Search Results (1,858)

Background: Subjective well-being (SWB) is an essential indicator of successful aging. Although social connections enhance SWB among older adults, few interventions have integrated community-based approaches with information and communication technology (ICT). This study evaluated the Chofu–Digital–Choju (CDC) project, a multi-component community intervention fostering in-person and online social connections among community-dwelling older adults in urban Japan. Methods: This quasi-experimental study (January 2022 to March 2024) included community-dwelling older adults aged 65–84 years in Chofu City, Tokyo, Japan. The intervention consisted of online classes, community hubs as local third places, and community events. Baseline and follow-up data were collected using self-administered questionnaires. Propensity score matching (1:1) was used to reduce selection bias, and generalized estimating equations were applied to evaluate the intervention effects. The primary outcome was SWB (Cantril Ladder). The secondary outcomes included social isolation, neighborhood relationships, social participation, health literacy, psychological health, physical activity, and ICT use. Results: Among the 1599 participants who completed both surveys, 209 (13.1%) participated in at least one CDC intervention component. After propensity score matching, 195 pairs were analyzed. No significant interaction effect was observed for SWB (β = 0.08, 95% confidence interval [CI]: −0.20, 0.37; p = 0.565). However, a significant interaction effect favored the intervention group for Internet usage frequency (odds ratio = 1.53, 95% CI: 1.08, 2.16; p = 0.016). A significant borderline interaction was also observed in health literacy (β = 0.13, 95% CI: −0.00, 0.26; p = 0.056), which reached significance in covariate-adjusted sensitivity analysis (p = 0.044). Subgroup analyses revealed that community hub participants showed significant interaction effects in health literacy (p = 0.021) and a trend toward reduced depressive symptoms (p = 0.084). Conclusions: The CDC intervention did not improve SWB over 2 years but enhanced Internet use and supported health literacy and depressive symptoms, particularly among hub participants. Community-based, multi-component interventions that integrate online and in-person activities may foster digital inclusion and specific health behaviors. Although SWB did not change in this study, these proximal gains may serve as foundational steps for long-term improvement. The study protocol was preregistered in the UMIN Clinical Trials Registry (UMIN000051393; Registered on 21 June 2023). Full article

Tubule-derived pro-fibrotic mediators are central for the development of kidney fibrosis. We previously showed that fibrotic stimuli activate and elevate GEF-H1 (ARHGEF2) in tubular cells, leading to RhoA-dependent fibrotic reprogramming. In search of new mechanisms of GEF-H1 regulation, here we used immunoprecipitation and proximity ligation assay to show interaction between GEF-H1 and Myotonic Dystrophy Kinase-related Cdc42-binding kinase (MRCK)α in tubular cells. MRCKα silencing elevated GEF-H1 activity, and induced GEF-H1-dependent RhoA activation, stress fibre formation and myosin light chain phosphorylation. MRCKα depletion also elevated phospho-cofilin levels in a RhoA-dependent manner. The fibrogenic cytokine TGFβ1 rapidly increased binding between GEF-H1 and MRCKα, while MRCKα silencing augmented TGFβ1-induced GEF-H1 activation, suggesting a negative feedback loop. An mRNA array detecting fibrogenic genes revealed increase in a subset of basal and TGFβ1-induced genes following MRCKα depletion. MRCKα silencing promoted nuclear translocation of the profibrotic transcriptional co-activator Myocardin-Related Transcription Factor (MRTF), and MRTF-A+B depletion prevented increase in ACTA2 (α-smooth muscle actin), a key marker of fibrotic reprogramming. Finally, total MRCKα mRNA was reduced in a murine kidney fibrosis model, and immunohistochemistry revealed a decrease in tubular MRCKα. Taken together, we identified MRCKα as a new suppressor of GEF-H1/RhoA/MRTF signaling. Reduced MRCKα expression in kidney fibrosis may promote tubular fibrotic gene expression. Full article

