The focus of the research was to examine the relationship between Socioeconomic status and prostate cancer in Alabama’s Black Belt region. The cancer rate in Alabama is high, and the state has one of the highest rates of prostate cancer in the USA. The research aims to identify probable reasons, raise awareness, and propose cancer prevention policies. The Geographic Information System, a robust technology, has been adopted to understand Alabama’s county-level prostate cancer incidence and mortality and its association with socioeconomic and health disparities. The analysis indicated an apparent socioeconomic disparity between the Black Belt and Non-Black Belt counties of Alabama. The poverty rate is higher in Black Belt counties. The data revealed that the preexisting condition of diabetes and obesity is closely associated with prostate cancer. Also, incidence and mortality disparities strongly relate to socioeconomic status, and the preexisting condition of obesity and diabetes adds to prostate cancer incidences. Poverty is the root course of inequalities in education, income, and healthcare facilities, particularly among African Americans, contributing to Alabama’s health burden of prostate cancer. The study proposes effective health policy intervention to prevent and reduce prostate cases and mortality among underserved communities in Alabama.Socioeconomic disparities influence the risk of many diseases, including cancer. The cancer rate in Alabama is high, and the state has one of the highest rates of prostate cancer in the USA. Alabama’s counties are embedded with socioeconomic disparities, politics, race, ethnicity, and oppression, among which social equity and socioeconomic status (SES) been closely associated with prostate cancer. The Geographic Information System (GIS) has become a valuable technology in understanding public health in many applications, including cancer. This study integrates Alabama’s county-level prostate cancer incidence and mortality and its association with socioeconomic and health disparities. We conducted robust data mining from several data sources such as the Alabama State Cancer Profile data, Alabama Department of Health, American Cancer Society, Center for Disease Control, and National Cancer Institute. The research method is the Geographic Information System (GIS), and we employed prostate cancer data within GIS to understand Alabama’s prostate cancer prevalence regarding SES. The GIS analysis indicated an apparent socioeconomic disparity between the Black Belt and Non-Black Belt counties of Alabama. The Black Belt counties’ poverty rate is also remarkably higher than non-Black Belt counties. In addition, we analyzed the median household income by race. Our analysis demonstrates that the Asian background population in the state earned the highest median income compared to non-Hispanic whites and the African American population. Furthermore, the data revealed that the preexisting condition of diabetes and obesity is closely associated with prostate cancer. The GIS analysis suggests that prostate cancer incidence and mortality disparities are strongly related to SES. In addition, the preexisting condition of obesity and diabetes adds to prostate cancer incidences. Poverty also reflects inequalities in education, income, and healthcare facilities, particularly among African Americans, contributing to Alabama’s health burden of prostate cancer. Evaluating the impact of SES on prostate cancer and mapping the spatial distribution is essential to understand the health disparity and health equity measures. Prostate cancer is one of the most significant health threats in the USA, with the highest incidence in African American men possessing the highest death rate and shortest survival rate of any racial/ethnic group in the U.S. ,2. AlabaGeographic Information Systems can illustrate geospatial inequalities in development programs and underline health disparity’s impact on minority communities in Alabama. This research employs GIS methodology to incorporate county-level prostate cancer data and explore the correlation between prostate cancer prevalence and socioeconomic factors. The advancements in GIS (hardware and software) technology, coupled with spatiotemporal and methodological enhancements and the widespread accessibility of geographically referenced spatial and statistical data, have led to general use in cancer research.Although multiple underpinnings cause prostate cancer incidences in Alabama, this research explores the impact of socioeconomic determinants, including preexisting conditions such as diabetes and obesity, on health disparity. SES is defined by an individual or group’s social standing or class and is generally measured using education, income, and occupation ,15,16,17Therefore, this study focuses on the Black Belt regions in Alabama. The Black Belt region has some of the highest health disparities in the state due to a lack of access to essential economic and social resources leading to poor health among African American populations in Alabama. Alabama’s Black Belt region consists of a distinct social and cultural boundary, and it extends from Virginia to Texas along with the Southeastern USA. It is mainly affected by poverty, limited healthcare systems, a lack of economic prospects, and poor access to healthy lifestyle selections. The Black Belt region is home to a large African American population. Most counties have a high percentage African American population.Numerous data sources have explored the relationship between prostate cancer and SES. The geospatial correlation between cancer and socioeconomic stress emphasizes Alabama’s health disparity and equity. A combination of socioeconomic factors and state and federal-level cancer epidemic data sources have also underscored high prostate cancer prevalence in Alabama’s Black Belt region (predominantly African American). Some of these data sources are (1) the Alabama Public Health Department, (2) the Alabama Statewide Cancer Registry, (3) the Alabama Data and Statistical Atlas, and (4) the National Cancer Institute. We also used secondary data, such as poverty and education data from the Alabama Possible  and the Alabama is one of the nation’s leading states in the cancer epidemic, including prostate cancer . The uniSeventeen of Alabama’s Black Belt counties are depicted in the Geographic Information Systems (GIS) displays, including white and African American populations . Apart fAccording to the Alabama Statewide Cancer Registry (2021), the African American male population faces more cancer incidence  and mortality  than the white population cancer incidence  and mortality  by a significant amount . This stSpatial inequality of healthcare development is one of the fundamental issues lacking in minority communities, and it requires broader discussion and policy formulation ,33,34,35The unique nature of spatial analysis through GIS provides a set of mechanisms for representing, organizing, exploring, and interpreting the existing spatial distribution of healthcare systems . ExaminiA comprehensive analysis of different aspects of SES and their relationship with prostate cancer cases in Alabama revealed many underlining factors, such as poverty, education, median household income, the association between diabetes and obesity, and access to health care for prostate cancer. Poverty is a critical issue that determines SES and adversely impacts human health ,40,41,42We conducted a correlation analysis to understand the relationship between poverty and prostate cancer. We collected the prostate cancer and poverty data containing a strong correlation in the Black Belt region in Alabama from the Alabama Department of Public Health. Eight out of seventeen Black Belt counties  had a poverty rate above 30 percent. The national poverty level ranges from 11 percent to 13.7 percent, whereas it increased to 16.8 percent in Alabama by 2019. It has been demonstrated that Black Belt counties were below the county’s statewide poverty line compared to other counties across the state of Alabama, and 12 out of 17 counties were among the top 25 percent of most poverty-driven counties in the United States . CompareAccording to the GIS analysis Sumter, Green, Perry, Dallas, Wilcox, Macon, Bullock, and Barbour counties have well over 150–200 prostate cases per 100,000 people A. The poPrior data found that poverty strongly relates to prostate cancer because it affects every segment of people’s health, suggesting that poverty correlates with an increased risk of prostate cancer regardless of race ,44. The Education is one of the socioeconomic measurements associated with increased risks of prostate cancer and other health issues . This, iOverall, spatial data on educational attainment and prostate cancer are correlated. The school systems in low-SES communities are often under-resourced, negatively affecting students’ academic progress and outcomes ,47. SES Diabetes is another closely related preexisting health condition that could influence prostate cancer. Prostate cancer and diabetes are two of the most common chronic diseases that trouble the aging male population . DiffereThe CDC (2021) surveyed on death rates vs. cases of diabetes, underlining that non-Hispanic black males represent the highest percentage of deaths with 47.6%, while non-Hispanic white males represent the second highest with 24.3%, and interestingly, non-Hispanic black/non-Hispanic white males represent only 2.0% .Alabama’s prostate cancer population lacks awareness of the cancer health riskLack of willingness for cancer screeningLack of access to cancer healthcare facilitiesLack of data gathering or data distribution on prostate cancerAccording to the American Cancer Society’s Cancer Facts & Figures (2021), 10,590 people are expected to die of cancer in 2021. In addition, the American Cancer Society (2021) underscores that approximately 4020 people will be diagnosed with prostate cancer in Alabama, and 480 people are expected to die, which makes prostate deaths number five out of the top ten cancer death in Alabama. Data also show that Alabama’s prostate cancer mortality rate is 22.9, significantly higher than the national rate of 