Factors Associated with Refusal of Rapid HIV Testing in an Emergency Department

HIV screening studies in the emergency department (ED) have demonstrated rates of HIV test refusal ranging from 40–67%. This study aimed to determine the factors associated with refusal to undergo routine rapid HIV testing in an academic ED in Boston. HIV counselors offered routine testing to 1,959 patients; almost one-third of patients (29%) refused. Data from a self-administered survey were used to determine independent correlates of HIV testing refusal. In multivariate analysis, women and patients with annual household incomes of $50,000 or more were more likely to refuse testing, as were those who reported not engaging in HIV risk behaviors, those previously HIV tested and those who did not perceive a need for testing. Enrollment during morning hours was also associated with an increased risk of refusal. Increased educational efforts to convey the rationale and benefits of universal screening may improve testing uptake among these groups

Key challenges in bringing CRISPR-mediated somatic cell therapy into the clinic

Genome editing using clustered regularly interspersed short palindromic repeats (CRISPR) and CRISPR-associated proteins offers the potential to facilitate safe and effective treatment of genetic diseases refractory to other types of intervention. Here, we identify some of the major challenges for clinicians, regulators, and human research ethics committees in the clinical translation of CRISPR-mediated somatic cell therapy

The glucocorticoid receptor 1A3 promoter correlates with high sensitivity to glucocorticoid-induced apoptosis in human lymphocytes

Glucocorticoids (GCs) are powerful inhibitors of inflammation and immunity. Although glucocorticoid-induced cell death (GICD) is an important part of GCs actions, the cell types and molecular mechanisms involved are not well understood. Untranslated exon 1A3 of the human glucocorticoid receptor (GR) gene is a major determinant of GICD in GICD-sensitive human cancer cell lines, operating to dynamically upregulate GR levels in response to GCs. We measured the GICD sensitivity of freshly isolated peripheral blood mononuclear cells and thymocytes to dexamethasone in vitro, relating this to GR exon 1A3 expression. A clear GICD sensitivity hierarchy was detected: B cells>thymocytes/natural killer (NK) cells>peripheral T cells. Within thymocyte populations, GICD sensitivity decreased with maturation. Interestingly, NK cell subsets were differentially sensitive to GICD, with CD16(+)CD56(int) (cytotoxic) NK cells being highly resistant to GICD, whereas CD16(-)CD56(hi) (cytokine producing) NK cells were highly sensitive (similar to B cells). B-cell GICD was rescued by co-culture with interleukin-4. Strikingly, although no significant increases in GR protein were observed during 48 h of culture of GICD-sensitive and -resistant cells alike, GR 1A3 expression was increased over pre-culture levels in a manner directly proportional to the GICD sensitivity of each cell type. Accordingly, this is the first evidence that the GR exon 1A3 promoter is differentially regulated during thymic development and maturation of human T cells. Furthermore, human peripheral blood B cells are exquisitely GICD-sensitive in vitro, giving new insight into how GCs may downregulate immunity. Collectively, these data show that GR 1A3 expression is tied with GICD sensitivity in human lymphocytes, underscoring the potential for GR 1A3 expression to be used as a biomarker for sensitivity to GICD

Pedology and Plant Provenance Can Improve Species Distribution Predictions of Australian Native Flora: A Calibrated and Validated Modeling Exercise on 5033 Species

Species distribution models (SDMs) are valuable tools for assessing species' responses to environmental factors and identifying areas suitable for their survival. The careful selection of input variables is critical, as their interactions and correlations with other environmental factors can affect model performance. This study evaluates the influence of climate and soil variables on the performance of SDMs for 5033 Australian terrestrial vascular plant species, representing the largest phylogenetic diversity of native flora assessed in such an analysis. Using an ensemble of correlative models, we assessed the predictive performance of climate and soil variables, individually and in combination, across four distinct ecoregions: Desert (n = 640 species), Mediterranean (n = 1246), Temperate (n = 1936), and Tropical (n = 1211). Our results demonstrate that on a continental scale, climate variables have a greater influence on plant distributions than soil variables. Although incorporating soil and climate variables enhanced model performance in some ecoregions, our results indicate that relying solely on small-scale variables such as soil may increase the likelihood of underfitting. The most influential predictor variables in the models varied across ecoregions and between specialist and generalist species. Mean annual rainfall (bio1) was consistently a strong climate predictor variable across ecoregions, but other climate variables became more important when analyses were restricted to ecoregion-specific species (i.e., specialists). Soil organic carbon (SOC) was the most important soil variable in the Temperate and Tropical ecoregions across generalist and specialist species. In the Mediterranean ecoregion, clay content (CLY) became more important than SOC when analyses were restricted to ecoregion-specific species, whereas nitrogen total organic (NTO) was consistently the strongest predictor soil variable for plants in the Desert. Our findings have significant implications for understanding the interplay between climate, soil, and plant distribution within diverse ecoregions. This study serves as a foundation for developing more accurate SDM predictions

Exploring Intercultural Learning and Second Language Identities in the ERASMUS Context

This chapter investigates a teaching activity from the European project Intercultural Education Resources for Erasmus Students and their Teachers (IEREST), which is titled 24h Erasmus Life and was conducted at the University of Bologna with 33 participants. Students and teachers worked online for six weeks using forums, videoconferences, chat rooms, and a course blog. The authors gathered data from the blog postings and employed thematic analysis, focusing on the students\u2019 language experiences, including identity-related features of language proficiency, linguistic self-concept, and second-language-mediated personal development. The outcomes of this study contribute to understanding the multifaceted nature of second language identity development during study abroad and its links to intercultural learning within a non-essentialist theoretical framework. Some pedagogical implications for mobile student preparation are also considered