Situated in the changing context of Mandarin learning in the United States, Mandarin these days is changing from a less commonly taught language to a more commonly offered foreign language option in American secondary schools. However, in the applied linguistic literature, "few empirical studies have focused on pre-college CFL learning" (Ke, 2012, p.98). Moreover, the transition from high school to university often entails complex social, cultural, and emotional changes (e.g., Nathan, 2006). The goal of this dissertation project, therefore, is to investigate how students' investment in Mandarin is socially and historically constructed at these three levels: personal, familial, and institutional, as they transition from high school to university. This study draws upon the theory of identity and investment (Norton, 1995) to examine how these teenage language learners are multidimensional beings with multiple desires, and how their investment is produced or reproduced from social interactions, and is subject to change. Three high school campuses were chosen, because Mandarin classes are now offered from kindergarten through twelfth grade in these schools. Six students who expressed their intentions to continue learning Mandarin in university consented to participate in this study. Data collection for this study lasted from March to December 2015, which covered these students' last semester of high school, their first semester of college, and the period between. Data were collected from interviews and monthly informal Skype chats, and supplemented with class documents. Using qualitative analysis methods, the findings show the following factors as salient to their investment in Mandarin learning at the high school stage: 1) the students' personal interest, and 2) the influence from their families and their institutions. In the university setting, these students' investment in Mandarin was mostly mediated at the personal and the institutional levels. The results reveal the identity shift from childhood to adulthood these adolescent learners experienced during the transition. Specifically, the adolescent learners became more independent in making their own decisions, and less dependent on their families, both financially and symbolically. Second, the findings also highlight how these individuals' investment in Mandarin could be constrained at the institutional level. This points to the need for L2 educators to pay attention not only to individual students' personal interests and motivations in language learning, but also to a better understanding of how students perceive their own identities and whether foreign language learning is accessible to learners institutionally.

Previous research has identified spirituality (Riggins, McNeal, & Herndon, 2008) as an important component of academic success for Black college students. Other factors researched include first year/ freshmen experiences, mentorships, faculty–student engagement (Caboni and Adisu, 2004), rigorous high-school curriculums, and summer bridge programs (Palmer, Moore, Davis, Hilton, 2010). Much of the research on college student success provides a comparison between Blacks, Whites, Asians, Latinos, and Native Americans (Caboni and Adisu, 2004; Carey, 2005; Palmer, Moore, Davis, Hilton, 2010; Townsend, 2007). However, few studies deal with Black students solely, and the influence of spirituality on the academic success within that one population. The lack of existing research on the relationship between spirituality and Black students’ college success, warrants a study that examines the possible ways in which spirituality might influence the academics of Black students (Hill, 2009). This grounded theory investigation examined the relationship between spirituality and the academic success among fifteen Black college students attending three Historically Black Colleges and Universities in Louisiana. Through depth interviews and analysis of resulting transcripts, it was found that spirituality plays a very important, yet indirect role in the academic successes of Black college students attending HBCUs. Three themes emerged: (1) Spirituality and Enduring Life’s Obstacles, (2) Spirituality as an Influence on Personal Transformation, and (3) the Academic Impact of Spirituality. This study helps to highlight a possible resolution to the post-secondary degree disparity seen between Blacks and Whites.

A thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfillment of the requirements for the degree of Doctor of Philosophy. Johannesburg, South Africa 2017. / Almost half of all cases of heart failure have a preserved ejection fraction. However, therapy targeting the mechanisms of this disorder has not improved outcomes. Left ventricular (LV) diastolic dysfunction is a characteristic feature of heart failure with a preserved ejection fraction. A more sound understanding of the mechanisms responsible for LV diastolic dysfunction produced by risk factors may lead to better approaches to preventing this syndrome. Although obesity is thought to be a major risk factor for LV diastolic dysfunction, this does not occur in all obese individuals. In the present thesis I have demonstrated in 737 randomly recruited participants from a community sample of African ancestry, that the relationship between insulin resistance (homeostasis model) and LV diastolic function, as assessed from trans-mitral velocity (E/A) and tissue Doppler imaging of the lateral and septal walls of the LV (e’ and E/e’), is markedly altered by the presence of a more concentrically remodelled LV (as indexed by LV relative wall thickness [RWT]). Importantly, insulin resistance was only associated with LV diastolic function or dysfunction in those with an RWT above a threshold value. In contrast no interactive effects on LV diastolic function between either blood pressure or age and RWT were noted. These data therefore suggest that obesity will only translate into LV diastolic dysfunction if it is associated with insulin resistance and a concentrically remodeled LV. Although hypertension is thought to play an important role in contributing to LV diastolic dysfunction, the pulsatile hemodynamic change primarily responsible for this effect is uncertain. In 524 randomly selected individuals from a community sample I have demonstrated that independent of confounders including left ventricular mass and RWT, aortic backward wave pressure effects (as determined using wave separation analysis), antedate the impact of aortic stiffness (indexed by aortic pulse wave velocity) or the factors determined by aortic stiffness (the time of backward wave return or forward wave pressures) on LV filling pressures (E/e’). These data therefore suggest that to adequately prevent LV diastolic dysfunction, targeting aortic backward wave pressures may be required. As conventional risk factors account for only a portion of the inter-individual variations in LV diastolic function, it is thought that the genetic factors may play a iv significant role. In 694 randomly recruited participants of African ancestry belonging to nuclear families, I demonstrated that independent of conventional risk factors, heritability accounts for approximately 50% of the variation in LV RWT, an important LV structural determinant of LV diastolic function. Moreover, in 442 randomly recruited individuals of African ancestry belonging to nuclear families, I also demonstrated that heritability accounts for approximately 50% of the variation in the index of LV filling pressures, E/e’, independent of LV mass or RWT remodeling and aortic function. These data provide strong evidence that genetic factors responsible for LV diastolic dysfunction and the structural determinants thereof should be sought. In conclusion, the results provided in the present thesis have advanced our knowledge of possible pathophysiological mechanisms that play a role in the development of LV diastolic dysfunction and hence possibly heart failure with a preserved ejection fraction. / MT2017

Maintaining redox homeostasis is crucial for normal cellular functions. Electron leak by the cytochrome P450 enzymes renders steroidogenic tissues acutely vulnerable to redox imbalance and oxidative stress is implicated in several potentially lethal adrenal disorders. This thesis aims to further delineate the role of oxidative stress in triple A syndrome and familial glucocorticoid deficiency (FGD). Triple A syndrome incorporates adrenal failure and progressive neurodegenerative disease. The AAAS gene product is the nuclear pore complex protein ALADIN, of unknown function. Patient dermal fibroblasts are sensitive to oxidative stress, with failure of nuclear import of DNA repair proteins and ferritin heavy chain protein. To provide an adrenal and neuronal-specific disease model, I established AAAS-knockdown in H295R human adrenocortical tumour cells and SH-SY5Y human neuroblastoma cells. This had effects on cell viability, exacerbated by hydrogen peroxide treatment. Redox homeostasis was impaired in AAAS-knockdown H295R cells, with depletion of key components of the steroidogenic pathway and a significant reduction in cortisol production, with partial reversal following treatment with N-acetylcysteine. Mutations in the mitochondrial antioxidant, nicotinamide nucleotide transhydrogenase (NNT), causing FGD, have recently highlighted the importance of redox regulation in steroidogenesis. I investigated seven individuals from a consanguineous Kashmiri kindred, mutation negative for known causes of FGD. A stop gain mutation, p.Y447* in TXNRD2, encoding the mitochondrial selenoprotein thioredoxin reductase 2 segregated with the disease trait; with complete absence of the 56 kDa TXNRD2 protein in patients homozygous for the mutation. TXNRD2-knockdown led to impaired redox homeostasis in H295R cells. This is the first report of a homozygous mutation in any component of the thioredoxin antioxidant system leading to inherited disease in humans.