Background/Objectives: Healthcare-associated infections (HAIs) remain an important cause of morbidity in coronary care units (CCUs). Although left ventricular ejection fraction (LVEF) is central to cardiovascular risk stratification, its relationship with infection susceptibility in CCU patients is poorly defined. We explored the association between LVEF and HAI incidence in a real-world CCU population. Methods: We performed a retrospective cohort study including 870 consecutive adult patients admitted to a tertiary CCU. Patients were stratified by LVEF into reduced (<40%) and preserved or mildly reduced (≥40%) groups. HAIs were defined using Centers for Disease Control and Prevention/National Healthcare Safety Network (CDC/NHSN) criteria and required microbiological confirmation. Demographic data, comorbidities, exposure to invasive devices, colonization status and clinical outcomes were collected. Associations with HAIs were assessed using univariate and exploratory multivariable logistic regression. Results: Of the 870 patients, 235 (27.0%) had LVEF < 40%. The overall HAI incidence was 1.8% (16/870) and was significantly higher in patients with reduced LVEF compared with those with LVEF ≥ 40% (3.82% vs. 1.10%, p = 0.018). Patients with LVEF < 40% had greater exposure to invasive devices (OR 2.06, 95% CI 1.52–2.79, p < 0.001). The excess HAI burden was mainly driven by urinary tract infections (1.70% vs. 0.15%, p = 0.021). Colonization rates at admission were similar between groups. In univariate analysis, reduced LVEF was associated with higher HAI occurrence, but it did not remain independently associated after adjustment. Admission infection, malignancy, CPAP use, and CCU length of stay ≥5 days emerged as independent factors in the exploratory multivariable model (Nagelkerke R² = 0.247). Conclusions: Reduced LVEF is associated with higher HAI incidence in CCU patients, reflecting greater clinical severity, longer hospitalization, and increased exposure to invasive devices. Although not an independent predictor, LVEF appears to function as a clinically useful marker of vulnerability that may support early risk stratification and targeted infection-prevention strategies in CCU settings. Full article

Insecticide resistance in Aedes aegypti (Linnaeus, 1762) poses a major challenge for vector control programs, undermining the effectiveness of chemical tools to mitigate both nuisance biting and the transmission of vector-borne diseases. Previous studies have documented widespread resistance to multiple adulticide active ingredients across Florida, particularly pyrethroids, along with high prevalence of knockdown resistance (kdr) mutations. Continued resistance monitoring is essential for guiding treatment decisions and detecting shifts in susceptibility over time. In collaboration with mosquito control programs across Florida, we assessed the susceptibility of 78 Ae. aegypti populations to up to six active ingredients, conducting 396 independent CDC bottle bioassays and calculating hazard ratios relative to a susceptible Ae. aegypti strain. For pyrethroids, 24 h post-exposure mortality was used to evaluate phenotypic recovery from knockdown. Hazard ratios revealed Ae. aegypti populations were more susceptible to organophosphate adulticide active ingredients, while the lowest hazard ratios, indicating higher resistance, were observed for sumithrin, deltamethrin, etofenprox, and permethrin, respectively. Evidence of knockdown resistance and recovery after 24 h was present across all pyrethroid exposures, with the highest levels following treatment with etofenprox and sumithrin. These findings confirm that pyrethroid resistance remains a significant barrier to Ae. aegypti control and provide updated, operationally relevant resistance data that can complement existing guidance and support evidence-based vector management strategies. Full article

Human preimplantation embryo arrest (PREMBA) represents a significant clinical hurdle in assisted reproductive technology (ART), in which approximately 10% of in vitro fertilized (IVF) embryos arrest at the cleavage stages. Whole-exome sequencing (WES) studies have discovered numerous genetic mutations associated with preimplantation embryo arrest. These mutations often disrupt critical biological milestones such as maternal mRNA clearance (BTG4, ZFP36L2, ZAR1), subcortical maternal complex (TLE6, PADI6, OOEP, NLRP2, NLRP5, NLRP7, KHDC3L), DNA double-strand break formation and homologous recombination (REC114, TOP6BL, MEI1, MEI4, TRIP13), spindle assembly (TUBB8 and TUBA4A) and cell cycle and checkpoints (FBXO43, MOS, CHEK1, TRIP13, CDC20), as well as nuclear transport and translational regulation (KPNA7, DDOST). However, the cause of most clinical cases remains genetically unexplained. Studies investigating these unexplained arrests have uncovered widespread multi-omics abnormalities, including transcriptional arrest, DNA hypermethylation, higher chromatin accessibility, aberrant histone modification, chromosomal aneuploidy and senescent-like states. This review provides a comprehensive overview of the molecular mechanisms underlying PREMBA, categorized into those that are attributable to known genetic mutations and those with unexplained reasons. Full article

