Maternal and child malnutrition is a worldwide public health problem with short, medium, and long-term adverse consequences for both mother and child. In Mexico, maternal and child malnutrition represents a serious public health problem that must be urgently addressed. In this context, Primary Health Care (PHC) plays an important role in the prevention, detection, monitoring, and treatment of the different forms of maternal and child malnutrition. Assessing the quality of nutritional care offered at this level of care is necessary in order to improve it; however, there are no indicators for the evaluation of this quality. Therefore, this study aimed at developing a set of indicators to assess the quality of maternal and child nutritional care at PHC.We developed indicators for different stages of life: preconception, pregnancy, infancy, and preschool age. A systematic review of the literature on clinical guidelines for the prevention, diagnosis, and treatment of the different forms of malnutrition was carried out; the recommendations of the guidelines evaluated with good quality were extracted.Based on these recommendations, 22 indicators were constructed. A pilot study was carried out to validate the indicators and 16 indicators were selected to assess the maternal and child nutritional care at PHC. Maternal and child malnutrition remains a global health problem. The coexistence of undernutrition and obesity increases not only the risk of maternal morbidity and mortality but also impacts the fetal growth and development with short and long-term consequences . As repoIn Mexico, based on the 2020 National Survey of Health and Nutrition about COVID-19 , 76% of Primary health care (PHC) aims to ensure the highest possible level of health and wellbeing of an individual and populations; it ranges from health promotion, prevention, treatment, rehabilitation, and palliative care . It has Currently, there are essential nutritional actions addressed to eradicate maternal and child malnutrition in all its forms. Despite the proven knowledge, most countries have failed to reach their targets, sometimes due to the lack of coverage but also for neglecting specific goals. The nutritional interventions that are cost-effective and group-focused must be prioritized, considering the social context and the economic resources of each entity. In addition, for the improvement of the quality of care, it is necessary to reduce the gap between the scientific evidence, the politics and governance, and the resources destined to the centers of primary care –11.According to the World Health Organization (WHO), the quality of care is defined as the degree to which health services for individuals and populations increase the likelihood of desired health outcomes, and this must be according to the best evidence-based professional knowledge . In the Currently, there is limited information about the description and development of indicators for quality of nutritional care during preconception, pregnancy, postpartum, and infancy. In Mexico, all the efforts are focused on quality of care to identify obstetric risk factors without regard to nutritional care . It is iTherefore, we aimed to develop and validate quality of care indicators for maternal and child nutritional care on PHC in the environment of the Mexican Health System. Having indicators that allow us to evaluate the quality of nutritional care in the aforementioned stages of life will allow us to identify improvement areas in the quality of care offered in PHC in Mexico.The development of the indicators to evaluate the quality of maternal and child nutritional care at PHC was carried out by following six steps. In A systematic literature search was carried out in PubMed and websites for clinical practice guidelines, guidelines and position statements related to the prevention, diagnosis, and management of all forms of malnutrition during preconception, pregnancy, postpartum, and infancy and preschool children. To assess the quality of these documents, the methodology of the Appraisal Of Guidelines For Research and Evaluation II (AGREE II)  instrumeThe recommendations, based on the results of the systematic literature search, were reviewed by two researchers with experience in medical care at PHC. Recommendations whose measurement required information sources other than those existing in health units and those that involved care at a higher level than PHC were eliminated.In order to reduce the number of recommendations while maintaining those with the highest degree of recommendation and measurement feasibility, a prioritization matrix was constructed. For this, we used the scoring system according to compliance with criteria based on the degree of recommendation, the feasibility of application, and ease of obtaining the sample necessary for measurement and relevance .The review was conducted in pairs by experts in quality of care and the disagreements were resolved through discussion and consensus. The values of each criterion were added to obtain a total score ranging from 0 to 12 points, considering the recommendation to be more useful when the score was higher. The highest scores were selected for each step of the care process  at each stage .The selected recommendations were reviewed by a group of experts in nutrition and quality of care to reduce the set to a manageable number for collecting information in the field and to be valid for the context of care in health services in Mexico.For the development of the indicators, the methodology suggested by Saturno-Hernández  was follBased on the structure of the indicators and their formulas, a data collection instrument was designed using Excel spreadsheets to facilitate its use in any electronic device.A pilot study was carried out to evaluate the reliability of the 22 indicators and the feasibility of their application. This study was performed in five PHC rural and urban units belonging to the Mexican Ministry of Health in the State of Mexico.The clinical records and nutritional control cards were the inputs to obtain the necessary information to evaluate the indicators. Each indicator was evaluated by two independent researchers by reviewing a systematic random sample of 30 clinical records and nutritional control cards for each life stage .The sampling was carried out through patient records on the Child Nutrition Status Control cards (SINBA-SIS-18-P) and Comprehensive Care for Pregnancy, Puerperium, and Lactation Period (SINBA-SIS-38-P)  from 202The reliability of the indicators was evaluated by inter-rater agreement based on the results of the kappa adjusted for prevalence and inter-rater bias (PABAK). Indicators with a result equal to or greater than 0.4 were considered reliable, taking into account the Benchmark scale .Feasibility was established based on the possibility of being measured through the available data sources in the medical units, recording the difficulties that arose during measurement.Based on the reliability and feasibility results, the group of experts carried out a second prioritization exercise to keep a feasible number of indicators that would be manageable by health personnel.Of the 922 recommendations identified in this work, 124 were excluded  since they were related to the second level of care or required information other than the available in health units. With the selected recommendations, 22 composite indicators were constructed and tested in the pilot study. The reliability of the indicators obtained in the pilot study is shown in Considering the aspects mentioned in “Materials and methods” section, we selected 16 indicators to assess the quality of nutritional maternal and child care at health units at PHC . We deciWe carried out, for the first time in Mexico, a systematic and validated process for the development of indicators to assess the quality of maternal and child nutritional care at PHC that can be implemented within the Mexican health system.The activities evaluated by the 16 selected indicators coincide with the recommended evidence-based nutrition actions over the life course by WHO  for imprIt is important to consider that the validation of indicators took place in a period in which Mexico and the entire world were in a pandemic due to SARS-CoV-2. The pandemic conditioned, on the one hand, the low demand for services due to confinement measures, the difficulties in transportation, or the fear of getting infected; and on the other hand, the decrease in the supply of health services. The health services that were the most affected by this situation were family planning, prenatal, obstetric, and postnatal care, newborn care, child care, adolescents, sexual, and reproductive health, chronic diseases, and nutrition programs. The latter were completely interrupted in some cases . As a reThe principal limitation identified during the validation process was the inability to measure the feasibility of all indicators due to the lack of clinical records. Clinical records are the source documents for most studies on the health care process; however, it is important to be aware of the deficiencies that prevail in these records in clinical practice in general. Some authors point out that the lack of adequate clinical records is not incompatible with good clinical practice . NeverthIn the pilot study, neglect or even lack of clinical records was observed; this did not allow the evaluation of relevant aspects of the care process for the different forms of malnutrition. This lack of clinical records may be due to an omission of care activities carried out by health personnel, which could cause problems in monitoring the health status of health service users. The absence of clinical records is also evidence of the quality of the care process.In addition, for some indicators, the number of medical records necessary to be able to estimate the reliability statistics was not completed. However, it was considered necessary to maintain some indicators that presented difficulties for their measurement, due to the relevance indicated by the scientific literature and the experts. For example, regarding the indicators of the preconception stage such as “Folic acid supplementation,” no records were found about patients who were planning a pregnancy; therefore, to assess the care provided to this group, alternative sources must be used, such as the registry of pregnant patients. Even though feasibility and reliability could not be evaluated in the indicators belonging to preconception, we decided to keep them in the group of the 16 final indicators due to the importance of the nutritional status at this stage in the course and outcome of pregnancy in both the mother and the offspring.Despite the limitations, to our knowledge, this is the first effort to design and validate a systematic set of indicators to evaluate the quality of maternal and child nutritional care. We consider it relevant to have indicators that allow evaluating the quality of maternal and child nutritional care that make it possible to highlight areas of opportunity, variability of care, and progress in the improvement of care. This study provides a path to focus on quality-improvement initiatives within PHC. The 16 indicators developed were used to assess the quality of maternal and child nutritional care in health units of PHC in six states in Mexico. The results of this evaluation will be published shortly.The systematic use of the 16 indicators at the PHC to monitor and evaluate the quality of maternal and child nutritional care could contribute substantially to improving the nutritional status during preconception, pregnancy, postpartum, infancy, and preschool stage at the individual and population level.The original contributions presented in this study are included in the article/MA-M, SH, IO-G, and SB-M: conceptualization and design. MA-M, IO-G, SH, AB-M, OA-R, MV-C, EM, CP, SB-M, MK-H, CM-M, MM, BS, MB, MS, and FC: investigation. MA-M, IO-G, AB-M, OA-R, CP, MV-C, MB, MS, AC, BS, and FC: supervision of the investigation. MA-M, IO-G, SH, AB-M, OA-R, MV-C, EM, MK-H, CP, SB-M, MB, MS, and FC: methodology. IO-G, SB-M, AC, BS, and AT-D: data curation and organization of the databases. EM, AB-M, and OA-R: formal statistical analysis. MA-M, IO-G, AB-M, OA-R, MK-H, CM-M, MM, and FC: review and edition of the manuscript. All authors contributed to manuscript revision, read, and approved the submitted version.