19.7 (American Cancer Society (2021)). Among the mortality rate, black males in Alabama have a considerably higher prostate cancer mortality rate than white males, with a rate of 47.1 versus 18.1. In addition, To understand the association between diabetes and prostate cancer, we used data from the Alabama Department of Health (2013) and developed GIS maps C. The GIObesity is one of the most potent dietary/lifestyle factors correlated with prostate cancer . Prior dThe spatial pattern of male obese percentage and prostate cancer per 100,000 people is shown in A strong correlation was observed between obesity, prostate, and poverty in the Black Belt region. Out of 17 Black Belt counties, only two counties—Montgomery and Pike—had less than 40 percent . In comparison, all other 15 counties represented an adult obesity rate of 40 percent or higher due to poverty and socioeconomic factors. It has been acknowledged that Alabama is the fifth most impoverished state in the nation, and individuals who live in the Black Belt counties lack access to fresh food, affordability for quality food, and a lack of healthcare programs that spread awareness on dietary health . FurtherAll four health and SES factors  were mapped using a statistical breakdown to understand Alabama’s overall health disparity status. It is stunningly observable in every situation that the African American population holds higher cases than other communities. It is also clear that the lack of availability and affordability of health and socioeconomic factors impact African American communities’ health conditions. Also, we examined the percentage of the diabetes population as pre-existing conditions that could lead to prostate cancer. Data was compiled from the Centers for Disease Control and Prevention and Behavioral Risk Factor Surveillance System (2020). Data illustrates that the diabetes epidemic condition is far higher among African American males than among white or US populations. The prevailing socioeconomic and health disparity situations are crucial to comprehend the prostate cancer health condition of people in Alabama as they closely correlate. It is profoundly significant among minority populations because they have been systematically marginalized from the mainstream for decades.Using the spatial analysis concept (GIS) within the prostate cancer epidemic in Alabama is a novel idea to comprehend the distribution of health care, access to facilities, and, most importantly, integration of the distribution of socioeconomic status and disparity. Better healthcare policy planning requires a series of data formulation: (1) spatial distribution of healthcare systems and availability of professionals, (2) correlation between cancer and other health epidemics, (3) demographic patterns, (4) infrastructure facilities, (5) socioeconomic status, (6) environment conditions, and, most importantly, (7) health awareness programs. Since GIS can pull to gather all data sources into one spatial database and represent diverse data layers on multimedia platforms, policy planners have the opportunity to witness them from multiple perspectives on the relationship between the cancer epidemic and SES. Lack of GIS expertise in the state-level of cancer registry to perform the spatial database (shape files)Lack of fundingProtection of the privacy of health informationLack of awareness of the desire to disseminate prostate cancer informationThere are a few limitations that we encountered in this research. The research purely represents the outcome using secondary data sources. It would be excellent if we had opportunities to include individual interviews from major ethnic (white and black) sources to validate the data. However, we could not perform the interview due to COVID-19 restrictions. In addition, finding uniform secondary data sources to correlate prostate cancer with other health epidemics and SES was challenging due to the lack of available information online. The state cancer registry underlines a general pattern of prostate cancer instead the detail—for example, age, ethnicity, SES, and region. It is also essential to highlight that finding and downloading GIS format (shape file) cancer data are challenging. This could be related to:Alabama is one of the top states concerning the cancer epidemic, and most importantly, prostate cancer is one of the top five health diseases in the state. We examined the impact of SES on prostate cancer in Alabama using Geographic Information Systems. The data showed that SES is critical for prostate cancer incidents in Alabama. SES factors such as poverty, education, income, diabetes, obesity, and access to health care are discussed. Our findings support the statement that the relationship between SES, race, and ethnicity is closely linked ,18,42,62Comprehensive development plans and programs targeting better education and employment opportunities are essential to relieving the low social-economic status of the underserved communities. Effective policy interventions must address some impediments in reducing prostate cases and mortality. We hope that prostate cancer education among African American men in the Black Belt region can create a positive outcome. Policymakers have a significant role in allocating resources to improve access to screening, education, and awareness interventions. To reduce prostate cancer disparity, robust screening guidelines may be needed. It is also imperative to have effective educational programs on prostate cancer to raise awareness among African American men. Outreach programs can be launched through health facilities focusing on prostate cancer; new technology-based facilities in the region are vital to increasing knowledge and screening. Prostate cancer cases and mortality among African American men in the Black Belt region lingered for decades , which r


The development of effective treatments to prevent and slow Alzheimer’s disease (AD) pathogenesis is needed in order to tackle the steady increase in the global prevalence of AD. This challenge is complicated by the need to identify key health shifts that precede the onset of AD and cognitive decline as these represent windows of opportunity for intervening and preventing disease. Such shifts may be captured through the measurement of biomarkers that reflect the health of the individual, in particular those that reflect brain age and biological age. Brain age biomarkers provide a composite view of the health of the brain based on neuroanatomical analyses, while biological age biomarkers, which encompass the epigenetic clock, provide a measurement of the overall health state of an individual based on DNA methylation analysis. Acceleration of brain and biological ages is associated with changes in cognitive function, as well as neuropathological markers of AD. In this mini-review, we discuss brain age and biological age research in the context of cognitive decline and AD. While more research is needed, studies show that brain and biological aging trajectories are variable across individuals and that such trajectories are non-linear at older ages. Longitudinal monitoring of these biomarkers may be valuable for enabling earlier identification of divergent pathological trajectories toward AD and providing insight into points for intervention. As of 2022, an estimated 5 million Americans are living with mild cognitive impairment (MCI) and 6.5 million Americans are living with One widely adopted neuroimaging approach to assessing brain health is determination of the brain age gap, or predicted age difference between chronologic and brain age, as a biomarker of brain aging and health. The two most widely used methods include the brainAGE (Brain Age Gap Estimation) method  and thatP < 0.001) in AD subjects , and/or ADAS  in AD subjects when pooled with healthy controls . Brain aAdditional studies have developed alternative methodologies for estimating brain age. When using resting-state functional connectivity to determine brain age, although low accuracy of age prediction was observed, significantly increased brain age gaps were found in AD subjects compared to controls . PreclinResearch into human longevity and “healthspan”—the average length of healthy years of life—has explored approaches toward measuring biological age, the level at which the body is biologically functioning, as compared against the expected level of functioning per chronological age . One appEpigenetic age has been found to be associated with AD . The HorAnalysis of epigenetic age acceleration has yielded variable findings in middle-aged adults and broadly with respect to dementia risk . In studSuch variability in findings may be associated with heterogeneity in sampled populations and aging processes within and across subjects, and factors associated with measurement of the epigenetic clock, such as the use of variable training sets, tissues, and algorithms. The absence of correlations may also arise from capturing distinct aging processes. Inter-individual variability in methylation profiles, based on the Horvath clock, has been observed in those with the same chronological age and different epigenetic age, as well as for those with the same chronologic and epigenetic age . In middn = 1,397) with exclusion of AD subjects. This clock was validated in an independent human cortex data set, was found to be associated with lower neuron proportions, and more accurately predicted age of brain tissue samples compared to the Horvath and PhenoAge clocks, as well as compared to a third blood and saliva-based clock . Within this cohort, almost half of the participants had a diagnosis of dementia, including AD dementia. Overall, all clocks, except for GrimAge, showed significant association with global AD pathology, encompassing neuritic and diffuse plaque load and neurofibrillary tangle burden, with DNAmClockCortical demonstrating the greatest association (P < 0.00001). This was reflected in the finding that for each standard deviation increase in DNAmClockCortical age, there was a 90% increased probability of pathologic AD , compared to a 30% increased probability when using the Hannum, Horvath, or PhenoAge clocks (no relation was identified for GrimAge). In