The greater amberjack (Seriola dumerili) is a globally important aquaculture fish species belonging to the family Carangidae. However, current research on the ovarian development and regulation of the greater amberjack is limited, particularly with regard to early ovarian development in artificially bred individuals. Therefore, this study aims to analyze the ovarian transcriptomes at the primary growth stage in one-year-old fish at the chromatin nucleolar stage and two-year-old fish at the perinucleolar stage to suggest how early ovarian development takes place in artificially bred greater amberjacks. To do this, the study constructed ovarian mRNA expression profiles of different stages of artificially bred fish and identified differentially expressed genes (DEGs), Gene Ontology terms, and Kyoto Encyclopedia of Genes and Genomes pathways important for various physiological processes. A functional analysis revealed that the DEGs closely related to ovarian development were involved in cell growth and death (e.g., ccnd1, cdk1, cdc6, cdc25b, fbxo43, cdkn1a and cdkn1d), the TGF-beta signaling pathway (e.g., gdf6, bmpr1b, gsdf, amh, tgfb3, and smad6), steroid hormone biosynthesis (e.g., hsd3b1, hsd11b2, hsd17b12 and hsd20b2), and the endocrine system (e.g., mapk8a, mapk11, mapk12a, mapk13 and adcy9). These findings suggest that ovarian development is the result of the coordinated regulation of various genes responsible for various functions. This study provides a theoretical basis for exploring the underlying molecular mechanisms of early ovarian development in artificially bred greater amberjacks. Full article

Fate-mapping studies have challenged the longstanding view of the adult mammalian heart as a post-mitotic organ, suggesting limited cardiomyocyte renewal. This has spurred efforts to determine whether selected cardiac stromal cells have regenerative potential; however, their contribution to cardiac regeneration has been found to be minimal compared with that of cardiomyocyte proliferation. Despite this, transplantation of some cardiac stromal cell populations has shown therapeutic potential through paracrine signalling. The identity of the paracrine-active stromal cell populations remains unclear due to overlapping characteristics with other cardiac stromal cell populations, such as fibroblasts, mesenchymal cells, and pericytes. This study sought to clarify the transcriptional identity and heterogeneity of adult mouse cardiac stromal cells by developing a cardiac collagenase–trypsin protocol and comparing it to the established method for isolating cardiosphere-derived cells (CDCs). This novel protocol resulted in a higher cell yield and shorter expansion time, and the resulting cells showed superior survival under serum starvation compared to commercially acquired cardiac fibroblasts (CFs). Single-cell qRT-PCR analysis revealed that collagenase–trypsin cells (CTs) and CDCs share similar gene expression profiles, distinct from those of CFs. Notably, CTs exhibited higher expression of Tcf21 and lower expression of Tbx5, suggesting an epicardial-derived fibroblast phenotype, whereas Tbx5 was enriched in CDCs and CFs, reflecting heterogeneity within the cardiac fibroblast compartment. This study offers insights into the complex identity of cardiac stromal cells and concludes that CTs closely resemble CDCs but can be generated more rapidly, making them a robust and efficient source of paracrine-active cardiac stromal cells. Full article

Background: Suicide remains a leading cause of death in the United States, with more than 49,000 fatalities in 2023. Rural counties consistently face higher suicide mortality rates than urban areas, reflecting deep-seated mental health inequities. Methods: This study analyzes 39 U.S. states with suicide mortality rates exceeding the national average, as defined by the Centers for Disease Control and Prevention (CDC) (>14.1 per 100,000), to examine rural–urban disparities and their intersectional demographic factors. Age-adjusted mortality data (2019–2023) from HDPulse were analyzed using IBM SPSS Statistics, version 31.0. Counties were classified by USDA Rural–Urban Continuum Codes and stratified by region, sex, age, and race. Subgroup differences were tested using a two-way ANOVA (p < 0.01). Results: Rural suicide rates were significantly higher than urban rates (28.69 vs. 20.20 per 100,000; p < 0.001). The West reported the highest mortality and widest rural–urban gap (38.23 vs. 24.83), while the Northeast had the lowest. Men had higher rates than women, particularly in rural settings (37.12 vs. 11.77). The largest rural–urban gap occurred among young adults (20–39 years). American Indian/Alaska Native populations experienced the highest rates (rural: 58.73; urban: 35.15). The literature review highlighted limited healthcare access, social stigma, substance use, and economic hardship as variables commonly associated with rural–urban differences in suicide mortality. Conclusions: Suicide mortality is markedly elevated in rural America across all subgroups, with the greatest risks among young adults, men, and American Indian/Alaska Native populations. Tailored prevention strategies and expanded mental health infrastructure are critical for high-burden states. Full article