Food Security, Sustainability, and Food Policy, and these journals focus on the publication of comprehensive views from interdisciplinary perspectives. (2) Studies on food security cover 138 countries or regions. The top three countries in terms of the number of published articles are the United States, the United Kingdom, and China. Among the top 20 countries in terms of the number of published articles, European countries are highlighted. (3) Climate change, food security, agriculture, policy, and management are the other high-frequency keywords in the field of food security; climate change occurred 321 times. The word sub-Saharan Africa also occurred more frequently, indicating that food security in sub-Saharan Africa has attracted wide attention. (4) The food security theme mapping clearly showed the research status and future development trends of various topics in the field. Currently, food production, climate change, and sustainable development are the most popular themes. Research on food sovereignty, ecological agriculture, child obesity, and other aspects is an emerging field. (5) We predict that in the future, the field of food security may focus on the expansion and improvement of the food security evaluation system, the balance between sustainable development and food security goals, the improvement of agricultural production and management efficiency, and the research on government policies and strategies. Our results provide a reference for grasping the current situation, key research direction, and development trend in the field of food security.Food security is related to human wellbeing and sustainable development and an important guarantee for world peace. In the context of global climate change, increased food demand, resource depletion, conflicts, and frequent public health emergencies, food security is widely seen as one of the top challenges. Food security research has obvious interdisciplinary characteristics, involving a wide range of fields. We analyzed the literature on food security in the Web of Science core collection from 1991 to 2021, using bibliometric methods with the aid of the Biblioshiny software package. By collecting, screening, analyzing, and visually expressing the literature data, the following conclusions were drawn: (1) In the past 30 years, the annual number of publications on food security increased. The period can be divided into three stages: 1991–2003 as the budding period, 2004–2012 as the development period, and 2013–2020 as the high-yield and active period. The top three journals discussing food security issues are  Food security concerns the stability of the international community and human wellbeing and plays an important role in sustainable development. The 2030 Agenda for Sustainable Development lists hunger eradication, achieving food security, and improving nutritional status as high-priority areas in the 17 Sustainable Development Goals , highligCurrently, research on food security mainly includes the connotation of food security, the influencing factors, and how to guarantee food security. In 1974, the UN Food and Agriculture Organization first defined food security as “we should ensure that anyone anywhere can get enough food for survival and health in the future”  Which topics containing food are the most popular in academia?(2)What is the current state of global cooperation on food security?(3)How do the keywords in food security research cluster together?(4)What areas of food security need further research?Research in the field of food security involves multiple disciplines and the comprehensive analysis of food security-related research from an interdisciplinary perspective to obtain an in-depth understanding of the current research situation. After Pritchard proposed the term bibliometrics in 1969, bibliometrics attracted global attention, which was most evident in the late 1970s. Bibliometric research mainly focuses on three fields: methodology, scientific information, and scientific policy, of which the first is the basic research field [Web of Science is the largest and most comprehensive collection of information resources in the world and contains more than 12,000 authoritative and high-impact academic journals in the fields of natural sciences, engineering, and biomedicine. We used the Web of Science core collection from the Web of Science database as the data source; the search method was the Topic Subject (TS) search, and the language was English. The search formula is TS = (“Food Security” or “Grain Security”). After deduplication and screening, 3734 documents in the field of food security, published between 1991 and 2021, were obtained, including 2832 research papers; 64 conference papers; 402 review articles; and 436 books, book chapters, letters, and other types of documents.Bibliometry, a traditional quantitative analysis method in the field of library and intelligence science, originated during World War II. After a long development period, it has been used in many disciplines and has become an important analysis method in scientific research. We combined bibliometric and other measurement research methods to process the retrieved literature information. The resulting data were further explored and analyzed using the software packages Bibliometric and VOS viewer and finally visualized for expression. This paper mainly observed and interpreted the overall literature data in the field of food security based on the publication volume evolution trend analysis, historical citation analysis, popular journal analysis, high-yield author analysis, main research country/institution analysis, keyword analysis, and theme analysis.The first step in a research review is conducting a research design, including raising research questions, clarifying research objectives, and identifying research methods . The secThe number of documents is an important indicator of the development stage of a certain field and a reference standard to predict the future trend. Food Security in 2009, on the issues of “how to define food security” and “how to measure food security” [By analyzing the local and global citation rates of the articles in the field of food security, we found that most of the top-cited articles were published around 2010, indicating that the research results in the field of food security during this period were more influential . The artecurity” . The sececurity” . The estecurity” . Dana [2ecurity”  called fecurity” , the conecurity” , and theecurity” ,25. In aecurity” ,27 also Food Policy, entitled “Food security: a post-modern perspective” [Global Environmental Change, revealed the possibility of a phosphate shortage in the future, emphasizing the importance of scientifically managing the phosphorus resources in the global food system.In Biblioshiny, 20 nodes were selected, representing seminal work within the domain and some classical studies . The earpective” , with thpective” , publish2. The core area was composed of seven journals; the journal with the largest number of articles was Food Security, and that with the highest H-index was Food Policy , with 119 articles. It is an international organization dedicated to providing research on food security, hunger eradication, and poverty and is a benchmark research institute in the field of food security. It is followed by Cornell University and Wageningen University, with 75 and 70 papers, respectively . The foritations . The ageKeywords are a high-level summary of the topic of the article, and analyzing keywords in the field can quickly and accurately capture research hot-spots. Regarding the field of food security, the frequency of individual keywords represented the number of research findings. Climate change was the most frequently encountered keyword and was detected 321 times. Climate change directly affected the four pillars of food security  and had the most extensive impact on food security. The second most frequently occurring keywords were agriculture, policy, management, poverty, and insecurity, indicating that these aspects were highly related to food security. Sub-Saharan Africa (68 times), China (50 times), and India (27 times) appeared as keywords, showing that these countries were the focus of food security research . For a lTheme mapping is a method that combines the advantages of traditional indexing and artificial intelligence, with keywords as the core of the data model to efficiently analyze its centrality and density, with the aim of exploring and reasoning about research topics. Theme maps can solve the problems caused by a large amount of disordered information. The horizontal and vertical axes indicate centrality and density, respectively, representing the workload and importance of the subject, respectively . The theFood production, climate change, and sustainability are currently the most popular themes, with high research density and centrality in the field of food security. The topics related to water security, energy security, water footprint, and the environment, whilst receiving a lot of attention, are not closely integrated with food security. The number and centrality of studies on food sovereignty, ecological agriculture, and childhood obesity were not high, indicating that these are emerging fields. In recent years, due to the impact of international conflicts and the COVID-19 pandemic, the issue of food sovereignty has received extensive attention . ResearcResearch on food security concerns various areas, and the content of such research has been constantly enriched, with significant progress in recent years. Studies in this field are of great significance for judging the development trend of food security scientifically and rationally. The development and evolution of the concept of food security have obvious stage and historical characteristics. The understanding of the connotation of food security has been constantly