analyses of the epigenetic clocks in relation to clinical and genetic factors, including dementia and AD dementia diagnoses, cognition and memory scores, and APOE genotype, it was found that older epigenetic ages based on the Hannum, Horvath, and PhenoAge clocks were not associated with increased likelihood of AD dementia, global cognitive decline over time, or specific cognitive function declines. In contrast, DNAmClockCortical was significantly associated with all these measures, and older epigenetic age was also associated with APOEε4 carrier status. This study underscores the unique nature of brain tissue when estimating epigenetic age, how epigenetic clocks may need to be tailored to disease processes, and that utilizing CpG sites that are conserved in both brain and other tissues will be important to explore , in combination with the “pace of aging” biomarker of biological age . This anThe DunedinPACE biomarker, which reflects aging-related changes across organ systems, also represents one solution toward capturing such overlapping features. DunedinPACE was developed using the DunedinPoAm (Dunedin[P]lace[o]f[A]ging[m]ethylation) algorithm which takes advantage of blood-based DNA methylation patterns that are associated with 19 pace-of-aging biomarkers , 2022. IAlthough brain and biological age measures have yet to be widely adopted into clinical trials, their continued development and evolution have yielded promising biomarkers to evaluate in future studies designed to assess the efficacy of geroprotectors and other interventions for treating MCI and AD. This lack of adoption is associated with multiple factors including: (1) evaluation of AD interventions has historically focused on identifying changes in disease symptoms including cognitive functions and/or neuroimaging alterations, rather than divergence away from healthy aging trajectories.; (2) more research is needed to determine if measuring this divergence is both clinically actionable and meaningful.; (3) Studies are also needed to evaluate if “improving” brain and biological age biomarkers is associated with actual positive brain and health changes, and if these changes result in slowing down the progression of, or preventing, onset of AD.; (4) particularly for biological age measures, it remains unclear as to how specific this estimate is for portraying brain health. For example, can someone who is neurologically healthy demonstrate an advanced biological age primarily due to accelerated aging in other organ systems?; and (5) the cost of collecting additional measurements in clinical trials may currently be prohibitive, especially since the clinical utility of brain and biological ages is still unclear. Even so, as future studies continue to shed light on these questions and optimize strategies for measuring brain and biological ages, the creation of standardized and validated approaches for determining brain and biological age will ultimately enable us to test if interventions truly slow aging and if this change further slows development of, or prevents onset of, MCI, AD, and other neurodegenerative diseases.Based on existing brain and biological aging research, one penultimate phenomenon that has become common knowledge is the unique nature of aging trajectories in the brain and body for each person  i.e., p, as wellWL drafted the manuscript. All authors contributed to manuscript revision, read, and approved the submitted version.


Digital technologies could contribute to health promotion and disease prevention. It is unclear if and how such digital technologies address the health needs of older people in nonclinical settings .This study aims to identify digital technologies for health promotion and disease prevention that target the needs of older people in nonclinical settings by performing a scoping review of the published literature. The scoping review is guided by the framework of Arksey and O’Malley.Our scoping review follows the PRISMA-ScR  guidelines. The information sources are bibliographic databases  and bibliographies of any included systematic reviews. Manual searches for additional studies will be performed in Google Scholar and most relevant journals. The electronic search strategy was developed in collaboration with a librarian who performed the search for studies on digital technologies for health promotion and disease prevention targeting the needs of older people. Study selection and data coding will be performed independently by 2 authors. Consensus will be reached by discussion. Eligibility is based on the PCC  criteria as follows: (1) older people (population); (2) any digital  technology, such as websites, smartphone apps, or wearables (concept); and (3) health promotion and disease prevention in nonclinical  settings (context). Primary studies with any design or reviews with a systematic methodology published in peer-reviewed academic journals will be included. Data items will address study designs, PCC criteria, benefits or barriers related to digital technology use by older people, and evidence gaps. Data will be synthesized using descriptive statistics or narratively described by identifying common themes. Quality appraisal will be performed for any included systematic reviews, using a validated instrument for this study type .Following preliminary literature searches to test and calibrate the search syntax, the electronic literature search was performed in March 2022 and manual searches were completed in June 2022. Study selection based on titles and abstracts was completed in July 2022, and the full-text screen was initiated in July 2022.Our scoping review will identify the types of digital technologies, health targets in the context of health promotion and disease prevention, and health benefits or barriers associated with the use of such technologies for older people in nonclinical settings. This knowledge could guide further research on how digital technologies can support healthy aging.PRR1-10.2196/37729 Digital technologies, such as wearable devices, smartphone apps, and health websites, could contribute to health promotion and disease prevention in the general population . In partIn the digitized world, surprisingly, little is known about the needs of older people regarding their use of digital technologies for healthy lifestyle promotion . AlthougRecent scoping reviews suggest that digital health technologies for older people are used predominantly in the clinical context of disease management. For example, digital technologies may elicit behavioral changes across a range of health conditions that are required to improve disease and medication management among people aged 60 years or above . FurtherThis study aims to identify digital technologies for health promotion and disease prevention that address the needs of older people using a scoping review of published literature. The scoping review is guided by a framework for scoping studies proposed by Arksey and O’Malley .Our broad objectives are to identify and examine the research activity in the field of digital technologies for health promotion and disease prevention that target the needs of older people in nonclinical settings and to identify evidence gaps that could guide future research. The scoping review will address the following specific objectives: (1) to identify the existing digital technology types  for health promotion and disease prevention that target the needs of older people, (2) to describe the health context of such digital technologies, including health targets  and health purposes , (3) to describe the target populations of such technologies in terms of sociodemographic characteristics , health status , and settings with nonclinical focus , (4) to assess the use pattern in terms of any health benefits or barriers associated with the use of such technologies for older people in nonclinical settings, and (5) to identify any evidence gaps.Our scoping review follows the PRISMA-ScR  guidelines . The PRIThis protocol was written before the study commenced . The study was registered at the Open Science Framework .The eligibility for our scoping review is based on the PCC  criteria .Detailed definitions of the PCC criteria are provided in Inclusion criteriaPopulation: older peopleConcept: digital health technologiesContext: health promotion and disease preventionSetting: nonclinical Study type: primary studies with any design or data type  and reviews with systematic methodologyPublication status: published in a peer-reviewed journalPublication language: English, German, or FrenchFull-text accessibleExclusion criteriaOlder people not includedDigital health technologies not includedOther context than health promotion and disease preventionClinical setting Other study types: protocols or narrative reviewsOther publication status: published without peer review, dissertations, books, conference papers, comments, corrections, letters, and editorialsPublication language other than English, German, or FrenchFull-text not accessiblePopulation: older peopleOlder people include populations with the age range defined by study authors.Studies with older people of any gender or health status  will be included.Studies will be excluded if older people are not the focus of the study  or if they are included among people of any age or with middle-aged adults.Concept: digital health technologiesDigital technologies are defined as any digitally supported health technologies. These technologies may include the components of (1) eHealth, that is, the use of information and communications technology to support health and (2) mobile health , that is, the use of digital devices or tools with mobile and wireless technologies to support health objectives according to a World Health Organization guideline on digital interventions .Studies will be included if they use any “traditional” technologies, such as websites accessed via computer or mobile telephones, or any “modern” technologies, such as smartphone apps, wearables, or exergaming.Studies will be included if digital health technologies are used alone or as part of a health intervention.Studies will be excluded if landline telephones are used as the main technology in the health