antigen stimulation, highlighting the central observations in both human and mouse studies regarding the differentiation of memory or "memory-like" T cells. The importance of both the cellular and molecular drivers of memory T cell development are emphasized to better understand the consequences of persisting antigen on T cell fates. Integrating what is known and is common across model systems and patients can instruct future studies aimed at further understanding T cell differentiation and development, with the goal of developing novel methods to direct T cells toward the generation of effective memory populations. [ABSTRACT FROM AUTHOR]

Peer review is applied as a powerful tool to enhance student collaboration online writing. The purpose of this paper is to analyse learners' mechanisms of peer reviewing in the nature of student interventions and interactions in written online peer reviewing and how categorization of student comments can be used as a means for analysing student peer reviewing. The study is an in-depth investigation of computer science students participating in a technical writing course, using Google Drive as their joint work space. While writing their group text, the students were participating in peer reviewing work. Results show combining analysis models provide a better understanding of the implication of commenting in both scrutinizing the progressive scale of assistance, as well as area, nature, and type of commenting, together with what themes evolve. Further, taking turns providing feedback is an enriching activity. [ABSTRACT FROM AUTHOR]

The purpose of this study is to investigate the mobile activities newly arrived migrants are engaged in when learning the Swedish language and about Swedish culture and society. Further, the study also explores the use of a mobile application (app) provided to the newly arrived migrants to use for pronunciation practice. The study involved 38 newly arrived Arabic speaking migrants participating in an introduction program of the Swedish language and Swedish culture provided by the Swedish government. The participants were divided into two groups: a control group who received training according to the traditional introduction programme and an experimental group who used a mobile app for pronunciation training as a complement to the programme. We applied a combination of qualitative and quantitative methods for data collection and analysis. The participants were interviewed about their use of mobile phones as well as recorded in a number of activities inside and outside the classroom to compare their language evolvement. In addition, surveys, logging of weekly mobile activities and observations were performed. The results show that the participants used a wide range of different mobile tools, both inside and outside the classroom. However, they used the mobiles mostly for communication with their family and friends rather than for communication with Swedes and learning Swedish. Further, compared to the control group, the experimental group showed an improved speech tempo and self-confidence in speaking. The study thus indicates that focused linguistic training with a pronunciation app is useful for developing spoken language skills, which can lead to improved integration. The participants expressed need and interest in having more mobile apps for both language and culture training. [ABSTRACT FROM AUTHOR]

Over the past decade participation in physical activity for adult women has decreased while body size has increased. Overweight and obese individuals are considered the majority demographic in the United States; however, plus-sized clothing sales are minimal in comparison to other segments. Furthermore, there is little known about the clothing practices of obese women who engage in physical activity. The current study addresses this research gap by exploring obese heterosexual women's clothing practices for exercise, with an emphasis on what women wear, their perceived choices, alternatives, and satisfaction. Lowe and Anspach's (Home Econ Res J 7(2):121-127, ) notion of freedom of dress was the guiding conceptual framework for in-depth interviews with (n = 56) obese women. A majority of the women perceived having limited freedom in dress, and reported crossdressing in men's clothing to engage in physical activity, which resulted in a perceived lack of gender expression. Crossdressing is wearing clothing of the opposite sex and gender expression is a way in which a person acts to communicate gender within a given culture. Women in this study indicated and the authors discuss that as clothing size increases, perceived freedom in dress decreases. In order to increase freedom in dress, our participants tended to believe it is their personal responsibility to lose weight. [ABSTRACT FROM AUTHOR]

We explored the role that social support plays in the lives of women who have undergone bariatric surgery. We conducted in-depth interviews with 13 women who had had bariatric surgery (M age = 53.0 years) and analyzed the data using constant comparison processes. We found that individuals in participants’ lives offered support by acting as role models and providing information, offering empathy and expressions of concern and caring, assisting with everyday responsibilities, and serving as companions. In turn, these forms of support guided participants’ behavior, calmed their concerns, enhanced their self-esteem, relieved them of daily responsibilities, and offered them companionship in their bariatric journeys. Consistent with the existing theory, differently situated individuals specialized in offering particular types of support. Although participants appreciated the support received, many indicated a desire for more or “better” support, pointing to a need for resources guiding supporters in how to best offer support to bariatric patients. [ABSTRACT FROM AUTHOR]