The purpose of this study was to examine the potential differences in selected acoustic measures of speech as a function of age, across sexes, and between families. The data used in this study were previously collected for a larger project on voice production at the University of Utah. Participants included 169 individuals, 79 men and 90 women, from 18 Utah families, ranging in age from 17 to 87 years. All participants had no history of articulation disorders, stroke or active neurologic disease, or severe-profound hearing loss. Participants were recorded reading two passages aloud in a sound booth. These two passages were selected as connected speech tasks from which to extract the following acoustic metrics: fricative spectral measures (center of gravity, standard deviation, skewness, and kurtosis), mean fundamental frequency (F0), semitone standard deviation (STSD), speaking time ratio, and cepstral peak prominence smoothed (CPPS). Results indicated significant aging effects on spectral center of gravity and skewness, mean F0, and STSD. There was a significant sex effect for spectral center of gravity and kurtosis, mean F0, speaking time ratio, and CPPS. Familial relationship had a significant effect for spectral skewness, STSD, and CPPS. Findings from the current study indicate that certain speech and voicing features point to a decline with age and that aging affects the speech of men and women differently. Additionally, these data suggest that related speakers may demonstrate similar patterns for prosody, voicing, and articulation behavior, although the statistical testing did not allow us to draw specific inferences about such similarities. These findings describe some normal variations in the speech production of persons of differing age, sex, and familial background. An understanding of these normal speech differences in healthy individuals is valuable for differentiating between typical and pathological speech patterns in a clinical setting.

Familial hypercholesterolemias (FH) are inherited mutations that cause elevated total cholesterol and low-density lipoprotein cholesterol levels (LDL-C) which lead to premature coronary heart diseases. Pharmacogenetics is the study of inherited genetic differences in drug metabolic pathways which can affect the patient’s response to the drug. Single Nucleotide Morphism (SNP) mutations in the LDLR, apoB, LDRAP1, and PCSK9 genes are linked to familial hypercholesterolemia. The mutations in the LDLR gene are the most common while mutations in the apoB and PCSK9 genes are the least common in hypercholesterolemia patients. My research will study how pharmacogenetics can be used to diagnose and prescribe patients with FH who have apoB and PCSK9 double gene mutations. I will genotype and sequence the PCR amplified gene segments of the patients with FH to identify any of the 6 apoB SNPs and any of the 3 PCSK9 SNPs that are known. Then, I will provide 4 different treatments: placebo, antisense therapy (mipomersen), PCSK9 inhibitor (alirocumab), and a combination of mipomersen + alirocumab, and I will measure the LDL-C levels before and after a 12-week trial. I hypothesize that individuals with both apoB and PCSK9 gene mutations with the known SNPs that cause loss of function will be more responsive when given both treatments by observing a significant decrease in LDL-C levels.

The purpose of this research was to develop a self-evaluating instrument to assess family and social values . It can be used individually or in small group s of students at the senior high school or Junior college level . The variables rated are: familial, religious, sexual, and social values. The instrument is self-scoring and a schema is provided at the end of the test booklet to ind1cate the pattern of values as they are compared to the median or average scheme for the instrument. The 36 items in the scale are responded to by a forced choice design of alternate answer boxes which appear under different combinations of value variables . An intensity of response is measured in the form of alternates ranging from zero to three. Each item must total to three points . This method of responding to the items produces data that are curvilinear; therefore, advanced factorial analysis of items is necessary to determine the exact nature of data that might be collected from such an instrument. Hence, the instrument is limited for research purposes . However, it is not limited for use as an individual or self-administering evaluative tool . The interdependent nature of the values can be studied by the individual and the instrument becomes a valuable teaching device. A pretest situation involving 100 lower-division students at Utah State University reported the following results . The mean on the familial variable was highest, the intensity and frequency of response was greatest on the familial variable, and the intercorrelations on each variable ranged no lower than r = .59 to a high of r = .78. As a classroom tool, the Cole Scale of Values developed in this study should prove helpful for use in teaching concepts related to individual conceptions of familial and social values. Because of the interdependent nature of responses, and the indiscrete nature of any data collected from it, this instrument is only recommended for research when suitable methods of analysis are used.