context.Context: health promotion and disease preventionHealth promotion and disease prevention  will be defined as any measures used to improve or maintain healthy lifestyle, prevent the onset of new diseases, or prevent worsening of existing diseases.Studies will be included if they focus on different aspects of healthy aging, such as physical activity, nutrition, mental and cognitive functioning, or sleep.Studies will be excluded if they focus on dental health, disease management, or digital technology development.Since our scoping review focuses on 3 broad topics , we aim to identify primary studies with any design  and reviews with a systematic methodology . This approach will assure that the relevant literature will be identified either in our literature search or in other reviews. Furthermore, identification of other reviews in this rapidly developing field can potentially reduce research waste that occurs when new reviews are produced, although reviews on similar topics already exist ,33.The information sources for our scoping review are (1) 4 international bibliographic databases , (2) bibliographies of any included systematic reviews, (3) Google Scholar, and (4) most relevant journals in the field. These databases were chosen because they identified the most relevant literature in our searches for digital technologies in other public health contexts. Due to potential financial interests in the field of digital health technologies, grey (nonpeer reviewed) literature will not be searched for. Instead, we aim to locate only published and peer-reviewed literature that may critically and objectively evaluate the health applications of such technologies in older people.The electronic search strategy was developed in collaboration with an experienced librarian on our team who also performed the search and deduplicated the results. The development and reporting of the search strategy adheres to PRESS (Peer Review of Electronic Search Strategies)  and PRISThe following aspects of the search syntax were implemented according to the PRESS guideline  and veriOnce consensus on the most effective search strategy was reached and approved by the team, the search strategy from MEDLINE was adapted to each other database individually by the librarian. A summary of the search strategy is reported in The electronic literature search was performed in each database separately from database inception through March 3, 2022. The search results were exported into individual libraries in EndNote and subsequently merged into a single library. This single library was exported into deduplication software Deduplicator , automatStudy selection will be performed in EndNote by 2 authors independently, and final consensus will be reached by discussion. The study selection procedure will involve automatic and manual elements as follows. First, all sources from the electronic search will be automatically divided into 2 libraries using the smart groups function in EndNote by 1 author as follows: (1) library I1 with sources fulfilling the inclusion criterion 1  flowchart. A list of included and excluded studies and reasons for exclusion after the full-text assessment will be reported in an appendix. Study selection from the electronic search was initiated in March 2022.Data coding will be performed using a single spreadsheet  that will be developed and calibrated within the team. If necessary, a coding manual will be developed to assure high interrater reliability of coding. Data coding will be performed by 2 authors independently, and consensus will be reached by discussion.A list of data items  will be Bibliographic informationFirst author, publication year, publication date, corresponding author region, title, and funding sourcesStudy designStudy type: primary study or reviewPrimary study design: randomized or nonrandomizedPrimary study data type: quantitative, qualitative, or mixedReview type: rapid, scoping, systematic, or overview of reviewsPrimary studies in reviews: number per review, overlap in primary studies among all reviews, and overlap in primary studies among reviews and our electronic searchStudy aim and focusStudy aim according to authorsStudy focus: evaluation, feasibility, efficacy, or otherPopulation (older people)Sample sizeSociodemographic characteristics: age, gender, and others Health status: healthy (without or at risk for any disease) or clinical (with any disease)Setting: daily life, home, community, or others with examplesConcept Type: any digital technology , wearable device, smartphone or other mobile tool, app, internet, website, exergaming, virtual reality, or others with examplesContext Health target: physical activity, nutrition, mental and cognitive functioning, sleep, or others with examplesHealth purpose: healthy lifestyle promotion, disease prevention , lifestyle monitoring, reminders, performance feedback, social or virtual network development, or otherUse pattern (benefits vs barriers)DurationBenefits Barriers Evidence gapsStudy conclusions or author statements focusing on ideas for future researchExcept for systematic reviews, the critical appraisal of included studies will not be performed because our scoping review aims to broadly identify digital technologies for older people rather than to evaluate their efficacy in the context of healthy aging. The quality of existing evidence will be discussed based on study designs identified in the scoping review.The critical appraisal of systematic reviews will be performed according to guidelines for overviews of systematic reviews  with a vThe appraisals will be performed according to a 2-step procedure described in our protocol for another scoping review . In the A spreadsheet  will be developed and used for appraising systematic reviews with AMSTAR2. All systematic reviews will be independently appraised by 2 authors, and consensus will be reached by discussion. The overall confidence ratings for each systematic review will be reported in an appendix.Data will be synthesized according to the objectives of our scoping review. The quantitative data items and AMSTAR2 appraisal outcomes for all systematic reviews will be synthesized using descriptive statistics . The qualitative data items will be narratively described by identifying common themes.Following preliminary literature searches to test and calibrate the search syntax, the electronic literature search was performed in March 2022 and manual searches were completed in June 2022. Study selection based on titles and abstracts was completed in July 2022, and the full-text screen was initiated in July 2022.Our electronic search identified just over 2000 sources. Study selection is expected to be completed in July 2022. The smart groups function in EndNote helped us to initially manage and automatically sort the literature. EndNote was very precise at identifying certain publication types, such as reviews, study protocols, dissertations, books, and conference papers. EndNote also helped us to identify sources with other populations, such as young people, and other settings, such as aged care. Most human judgement was required to decide if technologies used in studies were digital, and if so, if they were used in the context of health promotion and disease prevention. Furthermore, the study population was not mentioned in the titles of about 25% of search results, and the abstracts of these studies had to be manually assessed. So far, there have been only few minor disagreements between the 2 authors involved in the title and abstract screening. These disagreements were resolved by discussion between both authors based on additional information for or against inclusion.Fully automated and preliminary sorting of studies into smart groups in EndNote showed that various digital technologies are used for health promotion and disease prevention by older people, including any technologies , websites accessed via a computer, SMS (text messages) or mobile phones, exergaming, smartphones, or wearables. The studies addressed different health targets, including physical activity, mental health and wellness, nutrition, and cognitive functioning. The study focus is on effectiveness, feasibility, or evaluation of digital technologies.Two interesting aspects of our scoping review are to identify the digital technologies preferred by older people and to assess the reasons for using such technologies in the health context. Our preliminary inspection of studies suggests that while older people may use more modern technologies, such as smartphone apps or wearables, they also use (and possibly prefer) other technological solutions and devices, such as websites accessed via computers. Furthermore, while physical activity was the primary focus of previous reviews in this field (eg, the review by Taylor et al  and reviThe main strength of our scoping review is the electronic search syntax that was iteratively tested and revised by an experienced librarian on our team. Regardless of frequent piloting, there are several potential limitations in our search strategy, meaning that we might have missed some relevant studies in this new field. First, the research field of digital health promotion and disease prevention  and the We plan to publish the results of our scoping review in a peer-reviewed academic journal and also to disseminate our findings using plain-language summaries in English and German. Such summaries may facilitate the knowledge translation from our scoping review to a broader audience, including stakeholders working in the field of health promotion or the target population of older people. In general, knowledge translation is required to successfully process scientific findings before they can be applied in practice. Public health stakeholders involved in promoting physical activity among the elderly in Germany identified such short summaries as a strategy that could aid their work .Our scoping review will identify the types of digital technologies, health targets in the context of health promotion and disease prevention, and use benefits or barriers for older people in nonclinical settings. This knowledge could guide further research on how digital technologies can support healthy aging.