Background: Uterine fibroids have a disproportionate impact on African-American women. There are, however, no data to compare racial differences in symptoms, quality of life, effect on employment, and information-seeking behavior for this disease. Methods: An online survey was conducted by Harris Interactive between December 1, 2011 and January 16, 2012. Participants were U.S. women aged 29-59 with symptomatic uterine fibroids. African-American women were oversampled to allow statistical comparison of this high-risk group. Bivariate comparison of continuous and categorical measures was based on the t-test and the Chi-squared test, respectively. Multivariable adjustment of risk ratios was based on log binomial regression. Results: The survey was completed by 268 African-American and 573 white women. There were no differences between groups in education, employment status, or overall health status. African-American women were significantly more likely to have severe or very severe symptoms, including heavy or prolonged menses (RR=1.51, 95% CI 1.05-2.18) and anemia (RR=2.73, 95% CI 1.47-5.09). They also more often reported that fibroids interfered with physical activities (RR=1.67, 95% CI 1.20-2.32) and relationships (RR=2.27, 95% CI 1.23-4.22) and were more likely to miss days from work (RR=1.77, 95% CI 1.20-2.61). African-American women were more likely to consult friends and family (36 vs. 22%, P=0.004) and health brochures (32 vs. 18%, P<0.001) for health information. Concerns for future fertility (RR=2.65, 95% CI 1.93-3.63) and pregnancy (RR=2.89, 95% CI 2.11-3.97) following fibroid treatments were key concerns for black women. Conclusions: African-American women have more severe symptoms, unique concerns, and different information-seeking behavior for fibroids. [ABSTRACT FROM AUTHOR]

T cell migration is crucial for an effective adaptive immune response to invading pathogens. Naive and memory T cells encounter pathogen antigens, become activated, and differentiate into effector cells in secondary lymphoid tissues, and then migrate to the site(s) of infection where they exert effector activities that control and eliminate pathogens. To achieve activation, efficient effector function, and good memory formation,T cells must traffic between lymphoid and non-lymphoid tissues within the body. This complex process is facilitated by chemokine receptors, selectins, CD44, and integrins that mediate the interactions of T cells with the environment.The expression patterns of these migration receptors (MR) dictate the tissues into which the effector T cells migrate and enable them to occupy specific niches within the tissue. While MR have been considered primarily to facilitate cell movement, we highlight how the heterogeneity of signaling through these receptors influences the function and fate of T cells in situ.We explore what drives MR expression heterogeneity, how this affects migration, and how this impactsT cell effector function and memory formation. [ABSTRACT FROM AUTHOR]

This paper describes the visuals second grade students included in their own information book compositions during a science unit on weather during which multimodal science trade books on the topic of weather were read aloud. First, the multimodal nature of the information books used in the unit are described. Second, the teacher's talk about visual representations during read alouds of books on weather is presented. And third, the children's own information books about weather topics are examined for inclusion of labeled pictorial illustrations with accompanying captions and graphical representations. These analyses reveal that 1) information book authors vary in their use of visual information, 2) some graphics may be more salient for children, and 3) children's use of pictorial illustrations and graphical representations in their own compositions seems to be impacted by both teacher attention to particular types of visual representations and immersion in information book graphics. [ABSTRACT FROM AUTHOR]

The article presents information on the program Project A Student-Parent Initiative Revitalizing Education (ASPIRE) in Georgia which offers family programs in order to promote literacy for preschool children. The authors look at the Governor's Office for Children and Families in Georgia, the U.S. National Association for the Education of Young Children (NAEYC), and the impact that children's books have a child's knowledge of special language and story structure.

The early inflammatory response to influenza virus infection contributes to severe lung disease and continues to pose a serious threat to human health. The mechanisms by which neutrophils gain entry to the respiratory tract and their role during pathogenesis remain unclear. Here, we report that neutrophils significantly contributed to morbidity in a pathological mouse model of influenza virus infection. Using extensive immunohistochemistry, bone marrow transfers, and depletion studies, we identified neutrophils as the predominant pulmonary cellular source of the gelatinase matrix metalloprotease (MMP) 9, which is capable of digesting the extracellular matrix. Furthermore, infection of MMP9-deficient mice showed that MMP9 was functionally required for neutrophil migration and control of viral replication in the respiratory tract. Although MMP9 release was toll-like receptor (TLR) signaling-dependent, MyD88-mediated signals in non-hematopoietic cells, rather than neutrophil TLRs themselves, were important for neutrophil migration. These results were extended using multiplex analyses of inflammatory mediators to show that neutrophil chemotactic factor, CCL3, and TNFα were reduced in the Myd88-/- airways. Furthermore, TNFα induced MMP9 secretion by neutrophils and blocking TNFα in vivo reduced neutrophil recruitment after infection. Innate recognition of influenza virus therefore provides the mechanisms to induce recruitment of neutrophils through chemokines and to enable their motility within the tissue via MMP9-mediated cleavage of the basement membrane. Our results demonstrate a previously unknown contribution of MMP9 to influenza virus pathogenesis by mediating excessive neutrophil migration into the respiratory tract in response to viral replication that could be exploited for therapeutic purposes. [ABSTRACT FROM AUTHOR]

