Search Results (12)

Introduction: Adolescents and young adults (AYAs), especially those from underserved communities, often face barriers to sexual and reproductive health (SRH). This pilot study evaluated the implementation of mobile health technologies to promote SRH care, including the integration of the Rapid Adolescent Prevention Screening^TM (RAAPS) and the Health-E You/Salud iTu^TM (Health-E You) app at a School-Based Health Center (SBHC) in Los Angeles using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Methods: This multi-method pilot study included the implementation of an integrated tool with two components, the RAAPS electronic health screening tool and the Health-E You app, which delivers tailored SRH education and contraceptive decision support to patients (who were sex-assigned as female at birth) and provides an electronic summary to clinicians to better prepare them for the visit with their patient. Quantitative data on tool usage were collected directly from the back-end data storage for the apps, and qualitative data were obtained through semi-structured interviews and in-clinic observations. Thematic analysis was conducted to identify implementation barriers and facilitators. Results: Between April 2024 and June 2024, 60 unique patients (14–19 years of age) had a healthcare visit. Of these, 35.00% used the integrated RAAPS/Health-E You app, and 88.33% completed the Health-E You app only. All five clinic staff were interviewed and expressed that they valued the tools for their educational impact, noting that they enhanced SRH discussions and helped uncover sensitive information that students might not disclose face-to-face. However, the tools affected clinic workflows and caused rooming delays due to the time-intensive setup process and lack of integration with the clinic’s primary electronic medical record system. In addition, they also reported that the time to complete the screener and app within the context of a 30-min appointment limited the time available for direct patient care. Additionally, staff reported that some students struggled with the two-step process and did not complete all components of the tool. Despite these challenges, clinic staff strongly supported renewing the RAAPS license and continued use of the Health-E You app, emphasizing the platform’s potential for improving SRH care and its educational value. Conclusions: The integrated RAAPS and Health-E You app platform demonstrated educational value and improved SRH care but faced operational and technical barriers in implementing the tool. These findings emphasize the potential of such tools to address SRH disparities among vulnerable AYAs while providing a framework for future implementations in SBHCs. Full article

Introduction: Nonbinary individuals who do not identify as exclusively male or female often face unique emotional challenges due to societal cisheteronormativity and limited recognition of their identities. While existing research has primarily focused on anxiety, depression, and pathways to parenthood among nonbinary people, little attention has been paid to their comprehensive emotional experiences as parents. This study aims to explore the emotional universe of two nonbinary parents from Spain and the United States. Design: Hermeneutic study. Materials and Methods: We implemented purposive sampling, conducted semi-structured virtual interviews, and followed Ricoeur’s theory of interpretation for data analysis. We used the Universe of Emotions affective taxonomy as a starting category in this analysis. Our sample consisted of a 32-year-old white Spanish nurse (she/they/them), assigned female at birth and parent of two one-year-old toddlers, and a 34-year-old white North American physiotherapist (he/they/them) assigned female at birth and parent of a ten-year-old child. Results: Through its four themes (A story of misunderstanding: “What are you, a combat helicopter?”; Clearly, you don’t fit, so…; But (a new) family is there; No monster here: I’m, at the core, a human being), this study reveals the complex emotional journey experienced by two nonbinary parents. Conclusions: Central to this journey are three key emotions: strangeness, belonging, and acceptance. The participants describe an initial stage marked by body and social dysphoria, confusion, and rejection, followed by a transformative process in which parenthood becomes a catalyst for emotional and identity integration. This transition—from alienation to connection—reflects a broader movement from dehumanization to humanization, where the experience of parenting fosters emotional resilience, social recognition, and a renewed sense of self. Implications for the profession and/or patient care: Analyzing their emotions (both negative and positive ones), we obtained robust insights into these parents’ personal and social contexts. Therefore, we can facilitate understanding of the emotional complexity of nonbinary parents by the trans and cisgender communities. Through this understanding, nurses and the organizations they work for can improve their competence in their holistic care. Acceptance from nonbinary parents’ social contexts, of which nursing is a part, is a critical factor in their health and emotional wellbeing. Full article

Enterprises are the most important core organizations of the country and modern society, and their growth has always been a focal point in the theoretical field. This paper aims to focus on the sustainable development of platform enterprises by exploring the mechanism of platform growth. Thus, this paper reviews the literature and analyzes the challenges faced by platform enterprises during the four stages of birth, expansion, leadership, and self-renewal, as well as the strategies they have adopted. The main aims of this paper are to help understand the growth process of platform enterprises and identify three key points that need to be addressed for sustainable growth, including the disadvantages of resource externalities, the importance of the restructuration of business models, and the urgency of fulfilling social responsibility. To address the exogenous nature of resources, platform enterprises should pay attention to the initiative of complementors, the distribution of benefits, and ecological orchestration. The impact of technology, especially artificial intelligence, on business models and the application of technology to restructure business models should be given attention. It is also necessary to pay attention to how platform enterprises undertake their social responsibilities. A synthesis framework with seven propositions for future research has been proposed. Full article