enriched and improved, and the results have gradually changed from theoretical to applied results. At first, food security mainly emphasized the sufficiency of food production and supply. After that, studies in food security began to pay equal attention to the total amount of food and quality safety and to the balance of food supply and demand ,6. In reThe whole research and development process in the field of food security can be understood through the analysis of article references, high-frequency keywords, countries and institutions, and thematic maps. At present, the mainstream view is that the countermeasures and suggestions for food security should be discussed mainly based on the four pillars, availability, access, utilization, and stability. Climate change, food nutrition and security, and sustainable agricultural development are hot issues in the field of food security research. From the perspective of disciplines, the interdisciplinary trend of food security research is obvious, and a growing number of scholars in environmental science, demography, and geography are paying attention to food security. Some research fields focus on ensuring food security and putting forward corresponding countermeasures and suggestions. Scientists construct the evaluation index system of food security from the perspective of food production, distribution, consumption, and food reserves . Among tThe goal of food security research is to achieve food security in quantity, quality, and nutrition. Although the grain output still maintains a steady upward trend, and the nutritional level continues to improve, guaranteeing food security still faces enormous challenges, and the food security situation is still severe. Climate change poses many food security issues. Studies have shown that rising global temperatures and more extreme weather events will reduce the production of major food crops such as wheat, corn, and rice. To adapt to future climate change, adopting improved varieties, changing planting dates, and optimizing irrigation systems are important measures. Considering the productivity and sustainability of food and achieving the dual goals of food security and sustainable development are crucial topics. Agriculture accounts for 34% of greenhouse gas emissions, with the majority of them coming from land-use changes caused by agricultural activities and the rest from the food production supply chain . AchieviAgro-ecosystems are heavily dependent on water resources, and an increase in food demand will inevitably lead to an increase in water demand . Many scAccording to our analysis of the existing research results, we believe that the following issues in the field of food security will receive attention in the future:(1) Improvement of the evaluation system for the food security level: The global food security measurement requires a complete indicator system. Demographic, climate, financial , and policy factors combined influence food security. In 2000, the Committee on World Food Security comprehensively considered consumption, health, and nutrition and formed seven monitoring indicators: (a) the incidence of undernourished population; (b) per capita dietary energy supply; (c) the proportion of grain and rhizome food calories in the per capita dietary energy supply; (d) life expectancy at birth; (e) mortality rate of children under 5 years; (f) proportion of underweight children under 5 years; (g) proportion of adults with a body mass index >18.5. Although the developed countries have sufficient access to food as a whole, local food insecurity is the main problem. For many developing countries, the root cause of food security is still food insufficiency caused by poverty. Numerous publications related to the indicator system have also been produced at national and regional levels, but the current evaluation indicator system is still not comprehensive enough and can only reflect part of the food security level. Food security at the micro-level has gradually become a hot topic, and the measures at the family and individual levels need to be further improved.(2) Balancing sustainable development and food security: In the early stage, the degradation of natural resources, the decline in farmland production potential , and wat(3) Research on improving agricultural production and management efficiency: There are still defects in grain production, sales, and management, along with an unreasonable allocation of resources and an untimely market supply. Improving the quality of agricultural products , adjusti(4) Research on government food security policies and strategies: Currently, there are more severe food shortages in the world’s hunger hot-spots. In the context of intensive agricultural development, the rapid development of high-tech fields and the formation of technical barriers have widened the gap in the level of food security among countries. In the case of insufficient policy and institutional guarantees, along with the development of technology, the agricultural technology gap between developed and undeveloped countries will widen increasingly, making the poor population face a more serious food crisis. In the face of conflicts and disputes, natural disasters, and public health emergencies, the type of food security policies should also be the focus of sustainable food security research.The comparative analysis of relevant studies helps to determine differences, make up for deficiencies, and enrich research results. At present, research on food security involves factors such as concept, population, production, circulation, trade, policy, and the environment. The research perspective is multi-dimensional, and it can deeply discuss some specific issues. The literature is fruitful, and this research field is receiving increasing attention. However, the discussions on food security are scattered, ignoring the systematic characteristics of the research object, and it is difficult to form a unified logical main line connecting different research perspectives. We understood the development of food security research from a macro-perspective and noted the correlation between major research groups and countries as well as the distribution of research topics; we also analyzed the research results of major articles and authors. Our research attempts to clarify the cognitive context of academic circles on hot issues of food security help scholars understand the latest content of food security and can provide a reference for in-depth research on food security issues.This paper only used the core dataset in the Web of Science database as the data source. According to the retrieval conditions, the publications were from 1991 to 2022. Undeniably, there were some important research achievements before 1991. In addition, to exclude the interference of non-whole years with the research results, our research includes studies published before 31 December 2021. Therefore, we only analyzed the research results related to food security in the past 30 years. Our research is based on a single database, ignoring articles included in Scopus, CNKI, and other databases. In our following study, we will therefore explore how to incorporate other databases according to the current discussion, with the aim of expanding our research horizon.Food Security, Sustainability, and Food Policy published the largest numbers of articles and are dedicated to the discussion of food security issues, focusing on the publication of comprehensive views from interdisciplinary perspectives. Food security research covers 138 countries or regions, and the United States is at the vanguard in both quantity and quality. China is the developing country with the most significant contribution to food security research. Food security in sub-Saharan Africa, India, and other regions has received extensive attention. It is worth noting that most mature countries and institutions studying food security are located in Europe. Therefore, strengthening international cooperation in food security is the key to solving the world food problem. Climate change is the most frequently occurring keyword in the field of food security, followed by agriculture and management. The food security theme mapping shows that food production, climate change, and sustainable development had the highest research centrality degree and densities in the field of food security. Poverty in sub-Saharan Africa and India is an important theme for food security. At the same time, it is predicted that ecological agriculture, nutritional security, and food sovereignty will be research topics with good prospects.In this study, we quantitatively analyzed the current state of research in the field of food security, based on the literature related to food security in the Web of Science database and combining the advantages of different bibliometric software packages. The results show that in the past 30 years, food security has experienced three stages of development, namely the initial stage, the development stage, and the high-yield and active stage; scholars’ understanding of the connotation of food security has been enriched and improved; and the research results have gradually changed from theory to application and are more practical and operable. The journals To realize the world food security vision, the increasingly complex context of the global economy, including global climate change, production factors, technological progress, and international cooperation, needs to be considered. Maintaining and developing food security under the premise of sustainable development is the core of food security. Improving the food security index system, balancing the relationship between sustainable development and food security, improving the efficiency of agricultural production and management, and research on government food security policies and strategies will be the focus of the future.