Visceral leishmaniasis (VL) is a zoonosis of major public health importance. In urban areas, Lutzomyia longipalpis is the primary vector of Leishmania (L.) infantum. This study assessed the seasonality, spatiotemporal distribution, and climatic factors associated with L. longipalpis abundance in Araçatuba, São Paulo State, and detected Leishmania spp. DNA in captured females. Monthly collections were conducted from March 2023 to February 2024 in 72 households across eight urban areas using CDC-type light traps placed indoors and in peridomestic environments. A total of 1641 specimens (1516 males and 125 females) were captured, with 92.4% originating from peridomestic areas. Area 3 had the highest density (n = 671) and was the only area with PCR-positive females (n = 3). Vector activity peaked in December 2023 (n = 335). Male abundance differed significantly among peridomestic areas, particularly between Areas 3, 5, 6, and 7. In peridomestic areas, higher final temperatures increased vector abundance, whereas higher initial temperatures and humidity reduced it. Indoors, final temperature, humidity, and month were significant predictors. L. longipalpis exhibited a defined seasonal and spatial pattern influenced by climatic conditions. The detection of PCR-positive females (Area 3) highlights the epidemiological role of the vector and underscores the need for targeted interventions to control VL. Full article

Background: Acute tubulointerstitial nephritis (ATIN) is a significant yet under-monitored cause of U.S. mortality, particularly among the elderly. This study anrackalyzed national trends and demographic disparities in age-adjusted mortality rates (AAMRs) from 1999 to 2020 to identify high-risk populations and inform public health policy. Methods: Using the CDC WONDER database, we conducted a retrospective analysis of 6872 ATIN-related deaths. AAMRs (per 100,000) were stratified by sex, race, and census region. Temporal shifts were quantified using Joinpoint regression to determine annual percentage changes (APC) and 95% confidence intervals (CIs). Results: The analysis revealed a distinct “V-shaped” mortality trend across the 22-year period. Following an initial decline from 1999 to 2013, AAMRs rose sharply through 2020. Males experienced a slightly steeper recent increase (9.90%) compared to females (9.50%). While Black/African American individuals initially had higher mortality rates, a significant surge in deaths among Non-Hispanic White individuals after 2013 (APC 10.42%) led to a convergence of mortality rates between the two groups by 2020. Geographically, the Midwest (APC 12.08%) and the South saw the most pronounced recent increases, whereas the West showed a sustained upward trend beginning as early as 2008. Conclusions: There has been a concerning reversal in ATIN-related mortality trends in the United States over the last decade. The convergence of racial mortality rates and significant regional variations suggest that shifting healthcare access, environmental factors, or medication exposure patterns (such as polypharmacy) warrant urgent investigation to mitigate this rising public health burden. Full article

The COVID-19 pandemic accelerated the global educational evolution towards hybrid education. However, little was investigated on the long-term sustainability of this shift within specific pedagogical domains, such as hybrid classroom management, in emerging economies. This paper assesses the sustainability of this shift by evaluating the hybrid classroom management experiences of Liberian junior and high school teachers. Employing a Hermeneutic Phenomenological Design (HPD), data were collected through 26 interviews and analyzed using a reflexive thematic analysis (RTA). The findings revealed crucial barriers to sustainability, including inadequate digital infrastructure, a lack of structured official digital programs in schools for implementation, and insufficient professional development. To address these gaps, the study proposes a targeted, actionable policy roadmap for the Ministry of Education and stakeholders, including the establishment of a territorial Certificate of Digital Competence (CDC), Green Classrooms Infrastructure Grant for energy supply, and a negotiation of National E-data. This study provides policymakers in Liberia and other developing nations with useful information about the current situation. By providing a baseline for policy intervention, this study advances the discussion on achieving Sustainable Development Goal (SDG4) for quality education within emerging economies settings. Full article