This was the first time that an oral health panel was included in the agenda of World Health Summit meetings. The present document is the report of the panel of “Neglected Epidemics: The Role of Oral Public Health to Advance Global Health” in the 7th Regional World Health Summit (WHS), 29-30 April, 2019 Kish Island, Iran. This seems to be an important crucial step for further improvement of oral health as a significant requirement for overall health promotion at the regional and global level. The panel members prepared and published a declaration which has been published in the WHS June 2020 newsletter. We write to you in order to convey the messages of the panel to a wider audience community.Oral diseases represent a major public health problem due to their high prevalence regionally and globally. According to a recent study on global burden of diseases, untreated dental caries was the most prevalent condition among the 313 diseases assessed globally . FortunaGiven that most oral diseases like other non-communicable diseases (NCDs) are behavioural related conditions, individuals are expected to play an active role for their own health improvement. To support a good oral health behaviour, in addition to providing sufficient oral self-care knowledge, proper access to enabling environment as well as preventive health system should be made available where people grow up, live and work. Unfortunately, in many countries the opportunities for community-based activities in oral health promotion are either limited or underutilized.Recent scientific findings have brought better understanding on the important role of good oral health in overall health and even treatment of major NCDs. Chronic oral infection has close relation with diseases like atherosclerosis, heart diseases, respiratory diseases, malignancies and pregnancy complications such as premature births and low birth-weight -9. It haOn the other hand, oral diseases share the same risk factors with major NCDs as described in Common Risk Factor Approach. Conditions such as cardiovascular diseases, chronic respiratory diseases, cancers and diabetes as well as obesity are like oral diseases: all affected by tobacco use, harmful use of alcohol, and unhealthy diet which are mostly preventable -17. SuccOral health professionals including dentists, dental therapists, hygienists, and dental academics, together with other health professionals can play more effective role in controlling the burden of NCDs at the community level, as emphasized in UN Sustainable Development Goals (SDG17) . DelegatThe presentations and discussions in oral health panel at the World Health Summit, Regional Meeting of 2019, deemed the followings items important enough for improving and maintaining good oral health. Therefore, requesting kind attention of all health care providers and policy makers to the following points:Oral diseases as a neglected NCD is currently considered a “silent epidemic”, putting heavy burden on general health, deserving special attention by all relevant constituents.Oral health is a fundamental human right and it should be an integral part of Universal Health Coverage (UHC) within the global health agenda.Oral health strategies should be included in all health policies.To address essential oral health needs of a population through UHC, adequately trained oral health personnel with appropriate educational backgrounds should be available.In order to address Sustainable Development Goals (SDGs), a proper oral health (SDG 3)  for all In line with Common Risk Factor Approach, preventing the consumption of high sugar intake of foods and drinks, tobacco use, and harmful use of alcohol are particularly recommended.The health care professionals should encourage good oral health knowledge and practice for prevention of oral diseases. Therefore, oral health should be included in the training of all medical professional.Considering the high prevalence of oral diseases in the Eastern-Mediterranean Region, the NCD departments should include and support oral health strategies with high priority.The 21 countries in the Eastern-Mediterranean Region would highly benefit, if a regional oral health advisor is appointed at the regional office (EMRO).Innovative oral public health research should be supported equally if not more than clinical research, with more priority and sufficient resources by the Ministries of Health, dental schools and research institutions.


In recent decades, new and improved materials have been developed with a significant interest in three-dimensional (3D) scaffolds that can cope with the diverse needs of the expanding biomedical field and promote the required biological response in multiple applications. Due to their biocompatibility, ability to encapsulate and deliver drugs, and capacity to mimic the extracellular matrix (ECM), typical hydrogels have been extensively investigated in the biomedical and biotechnological fields. The major limitations of hydrogels include poor mechanical integrity and limited cell interaction, restricting their broad applicability. To overcome these limitations, an emerging approach, aimed at the generation of hybrid materials with synergistic effects, is focused on incorporating nanoparticles (NPs) within polymeric gels to achieve nanocomposites with tailored functionality and improved properties. This review focuses on the unique contributions of clay nanoparticles, regarding the recent developments of clay-based nanocomposite hydrogels, with an emphasis on biomedical applications. Current technological requirements for new biomedical advances include new or improved materials with adequate functionality and performance. Materials with unique properties for applications in medicine have emerged due to the continuous evolution and key discoveries in the biomedical sciences and biotechnological fields. This growth has a significant impact on the ongoing development of biomaterial technology and the current practice of medicine. Over recent decades, the integration of nanotechnology with other fields of science has captivated a great deal of attention, resulting in numerous approaches toward the manufacturing of improved materials and physiologically relevant systems .Nanomedicine is still a developing and demanding medical field, and it has produced diverse nanomaterials and biological devices such as optical tools, biosensors, imaging probes, advanced drug delivery systems, and vehicles for proteins and enzymes, among many others . CombiniThe ECM is a tridimensional 3D) noncellular viscoelastic and dynamic nanofibrous network. The main function of the ECM is to regulate cell proliferation, differentiation, and migration, and to provide a physical and biochemical foundation for cells. Consequently, developing biomaterials to mimic the ECM should include precise control over their physical, chemical, and biological properties, details which are critical for the growth of functional tissues . Add. Add9]. Several hydrogels have already been used in the past decade for various biomedical applications that require cooperative exchange with dynamic cellular microenvironments. These hydrogels possess structural similarities to the ECM found in vivo by mimicking native tissue microenvironment with similar properties common to living tissues. For example, the low interfacial tension between the hydrogel surface and biological fluids minimizes the occurrence of an immune reaction by better matching the living tissue properties ,13.In cases where the dimensions of the injured tissues are too intricate to be replicated or a given defect site is not accessible, injectable hydrogels are an alternative. Hydrogels can adapt to environmental conditions due to their flexible nature while maintaining their unique properties. Therefore, a solution with subsequently triggered network formation can be used as an injectable hydrogel system . Thus, dHydrogels with previously unattainable functions and behaviors have been developed due to the evolving innovations from biomolecular engineering and polymer chemistry . HoweverIt is well known that the smaller the reinforcement, the greater the prospects of obtaining well-developed materials for structural improvement and overall functional benefits . The groClay minerals can be classified according to the charge of their layers into neutral (nonionic), cationic, and anionic clays . The silSince no isomorphous substitution occurs in the 1:1 clay mineral group, they are electrically neutral and have weak hydrogen bonds and Van der Waals forces, no structural (permanent) charges, generally low cation exchange capacity (CEC), and less biomedical interest when compared to the 2:1 type due to their inability to undergo interlayer swelling in water. However, halloysite (HNT) is an exception, since its hydrated 1:1 kaolinite sheets roll up several times into tubular clay nanomaterials (inside O sheet and outside surface T sheet), enabling attractive features for biomedical applications such as total pore volume and high specific surface area .The basic 2:1 (T-O-T) structure without any substitution of atoms is called pyrophyllite, and its layers do naot swell in water. As with kaolinite (of the 1:1 clay family), pyrophyllite and talc are of low reactivity, and their layered structure is electrically neutral (consequently non-swelling and of low reactivity). Contrarily, for smectite and vermiculites, the occurrence of isomorphous cation substitutions leads to clay particles with a different net charge, surface reactivity, ion exchange capacity, gelation, and swelling behaviors. The smectite group is mainly known for montmorillonite (MMT) and laponite (a synthetic hectorite) which are the most investigated among all phyllosilicates for biomedical applications due to their ability to show extensive interlayer expansion/swelling. In addition, their relatively low net charge enables complete delamination caused by osmotic swelling, thus exposing a chemical-rich surface. These structural changes allow for the interaction with various biomolecules or polymers in addition to conferring unique rheological properties once dispersed in water. Contrarily, vermiculites and ilites display a higher layer charge that limits water accessibility to the interlayer region, which inhibits delamination due to restricted swelling, gelling tendency, and overall reactivity. However, they still possess high specific surface area (SSA) and cation exchange capacity (CEC). Lastly, as halloysites (from the 1:1 family), sepiolites are distinctive from other clay minerals (in the 2:1 family) due to their unique inverted 2:1 structure, which offers these clay minerals porosity and fibrous morphology with high SSA b 28]. . 