Where is the importance in uncovering a link between the economic position and level of familial dysfunction in the short stories of Ernest Hemingway and F. Scott Fitzgerald? Furthermore, in composing these findings, what does this information have to offer in terms of bringing different insights to the works of these two writers who have already received so much attention from critics? In reading and researching the short stories of Hemingway and Fitzgerald, I find that published criticism has not sufficiently examined the connection between economic position and familial dysfunction. Trying to understand the psychology behind the characters’ lives and their consequential actions, however, requires us to look at this connection. One can articulate the effects and results that economic circumstances have in relation to the characters’ familial duties and responsibilities. / Thesis / Master

Pour avoir une parfaite compréhension dune maladie, il est nécessaire den connaitre la fréquence, la symptomatologie et les causes dapparition. Dans le cas des adénomes hypophysaires, les données de la littérature concernant lépidémiologie de ces tumeurs sont contradictoires certaines études suggérant une haute prévalence, et dautres affirmant quelles sont plutôt rares. En parallèle, la compréhension de la physiopathologie des tumeurs endocrines telles que les adénomes hypophysaires a fait un bond en avant avec lavènement des techniques de biologie moléculaire. Pourtant, leur physiopathologie reste encore très floue. Le fait de se concentrer sur les causes familiales permet dapprocher plus efficacement les causes des tumeurs endocrines. Concernant les adénomes hypophysaires, mis à part les Néoplasies endocriniennes multiples de type I (MEN1) et le Complexe de Carney (CNC), le domaine des adénomes hypophysaires familiaux est peu compris. En effet, mise à part lacromégalie familiale, il ny a eu aucune étude sur dautres types dadénomes hypophysaires entrant dans le cadre familial. Les buts du travail contenu dans cette thèse étaient de décrire des aspects épidémiologiques et génétiques des adénomes hypophysaires. Tout dabord, nous avons étudié la discordance entre les taux de prévalence dadénomes hypophysaires provenant détudes radiologiques/autopsiques (les incidentalomes étant très fréquents) et dautre part ceux provenant de registres de cancers et plus rarement de données de population. Une étude intensive et complète de la prévalence des adénomes hypophysaires a été réalisée dans 3 régions géographiquement parfaitement délimitées dans la province de Liège. Dans cette étude qui a concerné une population de plus de 70 000 habitants, les adénomes hypophysaires diagnostiqués lont été en collaboration avec toute la communauté médicale de ces régions. Les données démographiques, cliniques, hormonales, radiologiques et pathologiques de tous les patients ont été confirmées de façon indépendante. A une date fixe, nous avons montré que les adénomes hypophysaires diagnostiqués suite à des symptômes cliniques surviennent avec une prévalence de 1 cas par 1064 habitants résidants dans les limites géographiques déterminées pour cette étude. Ces résultats montrent que la prévalence des adénomes hypophysaires évidents sur le plan clinique est de 3.5 à 5 fois plus haute que les estimations précédentes se rapportant à des populations ou des registres. Cela suggère que les adénomes hypophysaires significatifs sur le plan clinique surviennent assez fréquemment dans la pratique de tous les jours et ceci peut avoir des implications importantes sur la distribution des ressources de santé. Une étude épidémiologique internationale appliquant la même méthodologie est actuellement en cours. Létude des adénomes hypophysaires familiaux en-dehors du contexte de la polyendocrinopathie de type I ou du Complexe de Carney constitue la deuxième partie de ce travail. Jusquà présent, seule lacromégalie familiale avait été rapportée dans la littérature. Nous avons réalisé une étude internationale pour démontrer que tous les types dadénomes hypophysaires pouvaient survenir dans le cadre dune pathologie familiale différente de la polyendocrinopathie de type I et du complexe de Carney. La suspicion de cette pathologie est née à Liège au cours de la dernière décennie. Cette étude a