Over the years, the Mexican population in the United States has faced high prevalence of health-related inequalities and disadvantages and represents one of the most vulnerable migrant groups in the country. To help reduce the gaps in health care for the Mexican population, the Mexican government, in collaboration with strategic allies from various sectors, launched the Ventanillas de Salud (VDS) strategy, which was subsequently reinforced through the Mobile Health Units (MHU) care model. Both the VDS strategy and the MHU care model are intended to contribute to the development of initiatives, projects, and actions in health that will benefit the Mexican community living in the United States, which lacks or has difficulty accessing health services. This article provides a descriptive, analytical analysis of the VDS strategy and the MHU care model, as unique collaborative models, which can be replicated, and have achieved a positive impact on the health of Mexican and other Hispanic communities in the United States, at both the individual and community level. According to data from the Current Population Survey 2020, the Hispanic population in the United States (62.1 million people) represents 18.6% of the total population (331 million), while the community of Mexican origin (38.5 million) accounts for 11.5%. Within this Hispanic community, the majority have American citizenship (80.2% Hispanics and 81.2% Mexicans), either by birth or naturalization; one in 10 obtained Legal Permanent Resident status and one in 10 lacks documents for their legal stay in the United States. In absolute numbers, 10.8 million of all Hispanics lack medical coverage, of which 7.2 million are of Mexican origin . This annual event takes place in October when health is promoted and access to various medical services and prevention activities is facilitated  strategy was implemented as a pilot project in the Mexican Consulates in San Diego and Los Angeles, California, with the support of the United States-Mexico Border Health Commission (USMCB), the United States-Mexico Health Initiative , the University of California and The California Endowment .To fulfill its mission, VDS has over six hundred allies which include health institutions such as hospitals and federal health centers, community clinics, government organizations and educational institutions, which contribute to providing screening services, delivery of printed educational material, and help with navigating the health system in the United States, among others. These collaborative partners comprise a broad and valuable network that provides comprehensive preventive health services including health education, screening, and referrals.To strengthen the VDS, the Mobile Health Units's (MHU) care model was created to provide preventive health services to remote communities with difficult access to health services. Eleven MHU currently operate in cities with a large concentration of Hispanic populations: Chicago, Dallas, Denver, Las Vegas, Los Angeles, Miami, New York, Orlando, Phoenix, Raleigh, and Tucson .The VDS strategy was initiated in response to the success of the Binational Health Week and its acceptance by the community. During this event, preventive and health promotion services are offered annually to Hispanics who typically experience barriers to accessing such services in the United States. Such improved access and acceptance led community leaders and local organizations to request long term continuity of these services. In 2003, the VDS strategy was implemented as a pilot project at the Mexican Consulates in San Diego and Los Angeles, California, with the support of the United States-Mexico Border Health Commission and the United States-Mexico Health initiative , from the University of California and The California Endowment. In 2004, the VDS strategy was formally launched and extended to other consulates. With the aim of strengthening and expanding the coverage of preventive health services for the Mexican community in the United States to remote communities unable to access health services, in 2016, the first phase of the MHU care model was implemented in Dallas, Los Angeles, New York, Phoenix and Chicago. Its services were subsequently extended to Denver, Las Vegas, Raleigh, Orlando, Miami, and Tucson .The VDS strategy is an example of government and institutional collaboration with strategic allies in Mexico and the United States. The resources, both monetary and in kind, required to provide basic preventive services, are contributed by the following actors:Seed moneyInstitutional collaboration- Mexican govermentSpace on their premisesTechnology and support officeAlliancesTraining- Consular networkManage and operate the VDSSelect and hire staffGenerate intervention projectsOrganize fairs and events- Lead agenciesProvide specialied personnelPerform screening tests and administration fof vaccinesCarry out workshops and deliver educational materials and workshopsParticipate in health fairs and training- Network of associated agenciesThe VDS strategy has an advisory board comprised of nine members, including leaders in the health and migrant assistance sectors, who represent different sectors: government, academia, the non-government sector, and international organizations, from Mexico and the United States. The purpose of the Advisory Board is to provide advice on management, innovation, and binational managerial strengthening processes with the various sectors to improve strategy .In general, VDS and MHU focus on conditions with the highest incidence rates among the Mexican population living in the United States, grouping services into five categories:Counseling on prevention and health promotion issues through advice on priority health issues, such as nutrition, obesity, diabetes, women's health, child health, mental health, addictions, HIV/AIDS, and access to services, among others.1) Timely detection of various ailments, using measurements such as body mass index, cholesterol and glucose tests, and HIV/AIDS and COVID-19 tests.2) Referrals to health services available in their locality (community clinics), related to cultural and language particularities, to receive medical care if necessary and/or establish a medical home.3) Administration of flu and COVID-19 vaccines and for other illnesses.4) Advice on health insurance alternatives in the United States.5) Activities undertaken by VDS and MHU are based on training health promoters in priority health issues to strengthen their skills and provide comprehensive preventive health services for users . During In addition, these activities were supported using culturally adapted educational materials in Spanish focusing on health promotion and disease prevention. Between 2020 and the first semester of 2021, technical content was developed on various priority health topics , which subsequently allowed the design of 301 educational materials. The material is disseminated in community events and through social media networks: Facebook, Twitter, Instagram, YouTube, and the VDS strategy website.Likewise, in 2018, the Mexican Section of USMBHC launched the mental health initiative. In collaboration with the Pan American Health Organization (PAHO), it implemented training in the Mental Health Gap Action Programme (mhGAP) Intervention Guide designed to help health personnel and community health workers  reduce gaps in mental health. The training covers issues such as risk factors and warning signs of mental illness and information on depression, anxiety, trauma, and psychosis either to help a person cope with the mental health problem and/or to refer them in a timely manner to professional help .SICRESAL-MX, the data collection system previously described in the methods section, is the official mechanism for registering users of VDS and MHU services and for generating real-time quantitative data describing the sociodemographic and health conditions of users and the VDS and MHU services received by users. The database is a rich source of information with about 283 variables. Its importance lies in the fact that the capture of such data through the registration process enables its analysis through descriptive statistics for decision-making and the strengthening of preventive health services.The VDS strategy has met the needs of their users by providing comprehensive health services through culturally adapted preventive health promotion actions, by contributing to disease control, and preventing the use of emergency service through timely detection.The MHU care model has taken these services to remote communities that are unable to access health services, thus, reaching a sector of a vulnerable community and broadening the scope of services.According to data from SICRESAL-MX, between 2019 and 2021, the VDS and MHU served approximately 6.4 million people and provided 20.7 million services, of which 88.2% corresponded to counseling or advice, 8.1% to screening, 3.1% to vaccination services, 0.2% to information on other issues, and 0.1% to referrals. This level of care has achieved a favorable impact on the health of Hispanic VDS service community in the United States by offering preventive services that enable identifying ailments and raising health issue awareness. In addition, it contributes to disease control and prevents the use of emergency services through timely detection, service availability advice, and aiding in the establishment of a medical home. Likewise, because of the COVID-19 pandemic, services were expanded to adapt to the new context.Of those receiving screening services for specific conditions at the VDS and MHU, the most important data are presented below :Glucose screening showed that two out of every 10 people screened at VDS and three out of 10 at MHU displayed high levels.An alarming piece of data is that around three-quarters of people screened in VDS and MHU have overweight and obesity problems, especially men.In general, three out of 10 users attended VDS and MHU had high cholesterol levels. Once again, a higher percentage of men experienced this condition compared with women, especially among those who attended VDS.While six of every 10 persons had high blood pressure, women experienced