Type 1 diabetes (T1D) results from autoimmune destruction of insulin-producing β-cells in the pancreatic islets. There is an immediate need to restore both β-cell function and immune tolerance to control disease progression and ultimately cure T1D. Currently, there is no effective treatment strategy to restore glucose regulation in patients with T1D. FoxP3-expressing CD4+ regulatory T cells (Tregs) are potential candidates to control autoimmunity because they play a central role in maintaining self-tolerance. However, deficiencies in either naturally occurring Tregs (nTregs) themselves and/or their ability to control pathogenic effector T cells have been associated with T1D. Here, we hypothesize that nTregs can be replaced by FoxP3+ adaptive Tregs (aTregs), which are uniquely equipped to combat autoreactivity in T1D. Unlike nTregs, aTregs are stable and provide long-lived protection. In this review, we summarize the current understanding of aTregs and their potential for use as an immunological intervention to treat T1D. [ABSTRACT FROM PUBLISHER]

The article discusses the method of reading aloud in second-grade classrooms in order to model the structure of information books. The authors discuss a study of a second-grade classroom in which students were assigned the project of writing information books after studying informational texts about weather. They suggest that an understanding of the genre of information texts is especially useful in the 21st-century classroom due to the rise of mass media and communications in everyday life. Aspects of students' informational compositions are discussed including descriptive attributes, comparisons, and the use of timeless present tense. The authors emphasize the reading teacher's role in instructing students regarding genre elements and patterns of information books.

In a globally networked learning environment (GNLE), 16 students at a university in Sweden and 17 students at a university in the United States exchanged peer-review comments on drafts of assignments they prepared in English for their technical communication classes. The instructors of both sets of students had assigned the same projects and taught their courses in the same way that they had in the previous year, which contrasts with the common practice of having students in partnering courses work on the same assignment or on linked assignments created specifically for the GNLE. The authors coded the students' 816 comments according to their focus and orientation in order to investigate the possible differences between the comments made by the L2 students in Sweden and those made by the L1 (English as a second language) students in the United States, the possible impact of peer reviewing online, and the influence of the instructors' directions on the students' peer-reviewing behavior. [ABSTRACT FROM AUTHOR]

For language learning, online environments allowing for user generated content are becoming increasingly important since they offer possibilities for learners to elaborate on assignments and projects. This study investigates what wikis can do as a means to enhance group interaction, when students are encouraged to participate in constructing text and exchanging peer response. The research focus is on exploring what interaction unfolds in the wiki and how it promotes language learning, from a sociocultural perspective. This interaction is framed both by affordances in the wiki but also by what is expected from students as language learners in an English for Specific Purposes class environment. The analysis has a multilevel approach, focusing on patterns of interaction and the nature of feedback. The study shows that collaboration becomes specifically interesting from a language learning perspective. In the findings, on the student wiki pages there are numerous contributions relating to both local language and global content. Revising co-constructed text opens up possibilities for the students to evaluate existing contributions and it also provides opportunities for them to suggest constructive changes. In addition, with the environment being web based, we discuss certain benefits arising from the fact that it allows for user-generated content. [ABSTRACT FROM AUTHOR]

Context: Associations between chromosome 9p21 single-nucleotide polymorphisms (SNPs) and heart disease have been reported and replicated. If testing improves risk assessments using traditional factors, it may provide opportunities to improve public health.Objectives: To perform a targeted systematic review of published literature for effect size, heterogeneity, publication bias, and strength of evidence and to consider whether testing might provide clinical utility.Data Sources: Electronic search via HuGE Navigator through January 2009 and review of reference lists from included articles.Study Selection: English-language articles that tested for 9p21 SNPs with coronary heart/artery disease or myocardial infarction as primary outcomes. Included articles also provided race, numbers of participants, and data to compute an odds ratio (OR). Articles were excluded if reporting only intermediate outcomes (eg, atherosclerosis) or if all participants had existing disease. Twenty-five articles were initially identified and 16 were included. A follow-up search identified 6 additional articles.Data Extraction: Independent extraction was performed by 2 reviewers and consensus was reached. Credibility of evidence was assessed using published Venice criteria.Data Synthesis: Forty-seven distinct data sets from the 22 articles were analyzed, including 35 872 cases and 95 837 controls. The summary OR for heart disease among individuals with 2 vs 1 at-risk alleles was 1.25 (95% confidence interval [CI], 1.21-1.29), with low to moderate heterogeneity. Age at disease diagnosis was a significant covariate, with ORs of 1.35 (95% CI, 1.30-1.40) for age 55 years or younger and 1.21 (95% CI, 1.16-1.25) for age 75 years or younger. For a 65-year-old man, the 10-year heart disease risk for 2 vs 1 at-risk alleles would be 13.2% vs 11%. For a 40-year-old woman, the 10-year heart disease risk for 2 vs 1 at-risk alleles would be 2.4% vs 2.0%. Nearly identical but inverse results were found when comparing 1 vs 0 at-risk alleles. Three studies showed net reclassification indexes ranging from -0.1% to 4.8%.Conclusion: We found a statistically significant association between 9p21 SNPs and heart disease that varied by age at disease onset, but the magnitude of the association was small. [ABSTRACT FROM AUTHOR]