démontré que les adénomes hypophysaires familiaux isolés (Familial Isolated Pituitary Adenoma ou FIPA) constituent 2% des adénomes hypophysaires et 64 familles FIPA ont été caractérisées cliniquement. Cette étude a démontré pour la première fois que tous les phénotypes dadénomes hypophysaires peuvent survenir dans les mêmes familles. Quelques familles montrent seulement un phénotype parmi les membres atteints (familles FIPA homogènes) et dautres familles montrent différents types de tumeurs chez les patients atteints (famille FIPA hétérogène). Dans les familles FIPA, les adénomes hypophysaires étaient plus agressifs et tendaient à survenir à un âge plus jeune que dans les cas sporadiques. Les familles FIPA montrent une grande proximité familiale entre les membres atteints suggérant un mode dominant de transmission. Les études ultérieures ont été réalisées sur les aspects génétiques et anatomo-pathologiques des adénomes hypophysaires et particulièrement ceux qui survenaient dans le contexte FIPA. La découverte dun gène nouveau aryl hydrocarbon receptor interacting protein (AIP), dont quelques mutations ont été associées avec des adénomes hypophysaires nous a conduit à entreprendre la première étude génétique dans les FIPA. Des mutations AIP ont été découvertes dans 15 % des familles et 50% des familles homogènes dacromégales dans le contexte FIPA. Ceci suggère que dautres gènes peuvent également être responsables du contexte FIPA. Dans les familles FIPA qui portent la mutation AIP, les tumeurs étaient plus importantes et survenaient à un âge plus jeune que dans les familles FIPA sans mutation AIP. Neuf nouvelles mutations AIP ont été identifiées, dont la majorité permet de prédire la perte du ligand ou de la région de AIP qui interagit avec son récepteur. Une mutation AIP dans les FIPA était associée avec différents types dadénomes hypophysaires incluant acromégalie, prolactinomes, adénomes mixtes à GH-prolactine et adénomes nonsécrétants. Nous avons également observé que la même mutation AIP pouvait être responsable de différents phénotypes dans 2 familles FIPA différentes. Un suivi détaillé dune famille FIPA avec mutation AIP a permis de montrer pour la première fois quune anomalie endocrinienne différente dune tumeur hypophysaire pouvait survenir chez des porteurs de mutation AIP (élévation de lIGF1). Une analyse détaillée de lADN germinal et somatique provenant dun grand groupe international européen dadénomes hypophysaires sporadiques (non familiaux) a montré que les mutations AIP surviennent rarement dans cette condition. En conclusion : Le travail entrepris a apporté une nouvelle compréhension de la vraie prévalence des adénomes hypophysaires diagnostiqués de façon clinique dans une population et il a permis de codifier et de caractériser le désordre FIPA, une nouvelle entité clinique qui représente une aire de recherche potentielle pour des études cliniques et génétiques impliquant la fonction de AIP et dautres gènes non encore identifiés. To have a full understanding of a disease, it is necessary to at least know how frequently it occurs, its clinical features and by what means it is caused. In the case of pituitary adenomas, data in the literature on the epidemiology of these tumors is conflicting, with some studies suggesting a high frequency, others that they occur rarely in the clinical setting. In parallel, the understanding of the pathophysiology of endocrine tumors like pituitary adenomas has advanced greatly with the advent of molecular genetic techniques. However, much remains unclear regarding pathophysiology. A valuable avenue for studying the causes of endocrine tumors has been to focus on the familial setting. With respect to pituitary adenomas, apart from multiple endocrine neoplasia type 1 (MEN1) and Carney complex (CNC), the field of familial pituitary tumors is poorly understood. Indeed, apart from familial acromegaly, there have been virtually no studies on other pituitary adenomas occurring in the familial setting. The aims of the work described in this thesis were based on addressing aspects of the epidemiology and genetics of pituitary tumors. Firstly, the disconnect between the prevalence rates for pituitary adenomas from autopsy/radiology studies (incidentalomas being very common) and cancer registries/population