a higher prevalence than men.During the period of analysis (2019–2021), data from the SICRESAL-MX related to family history of illness of 41,000 people receiving either VDS and/or MHU services showed that 55% have a family history of diabetes and 20% have a family history of obesity. In addition, 452 mental health screenings were performed during this period indicating the prevalence of the following: depression (40%), anxiety (16%), psychosis (14%), violence (8%), sexual problems (8%), and other more rare conditions (14%).During the period of analysis, just over 154,000 people were served at VDS and MHU and provided information on their medical coverage . These dThe services provided by VDS and MHU in the United States are crucial for several reasons:First, there is a large and growing size of Hispanic population living in the United States. According to data from the most recent Census conducted in 2020, the total Hispanic population living in the United States amounted to 62.1 million, of whom approximately 62% were of Mexican origin (38.5 million people).Second, it addresses the predominant characteristics that act as barriers to medical care among this population such as their economic status, limited command of the English language, and limited access to health services that result in them suffering from poorer health.Third, the VDS and MHU address conditions that stem from a history of chronic-degenerative illnesses and diseases among the Mexican population, such as obesity, diabetes, and hypertension, documented both in Mexico, through the National Survey of Health and Nutrition , and theFourth, in recent years mental health has become a major concern in offering preventive and holistic care and giving it the same level of care as physical health problems receive. VDS and MHU began an initiative to approach healthcare among Mexicans in the United States to detect mental health signs and symptoms, and to refer them to access local or online services.Fifth in the face of the COVID-19 pandemic, VDS and MHU adapted its services and system and type of care offered to continue providing in person preventive services, such as administering vaccines, also, providing remote services, showing their ability to adapt and respond to emerging needs.Given these characteristics and based on the results of the quantitative analysis, both VDS and MHU are considered successful models in managing to detect the specific needs of their users and adapting to the context where they are implemented. They have also been strengthened over the years, thanks to their network of strategic allies in each consular district, which in turn manifests their perseverance, coordination, and institutional commitment.VDS and MHU have proven to be an important model of collaboration. Through alliances with institutions from different sectors, VDS and MHU have managed to direct outreach to a vulnerable sector of the Hispanic population to reduce the gap in access to health services. It is a unique care model, serving co-nationals in another country, contributing not only to the benefit of the health and wellness of Mexicans in the United States, but also to the health and wellness of other neighboring Hispanics.The ability of the VDS/MHU to effectively organize and manage health outreach services and to connect clients to these services, particularly in the area of COVID-19 and mental health, is a testament to the strength of its diverse network of collaborators in Mexico and the United States.In conclusion, we would like to suggest the following actions to strengthen the VDS and MHU services and ensure the continuity of the strategy. First, VDS and MHU should identify and formalize collaborations with strategic allies to promote the supply and distribution of the COVID-19 vaccine and others vaccines to the neediest and most vulnerable migrant communities. Second, it is also important to strengthen the mental health module. The relevancy of this module was highlighted by the COVID-19 pandemic and the detrimental impact on mental health related to social distancing and sheltering in place. Third, the VDS and MHU requires greater dissemination of the work carried out to strengthen their actions and give continuity to the strategy.The VDS strategy has been instrumental in providing much needed health-related preventive services to hard-to-reach populations and communities which they would otherwise have been unable to obtain.The datasets generated for this study are available on reasonable request to the corresponding author.IL and SS first draft and data analysis. MR, AL, AR, MC, LG, and CR revision and final draft. All authors contributed to the article and approved the submitted version.Initial funding for the project provided by the Mexican Government.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer KD declared a past co-authorship with the authors MG and CR to the handling editor.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


The growing pressure of anthropogenic activities on ecosystems and the ongoing climate change, as well as natural phenomena, influence the set of organisms organized in communities and ecosystems. Among the stressors that affect organisms are (among others): global warming and the resultant increase of temperatures of water and terrestrial habitats, the spread of pollutants e.g., metals, pesticides, persistent organic pollutants, or drugs. All organisms, subjected to the influence of these agents, react in altered metabolism, malfunctions of physiological processes, or behavioral alterations. If not balanced, these changes may lead to significant changes in populations and whole ecosystems. Importantly, the human-derived negative stimuli are often sudden, which disturbs the homeostasis in organisms.2-acidification and desiccation. The papers deal with the important groups of invertebrates: insects and crustaceans. Also, the range of the levels of biological organization, tested within the studies was wide: a transcription factor p53, heat shock proteins (Hsp70 and Hsp90), enzymatic activity, cellular studies, metabolism, reproduction, locomotion, morphology, and survival. As one can notice, the authors of the present Research Topic focused on the global-change threats. Among the most important findings, we may find the results indicating the importance of p53 proteins, which take part in the regulation of cell cycle, for the survival in the altered salinity of water as a habitat, significance of Hsp proteins in response to the environmental stress, relation between altered physical properties  and development of representatives of invertebrates.The importance of responding to the growing anthropo-pressure has repercussions in scientific literature. There is a growing interest of the scientific community in the effects of anthropogenic activity on living organisms. A brief analysis of the number of papers published on this topic shows the increasing trend of publications concerning pollutants, the environment, and invertebrates . These aRen et al for the first time reported that the expression of p53 mRNA and p53 protein levels are increased in case of altered salinity. Moreover, apoptosis and activity of antioxidant enzymes in the gills of arthropods exposed to stress varied significantly. The prooxidant-antioxidant balance is crucial for the homeostasis of organisms, and the imbalance may lead to numerous important diseases within organisms and play an important role in various pathological conditions, leading to cell damage. Next, Glyphodes pyloalis, based on studies of Hsp proteins. They also highlighted these proteins’ role in response to stressors. On the other hand, Leiva et al. presented a set of data showing the classical toxic effects: survival, biomass, development, and morphology. Interestingly, they integrated the abovementioned effects with the metabolic rate and antioxidant-enzyme activity. Their results clearly show the thread caused by anthropogenic changes in the biosphere of living organisms, including endangered species, and a wide range of levels of biological systems. Engell Dahl and Renault showed the effects of desiccation–which may coincide with the effect of global warming–on a beetle, Alphitobius diaperinus. They also focused on the similar effects on the level of organisms: survival, locomotion, and reproduction. The tenebrionid beetles are quite resistant to the lack of water, as they often live in crop and food stores. However, the stress led to reduced fertility. Together with the previously mentioned research of The presented results show the complicity of the effects of stressors, as well as the importance of keeping homeostasis at all levels of biological organization. Taken together, the papers presented in this research topic show complexity of effects caused by environmental stressors on invertebrates. The imbalance of homeostasis can be observed at all levels of biological organization, from biomolecules, through suborganismal levels, up to the levels of individual organisms and populations. This, in consequence, may lead to drastic changes within ecosystems. The results indicate the importance of multi-level research on the effects of stressors on invertebrates.


Nature Communications 10.1038/s41467-019-13929-1, published online 05 February 2020Correction to: In the published version of this paper, the members of the Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium were listed in the Supplementary Information; however, these members should have been included in the main paper. The original Article has been corrected to include the members and affiliations of the PCAWG Consortium in the main paper; the corrections have been made to the HTML version of the Article but not the PDF version. In the PCAWG Drivers and Functional Interpretation Group, the affiliation for Erik Larsson has also been changed from ‘Computational Biology Center, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.’ to ‘Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden’. Additional corrections to affiliations and author names have been made to the PDF and HTML versions of the original Article for consistency of information between the PCAWG list and the main paper.