Maternal and child health (MCH) disparities remain a critical public health concern in the United States, with the Southern region experiencing some of the nation’s highest maternal mortality rates. Black and Latinx women are disproportionately affected, reflecting persistent structural and systemic inequities. This review examines maternal health disparities among Black and Latinx women in the Southern United States and identifies structural, social, and policy-related contributors to these inequities. A narrative review approach was used to synthesize epidemiological data, policy reports, and peer-reviewed literature published between 2000 and 2025, drawing on national surveillance systems such as CDC WONDER and the National Center for Health Statistics, as well as state-level reports and policy analyses relevant to maternal health in Southern states. Across the region, maternal mortality rates frequently exceeded the national average of 23.2 deaths per 100,000 live births, with several states reporting rates above 38 deaths per 100,000. Structural contributors included limited access to maternity care, rural hospital closures, Medicaid non-expansion, chronic disease burden, and experiences of discrimination within healthcare systems, while social determinants such as poverty, housing instability, language barriers, and immigration-related fears further compounded risks for Black and Latinx women. In the post-Roe context, restrictive reproductive health policies intensified existing inequities. Overall, maternal health disparities among Black and Latinx women in the Southern United States are driven by interconnected structural, social, and policy factors, underscoring the need for coordinated policy reforms, expansion of culturally responsive care models, and targeted investment in Southern communities disproportionately affected by maternal mortality. Full article

Recent data from the Centers for Disease Control (CDC) indicate that the incidence of Autism Spectrum Disorder (ASD), a neurodevelopmental disorder characterized by deficits in social communication and the presence of restricted interests and repetitive behaviors, has increased to 1 in 31 children. Individuals with ASD have a constellation of neurological, behavioral, sensory, feeding, gastrointestinal, and immunological issues. Even though there is some genetic component to the pathogenesis of ASD, accumulation of environmental and pathogenic toxins could contribute to disruption of the gut–blood-barrier (GBB) and blood–brain barrier (BBB) via activation of mast cells (MCs) and microglia, resulting in a chronic cycle of gut–brain inflammation. Here we discuss how various environmental, pathogenic, and stress factors can disrupt gut–brain homeostasis to create susceptibility and epigenetic effects that contribute to the development of ASD. We also suggest simple ways to address some of the key pathogenetic processes involved in ASD. Full article

This paper presents a novel design for a reconfigurable CDC as a multiplexed sensor fusion that converts three analog signals into digital output bits with different resolutions. The proposed reconfigurable CDC design uses the SAR technique that introduces a small chip area and low power consumption. The proposed novel CDC introduces reconfigurability by using a switching capacitive DAC that solves the problem of converting more than one analog signal with a single converter to a different number of output bits, giving better performance than previous designs. In this paper, three analog signals are used (as a case study) in a weather station to be converted. These signals are temperature, pressure, and humidity that are sensed using the BME-280 Bosch sensor. All CDC specifications are measured for each reconfigured number of output bits. The used supply voltage is 1.0 V, and the sampling frequency is 100 kHz. The 12-bit resolution consumes 2.54 µW, ENOB is 11.47 bits, and SNR equals 73.4 dB. The 8-bit resolution consumes 1.7 µW, ENOB is 7.39 bits, and SNR equals 46.24 dB. The 4-bit resolution consumes 0.68 µW, ENOB is 3.58 bits, and SNR equals 23.45 dB. The total chip area is 0.18 mm². Full article

Precise tumor segmentation in multimodal MRI is crucial for glioma diagnosis and treatment planning; yet, deep learning models still struggle with irregular boundaries and severe class imbalance under computational constraints. An Enhanced 3D DenseNet with CDC architecture was proposed, integrating Central Difference Convolution, attention gates, and Atrous Spatial Pyramid Pooling for brain tumor segmentation on the BraTS 2023-GLI dataset. CDC layers enhance boundary sensitivity by combining intensity-level semantics and gradient-level features. Attention gates selectively emphasize relevant encoder features during skip connections, whereas the ASPP captures the multi-scale context with dilation rates. A hybrid loss function spanning three levels was introduced, consisting of a region-based Dice loss for volumetric overlap, a GPU-native 3D Sobel boundary loss for edge precision, and a class-weighted focal loss for handling class imbalance. The proposed model achieved a mean Dice score of 91.30% (ET: 87.84%, TC: 92.73%, WT: 93.34%) on the test set. Notably, these results were achieved with approximately 3.7 million parameters, representing a 17–76x reduction compared to the 50–200 million parameters required by transformer-based approaches. Enhanced 3D DenseNet with CDC architecture demonstrates that the integration of gradient-sensitive convolutions, attention mechanisms, multi-scale feature extraction, and multi-level loss optimization achieves competitive segmentation performance with significantly reduced computational requirements. Full article