28]. Besides their use as reinforcement agents, clay nanoparticles have also been used in the development of hybrid materials for specific medical applications such as regenerative medicine and as vehicles to efficiently deliver therapeutic molecules . The ability of clay minerals to bind therapeutic agents has been known for more than 50 years, when clinicians noted the unusually reduced existence of drugs in the blood stream (reduced systemic bioavailability) when patients were simultaneously receiving clay-based antidiarrheal treatments ,31. ThisSeveral types of clay minerals such as halloysite nanotubes , montmorThe incorporation of clay nanoparticles has also been used to control rheological behaviors and shear thinning characteristics of available bioinks in order to optimize the processability and 3D printability of complex structures . There aThe development of nanomaterials appears to be, based on recent research, the future of evolving nanomedicine technology . In 2002However, further research was required to determine what makes biological tissues so complex and why their performance surpasses the engineered polymeric materials used in biomedical applications . While sEven if nanotechnology advances allow for the generation of diverse, well-defined nanomaterials , their use in biomedical fields remains an ongoing challenge due to the need for convenient sterilization, ease in processing procedures, and application safety of all materials included, as well as interface compatibility between nanomaterials and polymeric matrices .To address the current limitations and need for safe and multifunctional systems, researchers have been focusing on designing physiologically friendly hydrogels reinforced with biocompatible clay nanoparticles . The incCombining two different materials can offer an array of possible interactions and interface conditions, resulting in new structural properties and overall behavior ,47. For The synergistic combination of polymeric matrices, therapeutic compounds, and nanometric clay fillers meets various requirements for different applications, especially in biomedicine . This reThe novelties behind clay nanocomposite hydrogels consist of new approaches to synergistically synthesize, modify, and reinforce conventional polymeric matrices using clay nanofillers and the possible benefits that spring out of it for biomedical applications. This section addresses the main techniques used to produce nanocomposite hydrogels with clay nanofillers and delves deeper into the main properties that are impacted by this interaction.2+ alginate/clay nanocomposite hydrogels from an optimized bead forming procedure. The zeolite and Cloisite-Na+ nanoclay sonicated dispersions were added to the sodium alginate solution. A 2% solution (w/v) was extruded using a syringe pump operating at a rate of 30 mL/h into goblets containing distinct concentrations of calcium chloride. The drops, when in contact with calcium chloride solutions, immediately turned into beads that were kept immersed for 2 h to ensure complete crosslinking. The nanocomposite beads were finally washed to remove the excess calcium and dried  (PEO) films, Gaharwar et al.  developeInjectable hydrogels require a precursor solution that can be easily injected and that can gelify in situ, thus producing a mechanically adhesive and robust hydrogel. These injectable hydrogels are very interesting for minimally invasive therapies from a clinical perspective. Injectability, flow behavior, and gelation temperature, among other characteristics of nanocomposite hydrogels, can be determined by rheological characterization.w/w). Similarly to the work discussed before, this nanocomposite hydrogel’s storage modulus (G’) increased from about 80 kPa to 200 kPa when the laponite content increased from 1% to 5% while that of the pristine RSF hydrogel is only 30 kPa. Huang et al.  designedA bioink formulation should efficiently deform and reform several times during the printing process while retaining flow behavior without consequences to its integrity. Thus, rheological characterization is extremely valuable in evaluating the viscoelastic and responsive properties of developed bioinks. Wilson et al.  designedThe viscoelastic and flow behavior properties of materials designed for 3D printing are challenging problems to address in order to obtain high-quality constructs. For this reason, Da’vila et al.  rheologiA hydrogel scaffold for use in tissue engineering must be structurally stable in order to endure in vivo mechanical stresses while supporting the ingrowing tissue . EnhanceTo mimic the native tissue interface, Cross et al.  producedThe degradability of biomaterial systems is a fundamental characteristic with significant effects on biomedical applications such as tissue engineering applications, where scaffolds should provide and maintain the needed structural support as long as the regeneration of new tissue demands. It is also an important factor for drug delivery applications in order to prevent therapeutic agents from premature burst release .w/v) of clay NPs exhibited significantly reduced degradation rates when compared to the other two groups. The same conclusions were drawn by Mauro et al. ..54].2+ and Si4+ ions, the nanocomposite hydrogel supported ALP production by primary rat osteoblasts (ROBs). Therefore, following implantation in vivo, new bone formation is stimulated. Micro-CT analysis and reconstructed 3D images demonstrated that nanocomposite hydrogel with 5% of clay stimulated bone growth in the tibia defect in comparison with control  suitable rheological behavior and extrusion processability for 3D-bioprinting, (ii) the printed construct must be stable without collapsing before solidification or crosslinking, (iii) high cell viability and suitable structure porosity for the diffusion of nutrients and oxygen, (iv) proper and suitable mechanical characteristics, and (v) osteogenic differentiation and long term new bone formation . 2+ and Si4+ ions, which influenced cell behavior and promoted a higher gene expression of ALP, OCN, and collagen after 7-day culture. The penetration of the new bone formed inside the microstructural holes of the scaffold confirms the excellent osteoconductivity of PNAGA–clay nanocomposites. The stimulated new bone volume around and inside the nanocomposite scaffold in the marrow cavity (5.5%) was shown by the reconstructed 3D models  that are dispersed into highly organized collagenous extracellular matrices abundant in proteoglycans, glycosaminoglycans (GAGs), and collagen fibers . The repThere have been in situ studies of the formation of injectable hydrogels and scaffold constructs for cartilage repair and structural support in vulnerable load-bearing cartilage tissue. Some examples are thermo-responsive injectable hydrogels composed of wool-derived fibrous protein (keratin), triblock copolymer (pluronic), and chitosan reinforced with laponite clay, exhibiting improved elastic modulus and biological stability, without compromising the in vitro cell viability, as well as enhanced cell adhesion and proliferation ; and LDHDrug delivery systems mainly aim to solve one of the biggest issues in the conventional treatments of many diseases: the poor delivery of drugs to the target sites causing undesired side effects. It is desired to maintain drug levels within the therapeutic concentration range during the course of treatment. This is possible by using delivery systems that are able to release a drug at the target site in a controllable manner . Additio3) increased almost 3-and 2-fold after 21 days while treated with just PBS and free DOX. In contrast, a gradual decrease in tumor volume was observed in mice treated with P3k/CND/DOX hybrid gel  are deeply affected by native microenvironment characteristics, such as the physiological three-dimensional arrangement they are situated in. The aim of 3D bioprinting is to produce 3D scaffolds that can mimic the composition, architecture, and mechanical properties of native tissues as well as regenerate functional tissues and support cell–ECM interactions . The incTo obtain 3D-printed anatomical structures with suitable functionality and physiologically bioactive characteristics, Chimene et al.  developeStimuli-responsive hydrogels combined with nanoclays with multifunctional characteristics can also be used as biosensors and soft robotic actuators, given that their properties can be triggered by temperature, pH, and light as well as magnetic and electric fields . In this category of stimuli-induced applications, Gao et al.  reportedThe multifunctionality of clay nanoparticles, combined with the dynamic and structural characteristics of hydrogels has proved to be useful in different fields of medicine. This combination generates synergistic effects between different materials and engineers nanocomposites with broad spectra of functionalities. The presence of clay particles in nanocomposites provided and enhanced the capacity for structural support necessary for the regeneration of new tissues by improving their load-bearing ability, slowing their degradation, and controlling the microstructure and network porosity that influence cell migration and the diffusion of oxygen and nutrients. The flow behaviors of stimuli-responsive hydrogels were tuned to successfully obtain new injectable precursor solutions for minimally invasive therapies that can jellify into mechanically robust and adhesive hydrogels. It also allowed for the production of printable bioinks with optimal filament formation and gelation temperatures. The optimizations by clay incorporation can also lead to high shape-fidelity 3D-printed constructs with physiologically bioactive characteristics. Furthermore, the binding and sustained release of molecules by the inherent mechanisms of clays, in addition to the capacity to swell and retain specific molecules of hydrogels, allows these nanocomposites to be ideal candidates for the targeted delivery of therapeutic agents. The developed scaffolds also promoted dynamic cell-scaffold interactions which are vital for superior microenvironment-integrative regeneration. Furthermore, the potential of these nanocomposites to support the regeneration of new tissues and stimulate bone growth due to gradual release of clay’s intrinsic ions, produce superior microfabricated structures with anatomical characteristics and properties common to living tissues, and function as targeted drug delivery systems capable of holding and maintaining the sustained release of different therapeutic agents with significant results, were found, among other beneficial biomedical applications. Since clay-based nanocomposite hydrogels demonstrate superior physical, chemical, and biological properties, their use represents a considerable advancement for biomedical science. In the future, researchers should focus on and shift their attention towards improving structural integrity, tunning the appropriate release of therapeutic agents within the desired time frame and at an effective rate, risk assessment, awareness of the effects imposed by these engineered systems within biological systems, and biodegradation. Further studies are required to better understand their mechanisms of action, the interactions between clay nanoparticles and hydrogel polymeric chains, the interactions between cells and the nanocomposites, as well as the possibility of toxic and adverse effects which a few studies demonstrated. Further developments might lead to 3D tissue models capable of providing cell support and a biomimetic environment to act as frameworks for toxicological studies. Additionally, since the fate of clay nanoparticles released from nanocomposites after their degradation is still underexplored, advanced techniques should be used to obtain insight into the physiological pathways of the released clay minerals in the body.