Infectious Diseases of Poverty [Global Report for Research on Infectious Diseases of Poverty [Infectious Diseases of Poverty.Exactly 10 years ago, on 25 October 2012, a group of scientists, policy-makers, and practitioners undertook an ambitious project to launch a new open-access journal, named The aim of the new journal was to publish a blend of original research articles and more empirical work, the latter embracing different types of articles, including scoping reviews, case studies, opinion pieces, and policy briefs. Its focus was to be on infectious diseases of poverty, coinciding with the launch of WHO’s first roadmap to overcome the global impact of neglected tropical diseases (NTDs) earlier that year , and undInfectious Diseases of Poverty, provides a juncture to review the relationship between the scope of publications and the journal’s impact. During the last decade, the journal has endorsed and promoted the One Health discipline, which has evolved from concept to practices [One World, One Health Conference formulating the Manhattan principles in 2004, to the action plan that has been formulated by four international organizations, namely the Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (WOAH/OIE), the United Nations Environmental Programme (UNEP), and WHO. Over the years, the number of publications and their citations of One Health research has grown considerably [The event to celebrate the 10th anniversary of continuous publication of the journal, ractices , and froiderably . In paraInfectious Disease of Poverty has been climbing up as well, exceeding 10 in 2021 with an H-index of 47, according to the Web of Sciences (accessed on 6 October 2022). Importantly, the journal continues to engage participants from the low- and middle-income countries (LMICs) in the leadership, management and dissemination of its outputs. These developments are complemented by a series of remarkable milestones  fora.Thirdly, the journal has made efforts to disseminate seminal research findings by 18 international channels, such as e-mail campaigns, editor picks, landing pages, cross-journal promotion, among others. This has substantially improved the visibility of the journal, the articles, and the authors of the respective papers. Multidisciplinary topics and promotional efforts have made the journal a reputable and valued academic platform for scientists, policy-makers, professionals, and students in the field of infectious diseases and One Health. As of September 2022, the journal has published 1060 papers by 5298 authors from 108 countries, that were downloaded over 4.7 million times. Such a huge amount of dissemination has facilitated collaboration between scientists worldwide. Yet, an analysis of authors’ cross-country collaborations has shown that the People’s Republic of China, the United States of America, the United Kingdom, Switzerland, and European countries still constitute most of the research-centres of collaboration in the field of infectious diseases of poverty, and that much more remains to be done to foster key competencies to conduct programmes from tropical and sub-tropical regions (Fig. As programmes to prevent, control, and eliminate infectious diseases of poverty have considerably been hampered by the COVID-19 pandemic with an estimated delay in the realization of the SDGs by 2030 , the jou


Pavlov and Cajal were two influential scientists who developed their work in the late nineteenth and early twentieth centuries. Both won the Nobel Prize in Physiology or Medicine. The authors analyze the similarities between their life and work, delving into a single aspect: the Nobel prize obtained by both with only two years of difference: Pavlov in 1904 and Cajal in 1906, shared with Camilo Golgi. Both belonged to two declining empires when nationalism was still of some importance. The theories proposed by them more than 115 years ago are still valid in much of what they contributed in their respective disciplines. Both won the Nobel Prize in Physiology or Medicine with a short chronological difference: Pavlov in 1904 and Cajal (shared with Camilo Golgi) in 1906,There are similarities between their life and work. Since it is impossible to cover the work of both, the authors have decided to delve into only one aspect: the Nobel Prize won by both with only two years of difference, Pavlov:1904, and Cajal:1906th century and in the first half of the 20th century, which tragically unleashed the First and Second World Wars. Nationalism impacted on the scientific field, as a source of competition in achievements between countries, for example, the Nobel prizes in science: Physiology or Medicine, Physics, Chemistry, to their creditThe historical context of these two characters was marked by a strong nationalism in Europe, both in the second half of the 19,Pavlov and Cajal both belonged to empires in decline; Russia, the home country of Pavlov, and Spain of Cajal. These two scientists, their Nobel prizes, and other distinctions obtained by them, were also of the most significant importanceCajal published in 1899 the first edition of his masterpiece "Texture of the nervous system of man and vertebrates" only a year before the "Disaster of 98" occurred, caused by the war between the United States of America and Spain. After a few naval battles, all lost by Spain, the decadent empire asked to sign a peace treaty, yielding independence to Cuba, and the cession of Puerto Rico, the Philippines, and Guam to the United States, which became a colonial powerIvan Pavlov's extensive and productive investigative career took place in Tsarist Russia and post-October 1917 Soviet RussiaRegarding the Nobel Prize, the juries had difficulties awarding it to Pavlov in 1904, his main competitor being Cajal,The controversy also had another ingredient. Many researchers worked alone, and Pavlov was the first to research with his Ph.D. students at the St. Petersburg Institute of Experimental Medicine. Some jurors had doubts about the originality of his work,Pavlov went to Stockholm to receive the award, becoming the first Russian scientist to obtain it. At 55, the scientist peaked his career: international recognition for his work and financial compensation of 73,000 gold rubles . He assigned it to his laboratory and future research,,Cajal, in turn, had become the leading exponent of the "neuronal doctrine," in opposition to the "reticularists," who did not accept the existence of unicellular structures in the nervous systemJones (1998), cited by GrantFinally, it would be the neural doctrine that ended up being accepted and the one that prevails, in almost all its aspects, to this day.


Throughout history, technologies have been created to increase the health of society. In general, technologies have been developed to improve processes and reduce costs. One of the most important issues is the development of new health technologies. Today, the use of nanotechnology, biotechnology, intelligent electronic systems, artificial intelligence, etc. to increase the health of society is very noticeable.In the present study, using the data obtained from the Iran National Registry of Drowning (INRD), new methods and technologies in drowning prevention have been studied.The proposed technologies for drowning are important in three ways: i-To improve processes (increase accuracy and ease of prevention), ii-To reduce the costs , and iii- To generate income from new methods (creating a market and producing new equipment). For example, a robotic detector from Coral Detection Systems that scans the pool for drowning activity is a high-tech system for the reduction of mortality. Finally, it can be said that the development of new equipment and methods in preventing drowning and launching startups in this area is very important to increase not only the level of community health but also the income of the swimming industry.Advanced Technologies, Drowning, Prevention, Iran


Smart cities are the future development direction of cities and are a comprehensive expression of the development of the organic life body of cities. The organic life form of a smart city relates to viewing the city as an organic life self-organizing system based on the wholeness and systemic nature of the smart city life form itself, to construct a holistic spatial linkage of the functions and mechanisms of the city life system, and to enhance the overall vitality of the space. This study is based on the literature of “smart city” research in the China National Knowledge Infrastructure (CNKI) database, and the current situation and related themes of smart city research in China are discussed through co-word analysis and cluster analysis using software such as SPSS and VOSviewer, among which there are four themes in co-word cluster analysis, namely, intelligent technology supporting smart city research; research on the integration of the social system of a smart city; research on the top-level strategic design and planning and construction of a smart city; and research on the development, evaluation, and concrete practice of smart city construction. Four conclusions are drawn from the development of smart city research in China: Firstly, smart city research has attracted the attention of multiple disciplines, and the research themes are scattered and integrated across disciplinary systems. Secondly, smart city construction, development rules, and characteristics need to be further explored, and the problems, future trends, and policy support for the modernization of China’s cities and towns have been focused on engineering and technology, with a lack of practical research in non-technical areas such as humanities and ethics. Thirdly, the philosophical humanism and ecological ethics of smart cities need to be systematized, and their construction and development needs to be humanistic, systematic, and comprehensive, thus contributing to the sustainability, livability, ecology, and wisdom of future urban development. Fourthly, the development of the smart city system is supported by theories related to global cities and innovative cities, and the world city, a product of globalization, is undergoing a transformation into a digital and intelligent organic urban life form. Since International Business Machines Corporation (IBM) put forward the concept of a “smart earth” in 2008, with the spatial application of information and intelligent technology, the term smart city has gradually become synonymous with the future development of the city. In 2012, China promulgated the Notice on Carrying Out the National Smart City Pilot Work, which marked the beginning of the specific practical work of China’s smart city construction. China’s smart city construction has experienced more than ten years of development. At present, the relevant themes need to be grasped as a whole, so as to summarize the development law, enrich the theoretical framework, and provide corresponding guidance for specific practical