Background and Purpose: A growing body of evidence documents multiple ways in which land use and transportation investments influence health. To date, most evidence linking the built environment to health either focuses on behavioral change or environmental exposures. Few studies simultaneously assess how behavior and exposure-based impacts of the built environment interact. This is concerning as increased walkability and transit access can possibly lead to increased exposure to air pollution and injury risk. Method: This paper synthesizes recent research on behavior and exposure-based mechanisms that connect land use and transportation investments with various health outcomes. Exploring the nexus between these pathways provides a framework to identify priority areas for research to inform policies and investments. Results: The most studied pathway articulates how land use and transportation can support healthy behaviors, such as increased physical activity, healthy diet, and social interactions. The second pathway articulates exposure to harmful substances and stressors and potential differential impacts by travel modes. Increased rates of active travel lead to lower generation of vehicle emissions and kilometers traveled; but may actually result in increased exposure which may have adverse effects on sensitive populations such as elderly and youth. Unhealthy exposures have historically concentrated in areas where the most disadvantaged reside-along major transportation corridors where land is cheapest and more affordable housing is located. Highlights • Synthesizes recent evidence on the link between built environment and health • Highlights the need to capture both behavior and exposure-based impacts • Few studies explicitly link built environment factors with clinical end points • Need longitudinal evidence that assesses unique and collective impacts of environmental and biological effects on disease and cost.

We have previously demonstrated that infection by coxsackievirus B3 (CVB3), a positive-stranded RNA enterovirus, results in the accumulation of insoluble ubiquitin-protein aggregates, which resembles the common feature of neurodegenerative diseases. The importance of protein aggregation in viral pathogenesis has been recognized; however, the underlying regulatory mechanisms remain ill-defined. Transactive response DNA-binding protein-43 (TDP-43) is an RNA-binding protein that has an essential role in regulating RNA metabolism at multiple levels. Cleavage and cytoplasmic aggregation of TDP-43 serves as a major molecular marker for amyotrophic lateral sclerosis and frontotemporal lobar degeneration and contributes significantly to disease progression. In this study, we reported that TDP-43 is translocated from the nucleus to the cytoplasm during CVB3 infection through the activity of viral protease 2A, followed by the cleavage mediated by viral protease 3C. Cytoplasmic translocation of TDP-43 is accompanied by reduced solubility and increased formation of protein aggregates. The cleavage takes place at aminoacid 327 between glutamine and alanine, resulting in the generation of an N-and C-terminal cleavage fragment of~35 and~8 kDa, respectively. The C-terminal product of TDP-43 is unstable and quickly degraded through the proteasome degradation pathway, whereas the N-terminal truncation of TDP-43 acts as a dominant-negative mutant that inhibits the function of native TDP-43 in alternative RNA splicing. Lastly, we demonstrated that knockdown of TDP-43 results in an increase in viral titers, suggesting a protective role for TDP-43 in CVB3 infection. Taken together, our findings suggest a novel model by which cytoplasmic redistribution and cleavage of TDP-43 as a consequence of CVB3 infection disrupts the solubility and transcriptional activity of TDP-43. Our results also reveal a mechanism evolved by enteroviruses to support efficient viral infection. Coxsackievirus B3 (CVB3) is a small, positive-stranded RNA enterovirus. 1 The single open reading frame of CVB3 is translated into a viral polypeptide that is subsequently cleaved by two virus-encoded proteases 2A and 3C to generate structural and non-structural proteins. 2 In addition to processing viral polyprotein, 2A and 3C target host proteins important for maintenance of protein translation and transcription, antiviral activity, and cellular architecture and signaling, contributing to virus-induced pathogenesis. [3][4][5] Although enteroviral replication takes place exclusively in the cytoplasm, viral infection has been demonstrated to lead to cytoplasmic translocation of nuclear proteins. 6 For example, heterogeneous ribonucleoprotein D (hnRNP D) has been shown to translocate from the nucleus to the cytoplasm during enteroviral infection. 5,7,8 Moreover, hnRNP D is cleaved by 3C and has an antiviral function against enteroviral infection. 5,7,8 Cytoplasmic translocation after enteroviral infection has also been demonstrated for several other hnRNPs (A1, C, and K)...

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