Endothelial cells (ECs) lining the cardiovascular system are subjected to a highly dynamic microenvironment resulting from pulsatile pressure and circulating blood flow. Endothelial cells are remarkably sensitive to these forces, which are transduced to activate signaling pathways to maintain endothelial homeostasis and respond to changes in the environment. Aberrations in these biomechanical stresses, however, can trigger changes in endothelial cell phenotype and function. One process involved in this cellular plasticity is endothelial-to-mesenchymal transition (EndMT). As a result of EndMT, ECs lose cell-cell adhesion, alter their cytoskeletal organization, and gain increased migratory and invasive capabilities. EndMT has long been known to occur during cardiovascular development, but there is now a growing body of evidence also implicating it in many cardiovascular diseases (CVD), often associated with alterations in the cellular mechanical environment. In this review, we highlight the emerging role of shear stress, cyclic strain, matrix stiffness, and composition associated with EndMT in CVD. We first provide an overview of EndMT and context for how ECs sense, transduce, and respond to certain mechanical stimuli. We then describe the biomechanical features of EndMT and the role of mechanically driven EndMT in CVD. Finally, we indicate areas of open investigation to further elucidate the complexity of EndMT in the cardiovascular system. Understanding the mechanistic underpinnings of the mechanobiology of EndMT in CVD can provide insight into new opportunities for identification of novel diagnostic markers and therapeutic interventions.
Substantial progress has been seen in the drinking water supply as per the Millennium Development Goals (MDG), but achieving the Sustainable Development Goals (SDG), particularly SGD 6.1 regarding safely managed drinking water with much more stringent targets, is considered as a development challenge. The problem is more acute in low-income water-scarce hard-to-reach areas such as the southwest coastal region of Bangladesh, where complex hydrogeological conditions and adverse water quality contribute to a highly vulnerable and insecure water environment. Following the background, this study investigated the challenges and potential solutions to drinking water insecurity in a water-scarce area of southwest coastal Bangladesh using a mixed-methods approach. The findings revealed that water insecurity arises from unimproved, deteriorated, unaffordable, and unreliable sources that have significant time and distance burdens. High rates of technical dysfunction of the existing water infrastructure contribute to water insecurity as well. Consequently, safely managed water services are accessible to only 12% of the population, whereas 64% of the population does not have basic water. To reach the SDG 6.1 target, this underserved community needs well-functioning readily accessible water infrastructure with formal institutional arrangement rather than self-governance, which seems unsuccessful in this low-income context. This study will help the government and its development partners in implementing SDG action plans around investments to a reliable supply of safe water to the people living in water-scarce hard-to-reach coastal areas.
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