data (rare) was studied. An intensive, comprehensive, case-finding study of the prevalence of pituitary adenomas was performed in three tightly-defined geographical areas in the Province of Liège. In this study, which involved a population of more than 70,000 people, diagnosed pituitary adenomas were sought in collaboration with the entire group of community medical practitioners in the study areas, and the demographics and clinical, hormonal, radiological and pathological features of all patients were confirmed independently. On a fixed date, it was found that clinically diagnosed pituitary adenomas occurred with a prevalence of 1 case per 1064 individuals residing within the geographic boundaries of the study. These results report a clinical prevalence of pituitary adenomas that is 3.5 to 5 times higher than previous population/registry estimates. It suggests that clinically relevant pituitary adenomas occur frequently in the everyday clinical setting, which may have important implications for health resource allocations. Also, it is possible to undertake detailed, comprehensive, crosssectional epidemiological studies in well-defined geographic areas, and this methodology can be applied internationally Studying the familial occurrence of pituitary adenomas outside of MEN1 and CNC was the next aim of the work described. Up to this time, only the familial occurrence of acromegaly had been reported with any frequency in the literature. An international study was undertaken to assess whether isolated pituitary adenomas of all types could occur in the familial setting, a suspicion raised in Liège over the past decade. This study demonstrated that familial isolated pituitary adenomas (FIPA) occur in about 2% of pituitary adenoma populations, and 64 FIPA families were characterized clinically. The study demonstrated for the first time that all phenotypes of pituitary adenomas can occur together in families; some families exhibit only one phenotype among affected members (homogeneous FIPA kindreds), others have multiple tumor types among affected family members (heterogeneous FIPA). In FIPA families, pituitary tumors were more aggressive and tended to occur at a younger age than sporadic pituitary adenomas. FIPA families display a high degree of familiality, suggesting a dominant mode of inheritance. Subsequent studies were performed on the genetic and pathological features of pituitary adenomas, particularly those occurring as FIPA. The discovery of a novel gene, aryl hydrocarbon receptor interacting protein ( AIP), mutations in which were associated with isolated pituitary adenomas, led us to undertake the first such genetic studies in FIPA. AIP mutations account for a minority (15%) of FIPA families and 50% of familial acromegaly kindreds in FIPA. This suggests that other genetic causes for FIPA also exist. In AIP mutation carrying FIPA families, tumors were larger and had a younger age at diagnosis than non- AIP mutated FIPA kindreds. A series of 9 novel AIP mutations were identified, the majority of which led to predicted loss of vital ligand and receptor interacting regions of the AIP protein. AIP mutations in FIPA were associated with multiple pituitary adenoma types, including acromegaly, prolactinomas, mixed growth hormone/prolactin secreting adenomas and non-secreting tumors. It was also found that the same AIP mutation was responsible for different pituitary adenoma types in two separate FIPA families. A detailed follow-up study of an individual FIPA kindred with an AIP mutation found for the first time that non-pituitary tumor-associated endocrine abnormalities (elevated circulating insulin-like growth factor-1) occur in AIP mutation carriers. A detailed analysis of germline and somatic DNA from a large international European cohort of sporadic (non-familial) pituitary adenoma cases showed that AIP mutations occur rarely in this setting. In conclusion, the work undertaken has provided new understanding of the true prevalence of clinically-relevant pituitary adenomas in the population, in addition to codifying and characterizing FIPA, a new clinical entity that represents a potentially valuable area for genetic and clinical studies involving the function of AIP and other as yet unidentified associated genetic causes.

