Role of extracellular vesicles in nonalcoholic fatty liver disease.

Background: Nonalcoholic fatty liver disease (NAFLD) is a common chronic liver disease that affects approximately one-quarter of the global population and is becoming increasingly prevalent worldwide. The lack of current noninvasive tools and efficient treatment is recognized as a significant barrier to the clinical management of these conditions. Extracellular vesicles (EVs) are nanoscale vesicles released by various cells and deliver bioactive molecules to target cells, thereby mediating various processes, including the development of NAFLD. Scope of review: There is still a long way to actualize the application of EVs in NAFLD diagnosis and treatment. Herein, we summarize the roles of EVs in NAFLD and highlight their prospects for clinical application as a novel noninvasive diagnostic tool as well as a promising therapy for NAFLD, owing to their unique physiochemical characteristics. We summarize the literatures on the mechanisms by which EVs act as mediators of intercellular communication by regulating metabolism, insulin resistance, inflammation, immune response, intestinal microecology, and fibrosis in NAFLD. We also discuss future challenges that must be resolved to improve the therapeutic potential of EVs. Major conclusions: The levels and contents of EVs change dynamically at different stages of diseases and this phenomenon may be exploited for establishing sensitive stage-specific markers. EVs also have high application potential as drug delivery systems with low immunogenicity and high biocompatibility and can be easily engineered. Research on the mechanisms and clinical applications of EVs in NAFLD is in its initial phase and the applicability of EVs in NAFLD diagnosis and treatment is expected to grow with technological progress.

Designing Intergenerational Spaces: What to Learn From Children.

OBJECTIVES: Adopting recommendations of the United Nations Committee on the Rights of the Child, this study addresses the value of children's input on the architectural design of the built environment of intergenerational shared sites and the intergenerational interactions that took place there. BACKGROUND: Intergenerational programs bring children and older adults together, inviting them to interact, exchange ideas and support each other. Most intergenerational programs are planned by staff and often take place in a multipurpose room without direct input from child or older adult participants. METHODS: Data for this study were collected through interviews and drawings from 16 children at three intergenerational centers in Hawaii, Kansas, and Virginia. The interviews were transcribed, analyzed, coded, and categorized. Child development experts analyzed the drawings to better understand how children experience their surrounding environment. RESULTS: Four themes emerged from the triangulated data: (1) outdoor spaces offer rich opportunities for shared programming, (2) children enjoy sharing meals and snacks with intergenerational partners, (3) children recognize environmental features that facilitate or limit intergenerational interaction, and (4) varied spaces support to informal, brief intergenerational interaction. Our findings provide evidence in the value of involving children in designing intergenerational centers and programming. CONCLUSION: The children who participated in this study provided meaningful insight reflecting the experience of intergenerational activities and the impacts of the built environment on the quality and variety of these interactions.