problems. Smart city construction promotes the optimization of urban ecosystems with intelligent perception and interconnection integration from five aspects: concept strategy, social development, economic development, spatial planning, and infrastructure, so as to provide corresponding methods and strategies to solve the problems faced by urban development [It is clear that smart cities are of significant value to the current problems and challenges encountered in urban development, and a large number of research results have emerged. The technological revolution has led to changes in traditional production and lifestyles, profoundly altering the way society is organized and the way urban space operates, shaping a whole new pattern of human urban social systems. Smart cities driven by digital and intelligent technologies have emerged, and the development of smart city construction relies on the interaction process between modern intelligent technologies and urban development needs. However, the specific objectives and action plans of smart city construction are applied piecemeal in the field of urban construction and rely excessively on the technical sphere, forcing people to experience unsatisfactory results and other real problems that need to be addressed accordingly. Based on this, this paper analyzes the state of smart city research in China, further explores the evolution of smart city research paradigms, tracks research frontiers and research hotspots, and provides reference and guidance for future smart city practice and theoretical research.From the specific practice of smart city development, it has become mainstream to build and develop smart cities around technology support. Governments around the world are focusing on smart city projects to achieve diverse goals such as sustainability, citizen engagement, and improved services . The devFrom the perspective of the theoretical development of a smart city, the theoretical connotation of a smart city and its technical support framework have undergone changes in specific practice. Smart City Version 1.0 is a smart urban solution promoted by technology companies; Smart City Version 2.0 is a local government solution leading the improvement of residents’ lives and sustainable lifestyles; Smart City Version 3.0 is a community collaboration model, which includes the best strategic solutions for citizens, policy makers, enterprises, and other subjects . The devBased on smart cities as a global issue involved in local practice, the issue of how to develop rationalized standards and norms for smart cities and the dynamic competition between world cities and second and third tier ‘follower’ cities have become globally engaged issues. To some extent, the global character of smart cities and the transformative governance issues they represent point the way to future research and policy practice . ThroughAlthough international research on smart cities started earlier, Chinese smart city research has just begun. In terms of research content, Chinese smart city research is more focused on technological innovation and infrastructure development, while international research is broader, covering technology, policy, and humanities; at the same time, international research is more concerned with the economic value derived from smart city construction, while Chinese research is more concerned with its public value. Many studies have addressed the conceptualization of the smart city itself, with one illuminating definition being that a smart city is a system integration of technological infrastructure that relies on advanced data processing with the goals of making city governance more efficient, citizens happier, businesses more prosperous, and the environment more sustainable . In viewBibliometrics is a cross-cutting science field that uses mathematical methods of mathematical statistics to analyze the literature in a field of interest. VOSviewer is commonly used in bibliometrics as visual mapping software to structure and visualize the knowledge domain of the literature by extracting data units and constructing a visual spectrum of the relationships between data. The SPSS statistical analysis process includes descriptive statistics, general linear models, regression analysis, log-linear models, cluster analysis, time series analysis, multiple responses, etc. COOC software is mainly used for literature database de-duplication, co-occurrence matrix, two-mode matrix, similarity matrix, etc. Bibliometric tools are commonly used in various disciplines of social and natural sciences to achieve a holistic grasp of trends and the current state of research in related disciplines through the processing of large amounts of data from relevant literature. This study is a bibliometric approach to data analysis of the literature related to "smart cities", and the research design is broadly divided into the following sections : (1) RetThe data used in this paper were obtained from the CNKI database. As of 31 March 2022, the title, key words, and abstract containing “smart city” were selected. The source categories of journals were searched, i.e., Peking University core, CSSCI journals, and CSCD journals, and a total of 2236 documents were retrieved. After the literature was processed , 1976 documents were finally obtained as sample data.Co-word analysis uses SPSS, COOC, VOSviewer, and other software to analyze the degree of association between words, such as keyword clustering, second mock examination co-occurrence analysis, hierarchical clustering, and so on, to outline the current situation of smart city research. Co-word analysis shows the relationship between the research objects through data and images, then summarizes the relevant literature, and discusses the research status and future development trend of smart cities.In this study, the year, author, journal, and high-frequency keywords were analyzed through bibliometric metrics. Specifically, (1) the annual publication of China’s smart city research was analyzed, (2) VOSviewer, COOC, and other software were used to analyze co-appearing authors and keywords and journals and keywords, and then the two-model co-occurrence relationship between related authors, journals, and keywords was excavated, and (3) multi-level clustering analysis and keyword clustering co-occurrence analysis were carried out for high-frequency keywords.According to the time distribution map of smart city research literature , China’sThere were 54 authors whose frequency was greater than or equal to five times, and 51 keywords whose frequency was greater than or equal to 10 times. The second mock examination of the co-occurrence of authors (54) and keywords (51)  represenThe 41 journals have published 10 or more articles. In addition, the 51 keywords had a frequency of 10 or more times. Visual analysis of the second mock examination of the co-occurrence between journals (41) and keywords (51) was carried out, and the results are shown in The keyword fields of the 1976 documents were measured by COOC  softwareThe 51 keyword dissimilarity matrix  in the CThe co-occurrence matrix of 51 keywords from the CNKI database  was impoKeyword clustering in According to The application of the latest technology in the Internet of Things era has accelerated the construction of urban infrastructure and has realized human–computer interaction and human–human interaction through network transmission, bringing convenience to human production and life. Unfortunately, however, the contradiction between user privacy and forensic investigation is inevitable. How to protect privacy and security based on forensic services requires corresponding solutions to provide a reasonable framework to ultimately ensure the security of data flow across domains . Data drThere is an “innovation alienation trap” in the science and technology innovation cycle. The irrational perception of the science and technology innovation cycle, the purpose of innovation, and the relationship between the city and society has led to problems in the process of using science and technology for smart city construction. It is necessary to understand the characteristics of the science and technology innovation cycle and its value objectives, to accurately grasp the scale of innovation, to create a good innovation space, to stimulate innovation, and to achieve a sustainable model of smart city development . The conThe “true wisdom” of smart city construction in the new crown epidemic period needs to be people-centered, and it needs to turn “crisis” into “opportunity”, “individuality”, and “collectivity” integration and to create an intelligent governance model of multi-subject co-governance . Major pResearch on specific practice areas of smart city society: The concepts of “Industry 4.0”, “Society 5.0”, and “Connected Industry” have gradually become the consensus of modern social development, promoted the construction of the national strategic extension framework system of smart cities, taken suitability, technology, comprehensiveness, and systematization as the basic requirements for improving the development of smart cities, and explored strategic docking and cooperation such as science and technology strategies and industrial enterprises . From thUrban planning and design, construction, development, evaluation systems, and other related research: Smart city construction is inseparable from digital infrastructure, and competitive advantages should be ensured in the fields of top-level design and core technology research and development. Compared with latecomer countries, the US digital infrastructure does not have an advantage , and theSustainable urbanization and informatization have become the trends of urban social development, and the use of informatization means to promote the sustainable development of urbanization and realize a low-carbon and sustainable urbanization ecological resilience system . Urban gWe need to promote the construction of smart cities and explore the realization path of smart governance based on four dimensions: governance concept, model, system, and mode . We needWe need to promote the construction of smart cities, the digital layout of global scenarios, and realize the construction of standardized systems for digital society and digital community infrastructure. We need to promote urban digitalization and refined governance, solve the problem of community governance application scenarios, and drive the development of science and technology industries related to urban construction . EnterprIn this paper, the selected literature data were limited to the CNKI database, and international databases were not comparatively studied, which makes the research data sample too localized and does not truly reflect the international value of China’s smart city research. In the next step of our research, we should strengthen the use of international databases to promote the international integration of China’s