Spermatogenesis involves a complex process of cellular differentiation maintained by spermatogonial stem cells (SSCs). Being critical to male reproduction, it is generally assumed that spermatogenesis starts and ends in equivalent transcriptional states in related species. Based on single-cell gene expression profiling, it has been proposed that undifferentiated human spermatogonia can be subclassified into four heterogenous subtypes, termed states 0, 0A, 0B, and 1. To increase the resolution of the undifferentiated compartment and trace the origin of the spermatogenic trajectory, we re-analysed the single-cell (sc) RNA-sequencing libraries of 34 post-pubescent human testes to generate an integrated atlas of germ cell differentiation. We then used this atlas to perform comparative analyses of the putative SSC transcriptome both across human development (using 28 foetal and pre-pubertal scRNA-seq libraries) and across species (including data from sheep, pig, buffalo, rhesus and cynomolgus macaque, rat, and mouse). Alongside its detailed characterisation, we show that the transcriptional heterogeneity of the undifferentiated spermatogonial cell compartment varies not only between species but across development. Our findings associate ‘state 0B’ with a suppressive transcriptomic programme that, in adult humans, acts to functionally oppose proliferation and maintain cells in a ready-to-react state. Consistent with this conclusion, we show that human foetal germ cells—which are mitotically arrested—can be characterised solely as state 0B. While germ cells with a state 0B signature are also present in foetal mice (and are likely conserved at this stage throughout mammals), they are not maintained into adulthood. We conjecture that in rodents, the foetal-like state 0B differentiates at birth into the renewing SSC population, whereas in humans it is maintained as a reserve population, supporting testicular homeostasis over a longer reproductive lifespan while reducing mutagenic load. Together, these results suggest that SSCs adopt differing evolutionary strategies across species to ensure fertility and genome integrity over vastly differing life histories and reproductive timeframes. Full article

The number of non-payments is an indicator of delinquent behaviour in credit scoring, hence its estimation and prediction are of interest. The modelling of the number of non-payments, as count data, can be examined as a renewal process. In a renewal process, the number of events (such as non-payments) which has occurred up to a fixed time t is intimately connected with the inter-arrival times between the events. In the context of non-payments, the inter-arrival times correspond to the time between two subsequent non-payments. The probability mass function and the renewal function of the count distribution are often complicated, with terms involving factorial and gamma functions, and thus their computation may encounter numerical difficulties. In this paper, with the motivation of modelling the number of non-payments through a renewal process, a general method for computing the probabilities and the renewal function based on numerical Laplace transform inversion is discussed. This method is applied to some count distributions which are derived given the distributions of the inter-arrival times. Parameter estimation with maximum likelihood estimation is considered, with an application to a data set on number of non-payments from the literature. Full article

MCPH1, or BRIT1, is often mutated in human primary microcephaly type 1, a neurodevelopmental disorder characterized by a smaller brain size at birth, due to its dysfunction in regulating the proliferation and self-renewal of neuroprogenitor cells. In the last 20 years or so, genetic and cellular studies have identified MCPH1 as a multifaceted protein in various cellular functions, including DNA damage signaling and repair, the regulation of chromosome condensation, cell-cycle progression, centrosome activity and the metabolism. Yet, genetic and animal model studies have revealed an unpredicted essential function of MPCH1 in gonad development and tumorigenesis, although the underlying mechanism remains elusive. These studies have begun to shed light on the role of MPCH1 in controlling various pathobiological processes of the disorder. Here, we summarize the biological functions of MCPH1, and lessons learnt from cellular and mouse models of MCPH1. Full article

Duchenne muscular dystrophy (DMD) is not currently part of mandatory newborn screening, despite the availability of a test since 1975. In the absence of screening, a DMD diagnosis is often not established in patients until 3–6 years of age. During this time, irreversible muscle degeneration takes place, and clinicians agree that the earlier therapy is initiated, the better the long-term outcome. With recent availability of FDA-approved DMD therapies, interest has renewed for adoption by state public health programs, but such implementation is a multiyear process. To speed access to approved therapies, we implemented a unique, hospital-based program offering parents of newborns an optional, supplemental DMD newborn screen (NBS) via a two-tiered approach: utilizing a creatine kinase (CK) enzyme assay coupled with rapid targeted next-generation sequencing (tNGS) for the DMD gene (using a Whole-Exome Sequencing (WES) assay). The tNGS/WES assay integrates the ability to detect both point mutations and large deletion/duplication events. This tiered newborn screening approach allows for the opportunity to improve treatment and outcomes, avoid the diagnostic delays, and diminish healthcare disparities. To implement this screening algorithm through hospitals in a way that would ultimately be acceptable to public health laboratories, we chose an FDA-approved CK-MM immunoassay to avoid the risks of false-negative/-positive results. Because newborn CK values can be affected due to non-DMD-related causes such as birth trauma, a confirmatory repeat CK assay on a later dried blood spot (DBS) collection has been proposed. Difficulties associated with non-routine repeat DBS collection, including the tracking and recall of families, and the potential creation of parental anxiety associated with false-positive results, can be avoided with this algorithm. Whereas a DMD diagnosis is essentially ruled out by the absence of detected DMD sequence abnormalities, a subsequent CK would still be warranted to confirm resolution of the initial elevation, and thus the absence of non-DMD muscular dystrophy or other pathologies. To date, we have screened over 1500 newborns (uptake rate of ~80%) by a CK-MM assay, and reflexed DMD tNGS in 29 of those babies. We expect the experience from this screening effort will serve as a model that will allow further expansion to other hospital systems until a universal public health screening is established. Full article