Studies on online labor platforms (OLPs) have revealed that OLPs can have extensive managerial control over independent workers, which affects their autonomy and precariousness. The permeability of the management makes some OLPs' roles as neutral intermediaries in labor exchanges questionable. While there are several platform work studies on the effects of human resource management (HRM) activities, earlier studies have focused more on certain types of OLP companies. Earlier OLP classifications did not make systematic distinctions between HRM activities either. This paper offers a classification to view how HRM activities manifest in OLPs. The study utilizes terms of service and webpage data from 46 multinational and Finland-based OLPs. Based on these data, OLPs have been classified into six models with five governance principles and institutional logic. The study uses the idea of institutional complexity and claims that OLPs balance their operations between the complexity of two institutional logics, market, and corporation, by using varying strategies with their HRM activities. Differently managed OLPs are also often marketed to different worker groups. This indicates that workers' levels and quality of autonomy differ between OLPs. Hence, could be expected that platform workers' expectations toward OLPs, perceptions of fairness, and experiences of wellbeing may be influenced by the HRM activities in which they engage. The results contribute to the ongoing discussions of power asymmetries between OLPs and platform workers, and thus OLPs' roles as either marketplaces or hierarchical corporations. Formed models can be utilized to enrich studies on key issues of platform workers' autonomy, precariousness, and experiences in different types of OLPs. Businesses built on the intermediation of decentralized exchanges among peers through digital platforms have extensively found their way into various sectors of economic life in the 2010s, creating new ways of working and earning , whose HRM activities are analyzed with the theory of five governance principles. Principles consist of (1) deciding on memberships, (2) governing rules, (3) monitoring rule compliance, (4) sanctioning non-compliances, and (5) establishing a hierarchy  free marketplaces, (2) managed marketplaces, (3) temporary employment platforms, (4) managed networks, (5) managed work processes, and (6) managed like corporations. The worker groups to which OLPs advertise their services as working opportunities have also been viewed through the models. This gives a tentative idea of what HRM activities are common in what types of work and to what groups of workers they apply. This information and these models will offer instruments to deepen future studies on workers' experience, power relations, and legitimacy questions in differently managed OLPs. The following section will present a definition of OLPs and earlier classifications from new perspectives.Digital online labor platforms are for-profit companies that serve as digital intermediaries for temporary, paid work tasks , the client, and the independent work provider .The OLP has a digital platform for mediating tasks, projects, or fixed-term employment relationships.The OLP positions itself as an intermediary between clients and workers.The mediated service is labor.via articles or news using the research literature vocabulary. I also received suggestions from working life researchers and others stakeholders of OLPs. The first sample of OLP companies consisted of 39 cases and was collected in 2021. In 2022, the number of cases was supplemented to 46 with seven additional cases. The cases included two platform cooperatives to increase the coverage of the sample  and clients. Terms of service identify the roles and obligations of each party, but they do not always open work mediation processes directly; they do it indirectly by framing parties' roles and permitted and unauthorized functions in work intermediation. A large part of the terms of service consists of privacy and data protection policies, which were not the focus of this analysis and were thus removed from the final data.The data consisting of terms of service and webpage presentations cannot tell the operation practices; they can only tell how OLPs display them and the legal frameworks within which the work takes place. Data reveal the formal aspects of OLPs, but some functions, like how OLPs balance supply and demand in their markets and guide workers' actions and behavior with “soft control” techniques like incentives  and managed networks (Model 4).There were also two platform cooperatives included in this sample. One represented the free marketplace model (1), and the other the model of managed work processes (5). The latter was challenging to classify because, even though there were written rules for work performance and the OLP handled the allocation and work-related matters with algorithmic procedures, the development of services was user driven. No sanctioning practices or other elements created hierarchies, so the power imbalance question differs from OLPs in the same model. The power imbalance question also differs because ownership relates to power distribution and its centralization or decentralization in platform ecosystems , the decision-making power on marketing is with the workers. In managed networks (Model 4), this power is limited by OLPs. In managed work processes (Model 5) and managed corporations (Model 6), the possibility of workers marketing themselves is minimal or non-existent. Therefore, OLPs of the latter models are not particularly suitable for service marketing but could be utilized to acquire pre-defined tasks for direct income needs. Recognition of what kind of working environments and opportunities for operations these HRM activities create will enable us to analyze the possibilities and issues associated with different models. This helps to recognize the elements affecting workers' experiences, wellbeing, and fairness perceptions in different OLPs. In addition to HRM activities' great impact on worker experiences, these activities can also affect what workers expect from OLPs. Workers entering marketplace OLPs (Models 1 and 2) may seek only additional forums to market their businesses, whereas people entering managed work processes OLPs (Model 5) may expect continuous task offers and definite income, and thus more responsibility from OLP companies.Earlier classifications have separated OLPs based on skill levels, sectors, and working methods  and managed like corporations-models (Model 6), which consist mostly of transportation and delivery (Model 5), and translation (6) sector OLPs. This may indicate that certain HRM models have a more legitimized position within sectors. OLPs with more intensive HRM also advertise working opportunities for those in a more vulnerable position in labor markets, like migrants or the uneducated. On the other hand, OLPs with less intensive HRM offers possibilities for the educated and those generally in a more stable position. This indicates that OLPs not only develop in different directions but also that their working opportunities are targeted at different people, treat them differently, and offer them different levels of autonomy.As previously stated, earlier studies have focused more on OLPs that have caused contradictions with misclassifications of entrepreneurs and algorithmic management activities. In light of this classification, focusing research on OLPs with intensive HRM will give a one-sided picture of OLPs' HRM activities. The results indicate that OLPs strategically use different algorithmic or non-digital HRM activities for different governance principles. There are also sectoral, task, and work-related factors that may affect OLPs and the extent of their HRM activities.Models can add value to the research on OLPs' societal impacts. Research on platform work precariousness has recognized versatile risks to income, job security, social security, autonomy, etc. (e.g., Kahancová et al., The original contributions presented in the study are included in the article/In terms of data collection, analysis, and writing, JI was the only author who contributed to the article.