Background. Rheumatoid arthritis (RA) is an autoimmune disease mainly affecting the joints but has also extra articular manifestations and an increased cardiovascular (CV) co-morbidity. Rheumatoid factor (RF) and antibodies against citrullinated proteins/peptides (ACPA) are diagnostically important and are related to a more severe disease. The aetiology is unknown but RA is considered a complex disease caused by both genetic and environmental factors. The heritability is estimated to be 60% with the main contribution from the HLA region. The relative homogeneity of the population in northern Sweden due to low immigration and founder effects has shown to be suitable for genetic studies. Objectives. The aim of this thesis has been to identify genes contributing to the susceptibility of RA and the CV co-morbidity in particular. To achieve this, multi-case families from the four northern most counties of Sweden were collected for linkage studies to identify susceptibility genes. Association studies with genetic polymorphisms in genes, involved in inflammation or being of importance for atherothrombotic manifestations (ATM) in the general population, were performed in RA-patients concerning ATM e.g. myocardial infarction, angina pectoris with intervention, stroke/TIA, deep vein thrombosis/pulmonary embolism (DVT/PE) at follow-up. Methods & Results. 47 families with 134 affected and 216 unaffected relatives were included in a genome-wide linkage study (GWL) performed with microsatellite markers at an average of 10cM resolution analysed using ABI PRISM 3730 DNA sequencer and non-parametric multipoint linkage in the Merlin program. Eight linked loci were identified with HLA as the most significant and a novel region on chromosome 14. In a follow-up analysis on a custom Illumina chip, with 13 additional families, yielding a total of 198 affected and 197 unaffected relatives. The majority of the 1536 single nucleotide polymorphisms (SNPs) used in the Illumina follow-up analyses was focused on chromosome 14. Statistical analyses with linkage and transmission disequilibrium test narrowed the region to 4 cM, a region containing multiple plausible RA candidate genes (Paper I). In Paper II  serum samples from 163 affected and 157 first degree relatives were analysed with EliA ACPA assay on ImmunoCAP250 for ACPA (IgA, IgG, IgM) and RF (IgA, IgM) isotypes. Both concentrations and frequencies were increased among the relatives compared with controls but lower compared with RA-patients and with a different relative distribution of the isotypes. The genetic contribution to ATM was studied in Paper III and IV using selected SNPs analysed using ABI PRISM 7900HT sequence detector system. In Paper III, RA-patients (n=467) were compared with age and sex matched controls (n=696) with respect to SNPs in tumor necrosis factor receptor II (TNFRII)(M196R), ß-fibrinogen -455 (G-455A), plasminogen activator inhibitor type-1 (PAI-1) (4G/5G) and Factor XIIIA (Val34Leu). Hypertension was predicted by TNFRII R allele and to a higher extent in combination with the A-allele in ß-fibrinogen. The 4G allele in PAI-1 was more frequent in patients with ischemic heart disease (IHD) and the FXIIIA Leu34 variant in patients with DVT/PE. In Paper IV, the minor allele of the polymorphism in growth differentiation factor 15 (GDF15) was found to be associated with RA (n=696) per se but also to ATM, a SNP in the 9p21.3 locus was also associated with ATM. A significant association to stroke was found in female patients homozygote for the minor allele of GDF15. Stoke among male patients was significantly associated with carrying the major allele of two SNPs in the CD40 gene. DVT/PE was associated with the minor allele of GDF15. Conclusion. A novel locus on chromosome 14 of importance for RA susceptibility in northern Sweden was found. The minor allele of TNFRII separately and together with the minor allele of ß-fibrinogen -455 was associated with hypertension and the 4G allele in PAI-1 was associated with IHD and  the Leu34 variant was associated with DVT/PE in RA patients. The GDF15 minor allele was associated with RA per se, ATM and DVT/PE in RA patients and a genotype in the SNP on 9p21.3 was associated with ATM. Stroke among females was associated with GDF15 and stroke among males with two SNPs in CD40.