The gastrointestinal tract is a functionally and anatomically segmented organ that is colonized by microbial communities from birth. While the genetics of mouse gut development is increasingly understood, how nutritional factors and the commensal gut microbiota act in concert to shape tissue organization and morphology of this rapidly renewing organ remains enigmatic. Here, we provide an overview of embryonic mouse gut development, with a focus on the intestinal vasculature and the enteric nervous system. We review how nutrition and the gut microbiota affect the adaptation of cellular and morphologic properties of the intestine, and how these processes are interconnected with innate immunity. Furthermore, we discuss how nutritional and microbial factors impact the renewal and differentiation of the epithelial lineage, influence the adaptation of capillary networks organized in villus structures, and shape the enteric nervous system and the intestinal smooth muscle layers. Intriguingly, the anatomy of the gut shows remarkable flexibility to nutritional and microbial challenges in the adult organism. Full article

This paper extends the traditional jump-diffusion model to a comprehensive general Lévy process model with the stochastic interest rate for European-style options pricing. By using the Girsanov theorem and Itô formula, we derive the uniform formalized pricing formulas under the equivalent martingale measure. This model contains not only the traditional jump-diffusion model, such as the compound Poisson model, the renewal model, the pure-birth jump-diffusion model, but also the infinite activities Lévy model. Full article

One of the key indicators of a population’s well-being and the economic development of a country is represented by health, the main proxy for which is life expectancy at birth. Some factors, such as industrialization and modernization, have allowed this to improve considerably. On the other hand, along with high global population growth, the factor which may jeopardize human health the most is environmental degradation, which can be tackled through the transition to renewable energy. The main purpose of our study is to investigate the relationship between renewable energy consumption, social factors, and health, using a Panel Vector Auto Regression (PVAR) technique. We explore the link between some proxy variables for renewable energy consumption, government policy, general public awareness, the market, lobbying activity, the energy dependence on third countries, and health, spanning the period from 1990 to 2015, for a cluster of 12 European countries characterized by common features. Specifically, our analysis shows the importance of having a stringent policy for the development of renewable energy consumption and its influence over other social factors, rather than the existence of causal relationships between health and renewable energy consumption for the analyzed countries. This kind of analysis has a great potential for policy-makers. Further, a deeper understanding of these relationships can create a more effective decision-making process. Full article

The adult mammalian heart is incapable of regeneration following cardiac injury, leading to a decline in function and eventually heart failure. One of the most evident barriers limiting cardiac regeneration is the inability of cardiomyocytes to divide. It has recently become clear that the mammalian heart undergoes limited cardiomyocyte self-renewal throughout life and is even capable of modest regeneration early after birth. These exciting findings have awakened the goal to promote cardiomyogenesis of the human heart to repair cardiac injury or treat heart failure. We are still far from understanding why adult mammalian cardiomyocytes possess only a limited capacity to proliferate. Identifying the key regulators may help to progress towards such revolutionary therapy. Specific noncoding RNAs control cardiomyocyte division, including well explored microRNAs and more recently emerged long noncoding RNAs. Elucidating their function and molecular mechanisms during cardiomyogenesis is a prerequisite to advance towards therapeutic options for cardiac regeneration. In this review, we present an overview of the molecular basis of cardiac regeneration and describe current evidence implicating microRNAs and long noncoding RNAs in this process. Current limitations and future opportunities regarding how these regulatory mechanisms can be harnessed to study myocardial regeneration will be addressed. Full article

The Crumbs complex has prominent roles in the control of apical cell polarity, in the coupling of cell density sensing to downstream cell signaling pathways, and in regulating junctional structures and cell adhesion. The Crumbs complex acts as a conductor orchestrating multiple downstream signaling pathways in epithelial and neuronal tissue development. These pathways lead to the regulation of cell size, cell fate, cell self-renewal, proliferation, differentiation, migration, mitosis, and apoptosis. In retinogenesis, these are all pivotal processes with important roles for the Crumbs complex to maintain proper spatiotemporal cell processes. Loss of Crumbs function in the retina results in loss of the stratified appearance resulting in retinal degeneration and loss of visual function. In this review, we begin by discussing the physiology of vision. We continue by outlining the processes of retinogenesis and how well this is recapitulated between the human fetal retina and human embryonic stem cell (ESC) or induced pluripotent stem cell (iPSC)-derived retinal organoids. Additionally, we discuss the functionality of in utero and preterm human fetal retina and the current level of functionality as detected in human stem cell-derived organoids. We discuss the roles of apical-basal cell polarity in retinogenesis with a focus on Leber congenital amaurosis which leads to blindness shortly after birth. Finally, we discuss Crumbs homolog (CRB)-based gene augmentation. Full article