On March 7 and 8, 2022, the Coalition for Epidemic Preparedness Innovations (CEPI) and the UK government cohosted the Global Pandemic Preparedness Summit in London, UK  and manufacturing responses, including the optimization of clinical trials. They also underscored the need for master protocols, enabling faster data sharing and balanced research participation between high-income countries and low-income and lower-to-middle-income countries, and innovations in clinical trial design and execution to compress timelines for delivering trial outcomes. Additional recommendations included standardization of animal models and assays to assess vaccine candidates and avoid duplication of efforts, as well as improved global coordination of surveillance and data sharing connected with R&D efforts. Speakers urged development of global regulatory paradigms, ones with new platforms and requirements of emergency response that would take account of accumulating experience but not compromise on safety or quality. Summit participants also noted that regulators must come to a consensus regarding requirements for clinical trial data, become more familiar with technology platforms through review of data across various pathogens over time, and provide guidance on the feasibility of alternative pathways to emergency use approval, especially in the context of the 100 Days Mission  Accelerator, a global collaboration to accelerate development, production, and equitable access to COVID-19 tests, treatments, and vaccines—were set up to address this situation. However, such initiatives have lacked the financial resources to secure sufficient doses early through advance purchase agreements. Lack of solidarity and prevalence of vaccine nationalism rendered COVAX supply-constrained through much of 2021 (https://www.modernatx.com) plans to set up an mRNA manufacturing facility in Kenya (https://www.skbioscience.com) plans to produce routine vaccines in preparation for Disease X that can quickly transfer to large-scale manufacturing if a new pandemic occurs; and WHO has designated South Korea as a biomanufacturing training hub  and partners are setting up mRNA vaccine technology transfer hubs in South America (There was consensus among speakers that responding quickly and effectively to pandemic threats requires close collaboration, leveraging the individual and collective strengths of the public and private sectors, and the normative function of multilateral organizations, such as WHO. WHO member states are working to establish the rules of the road for future epidemics and pandemics, including equitable sharing of countermeasures (The summit concluded with representatives from industry, philanthropy, and governments pledging their political and financial support of nearly $1.6 billion against a target of $3.5 billion for CEPI’s 5-year pandemic plan and 100 Days Mission (


This study aimed to examine the associations between parental mindfulness and preschool child behavior problems and to investigate the mediating role of marital satisfaction and coparenting in the relationship between mindfulness and preschool child behavior problems. This was a cross-sectional study in which general sociodemographic data were obtained from 3448 parents of children in grades junior to senior of kindergarten who were assessed using instruments such as the Mindful Attention Awareness Scale (MAAS), the Strengths and Difficulties Questionnaire (SDQ), the ENRICH Marital Satisfaction Scale (TEMSS), and the Parents’ Perceptions of the Coparenting Relationship Questionnaire (PPCR). (1) Mindfulness, preschool child behavior problems, marital satisfaction, and coparenting were significantly correlated with each other, where mindfulness was positively correlated with marital satisfaction and coparenting and significantly negatively correlated with preschool child behavior problems. (2) Mindfulness negatively predicted preschool children’s problem behaviors. (3) Marital satisfaction independently mediated the relationship between mindfulness and preschool child behavior problems. (4) Coparenting also independently mediated the relationship between mindfulness and preschool child behavior problems. (5) Marital satisfaction and coparenting play a chain-mediating role between mindfulness and preschool children’s problem behaviors. Mindfulness predicted preschool child behavior problems, with marital satisfaction and coparenting as mediators. The preschool stage is a period of rapid emotional and social development for young children, and because their physical and psychological functioning is still immature, they are prone to deviant behaviors  and evenFor preschool children, the family setting is a key environmental factor affecting their development . Family In recent years, researchers have begun to focus on the effects of parental mindfulness on child development. Mindfulness refers to an individual’s purposeful, nonjudgmental attention to internal and external stimuli in the present moment  and is eExisting research on mindfulness also suggests that individuals with high levels of mindfulness tend to perform better in establishing and maintaining interpersonal relationships and are more likely to have satisfying marital relationships ,18. On tFamily systems theory suggests that subsystems in families are interdependent and that behaviors and emotions experienced by parents in the couple subsystem spill over ,26 into Parenting preschool children is more challenging for parents than during their infancy , and thuFamily factors that influence children’s development do not operate in isolation. There is an interactive joint effect between them , namely,how parental mindfulness influences preschool children’s problem behaviors and what we can do to prevent and mitigate such behaviors.In summary, the acute awareness and acceptance that mindfulness brings may improve the parenting process and predict behavior problems in preschool children in reverse. This process may be achieved through mindfulness, increasing marital satisfaction, and improving coparenting. This study constructs a chain mediation model based on family systems theory to examine the mechanisms of marital satisfaction and coparenting in the relationship between parental mindfulness and preschool children’s problem behaviors. These findings will facilitate our understanding of In this study, a convenience sampling method was used to distribute questionnaires to parents of junior, middle, and senior classes in 12 kindergartens in Shandong, Inner Mongolia, and Jilin, China. A total of 4000 questionnaires were distributed, and after excluding 552 of them owing to incomplete responses or responses with regular patterns, 3448 (86.2%) questionnaires remained valid. Of these, 1761 (51.07%) were parents of boys, and 1687 (48.93%) were parents of girls. The number of parents of junior-class students was 1193 , middle-class students was 1010 , and senior-class students was 1245 .The questionnaire included a demographic information sheet that collected information, including whether the participant’s child was an only child, the participant’s occupation, education level, and average monthly household income. Details are shown in In this study, the MAAS, developed by Mackillop and Anderson (2007)  and reviIn this study, the SDQ for preschool children, developed by Goodman (2001)  and reviThe study used TEMSS, developed by Fowers and Olson (1993)  and reviThis study used the PPCR questionnaire developed by Stright and Bales (2003)  and reviThe data analysis for this study was performed using SPSS 25.0. Following the recommendations of Podsakoff et al. (2003) , we perfIn this study, data were collected uniformly in the form of a self-statement questionnaire for each research variable; thus, there may be a degree of common method bias that requires testing before data analysis to determine whether common method factors could have a significant effect on the results. As suggested by Zhou and Long (2004) , first, The mean, standard deviation, and correlation matrix for each of the study variables are shown in c), while it was a significant positive predictor of marital satisfaction (a1) and the level of coparenting (a2). Marital satisfaction significantly positively predicted the level of coparenting (d) and negatively predicted preschool child problem behavior (b1). Parental mindfulness (c’) and the level of coparenting (b2) were significant negative predictors of preschool child problem behavior.Based on these results, we tested the mediation model using SPSS macro PROCESS (Model 6) with 5000 bootstrap samples. The results are shown in c’) between parental mindfulness and preschool child problem behavior was significant , suggesting that marital satisfaction and coparenting play a partially mediating role in the effect of mindfulness on preschool child problem behavior. The mediating effect consisted of three mediating pathways: an independent mediating effect for marital satisfaction , an independent mediating effect for coparenting , and the chain mediating effect of marital satisfaction and coparenting .The mediation analysis   suggesteAnother interesting perspective is that although parenting children with problem behaviors is challenging for most parents, it does not affect different parents to the same degree . ResearcThis study also found that marital satisfaction and coparenting mediated independently between parental mindfulness and preschool child problem behavior, respectively. In other words, hypotheses two and three are valid.Gottman and Notarius (2002)  found thIt is undeniable that parenting is a joint activity for couples and that the quality of coparenting also influence children’s problematic behavior. At the core of mindfulness is non-judgmental acceptance, an attitude that is very important to coparenting. When one partner is able to receive acceptance, acknowledgement, and well-meaning advice from their partner, they develop more feelings of being supported; supportive coparenting influences the pattern of the parent–child relationship, reducing negative influences and enhancing the quality of parenting . ConversDue to the spillover effect , maritalFirst, this study did not distinguish whether the questionnaire was completed by the child’s father or mother at the time of data collection. There may be significant differences between fathers and mothers in terms of mindfulness, marital satisfaction, and coparenting, influenced by factors such as gender and social roles. In addition, studies have shown that children in some special families, such as single-parent families and reconstituted families, tend to be more prone to behavior problems . WhetherSecond, this study analyzed preschool children’s problem behaviors in aggregate, ignoring the uniqueness of each type of problem behavior. Future research could consider each dimension separately for a more in-depth analysis. Third, this study used parental reports to collect data, which may have been influenced by social approval effects. Future studies could adopt multiple subjects reporting children’s problem behaviors  to make the data source more objective. Finally, developmental context theory emphasizes the temporal dimension in the ongoing interaction between the individual and the environment, and this interaction is age-specific depending on the individual’s stage of physical and mental development . TherefoThis study found that mindfulness negatively predicted preschool children’s problem behaviors. Both marital satisfaction and coparenting independently mediated the relationship between mindfulness and preschool child behavior problems. Marital satisfaction and coparenting play a chain mediating role between mindfulness and preschool child problem behaviors.