smart city research discourse system. Smart city research has attracted extensive attention from many disciplines, including urban science, management science, geographic science, urban sociology, economics, and other multidisciplinary fields. China’s smart city research focuses on the essential connotation, historical development, influential factors, logical framework, industrial application, and other fields of smart cities. In the future, the research on smart city construction should focus on the practical exploration of interdisciplinary system integration, urban digital simulation, dynamic mechanisms, and so on . ThroughFirst, the research theme of China’s smart city shows a tendency of scattered fragmentation. To a certain extent, there is no unified framework for domestic smart city research, which shows that smart city theory is in the initial stage of exploration, and its connotation essence has not reached a consensus, and the smart city framework under different theoretical frameworks is also different. Among them, the construction of smart cities from the perspective of system theory generates a holistic intelligent system through the coupling of three major systems: physical city, social city, and digital city, so as to realize digital, sustainable development and creative city construction . From thSecond, the law of smart city construction and development needs to be further explored. For example, urban governance, especially the governance of megacities, needs to explore a social governance path that conforms to the characteristics of the development laws of megacities, pay attention to the construction of a digital and intelligent urban governance system, improve the level of urban services, and make cities more agile, intelligent, ecological, and livable. At present, population aging has become a development trend in China. How to use big data to drive the precise and intelligent development of the traditional pension model has become a real problem. The big data platform can accurately meet the needs of the elderly and guarantee that the flow of data, capital, and service is coordinated and unified, the allocation of resources is optimized, and the healthy and orderly development of the aging society is realized .Third, the philosophical humanism and ecological ethics of smart cities need to be systematized. The risks encountered in urban governance in the digital era need to be considered from the overall nature of urban society, and issues such as technical risks and the nature of human practice should be examined from the perspective of urban ethics to provide reasonable space for the innovation of the co-construction system of smart city construction . The coaFourth, the organic life form of a smart city needs to be nourished by theories related to global cities, innovative cities, and urban innovation. The world city, a product of globalization, is undergoing a transformation into a digital, intelligent organic city life form, a process that will inevitably bring about structural changes in society, which will in turn affect the industrial system of the urban space and issues such as citizen participation. The organic and innovative smart city is a system in which innovation agents, mechanisms, and environments interact with each other, with intrinsic dynamic mechanisms driving the sustainable economic, social, and cultural development of the city.Finally, smart cities may reshape the future of urban development, and the technocratic-induced critique of smart cities will become a new model for the vision of neoliberal urban governance. With the rise of the critical discourse on smart cities, the framework of the smart city vision needs to be redefined and combined with a case study of the smart city in Cologne, Germany, to demonstrate social innovation and the future changes of sustainable cities that are “genuinely” smart . Smart c


Cognitive decline is a gradual neurodegenerative process that is affected by genetic and environmental factors. The doctor-patient relationship in the healthcare for cognitive decline is in a “shallow” medical world. With the development of data science, virtual reality, artificial intelligence, and digital twin, the introduction of the concept of the metaverse in medicine has brought alternative and complementary strategies in the intervention of cognitive decline. This article technically analyzes the application scenarios and paradigms of the metaverse in medicine in the field of mental health, such as hospital management, diagnosis, prediction, prevention, rehabilitation, progression delay, assisting life, companionship, and supervision. The metaverse in medicine has made primary progress in education, immersive consultation, dental disease, and Parkinson's disease, bringing revolutionary prospects for non-pharmacological complementary treatment of cognitive decline and other mental problems. In particular, with the demand for non-face-to-face communication generated by the global COVID-19 epidemic, the needs for uncontactable healthcare service for the elderly have increased. The paradigm of self-monitoring, self-healing, and healthcare experienced by the elderly through the metaverse in medicine, especially from meta-platform, meta-community, and meta-hospital, will be generated, which will reconstruct the service modes for the elderly people. The future map of the metaverse in medicine is huge, which depends on the co-construction of community partners. By 2050, the global population over the age of 60 will be about 210 million, and more than 130 million may suffer from Alzheimer's disease (AD) , which lAt present, the relationship established between patients with cognitive decline and their doctors is still in a “shallow” medical world, and the service for the healthcare for cognitive decline needs to be improved. First, the ordinary medical archives did not fully cover the information about the patient's daily life and their environmental conditions. The diagnosis and treatment were based on insufficient participation of the patients lacking data on life logging. Second, scientific management in life, sports, and entertainment for the elderly was lacking. Third, trust and effective communication between doctors and patients were lacking. To effectively solve the above problems, establishing a new medical world with deep empathy among doctors and patients is urgent. This article technically analyzed the application scenarios and paradigms of the metaverse in mental health and proposed that people in the related fields around the world work together.Telehealthcare has been used in the treatment and research of intellectual developmental disorders , which pThe metaverse technology applied in the field of education and teaching is called the Metaverse in Education, and applied in the field of healthcare and medicine is called the Metaverse in Health and the Metaverse in Medicine. The International Association and Alliance of Metaverse in Medicine (IAMM) released an Expert Consensus, defining 2022 as the 1st year of “Metaverse in Medicine,” and defining the Metaverse in Medicine as the medical internet of things (IOT) practiced through augmented reality (AR) technology using AR glasses or virtual reality (VR) glasses . Kye et The metaverse in medicine supports immersive senses and has a wide range of application scenarios. It can be applied in medical education and training, diagnosis, prediction, prevention, delay progress, supervision, elderly companionship, life assistance, and recovery for patients at risk or suffering from cognitive decline.Under the outbreak of COVID-19 pneumonia, the paradigm of non-face-to-face detection, self-healing, and self-healthcare will be generated through the metaverse platform, metaverse community, and metaverse hospital. “Meta-hospital” is a cloud platform of the metaverse in medicine serving cloud doctors, cloud patients, and educators, in which education, training, consultation, diagnosis and treatment, popular science publicity, home testing, and clinical research are carried out.The digital twin technology in the metaverse is used to construct the digital scenarios of the hospital. A digital twin is a virtual form of a physical entity, with dynamic, bi-directional links between the physical entity and its original twin in the digital domain . DigitalArtificial intelligence technology has obtained reliable results in genetic diagnosis and neuropsychological diagnoses of neurodevelopmental diseases, such as intellectual disability, autism, and depression , 14, whiThe clinical diagnosis of cognitive decline needs clinical evaluation and psychiatric test data, as well as neuroimaging and neurophysiological data. Brain neuroimaging and neurophysiological data provide important information on the changes in brain structure and function. In view of the gradual development of AD, full-time lifelogging, at-home motion sensor, multi-mode environment monitor, wearable monitor, and handwriting computer analysis were used to continuously record the activities, so as to obtain the dynamic data that could not be obtained before . Sensor *c) dimensions, where m represents the size of pixel blocks * pixel blocks in the image, and c represents the number of pictures. The input text data are treated by natural language processing and recognized by the model in the form of (m*c) dimension. In the cross attention layer of the model, Q(uery), K(ey), and V are used to split the input vector into a series of < key, value > data pairs. By calculating the similarity and correlation between Q and each element, the weight coefficient of V corresponding to each k is obtained, and the weighted sum of V is calculated. Since the flattened image data have a large m value, to reduce the dimension, the dimension-reduced Q is obtained through the asymmetry projection, and then enters the attention layer, which greatly reduces the calculation time and training complexity. The obtained hidden features were input into the transformer to get the feature results, and this process is repeated for 48 layers, and then the average results and final feature judgments are obtained.To realize the fusion of the above multimodal data, a transformer-based attention iteration model is introduced. In this model, data of different modes can be input. The input image is flattened into  and depression, relieving pain, improving amblyopia, coping with traumatic brain injury, and Parkinson's disease. Consultation and treatment by the man-machine dialog of mental disorders were realized in 2015. VR is an efficient rehabilitation tool for stroke, Parkinson's disease, and other neurological diseases .With the development of the metaverse in medicine, more products with the function of lifelogging and with games and sports elements for the elderly will enter their lives. By 2022, the number of connected wearable devices in the world is estimated to exceed 1.1 billion. The Vidicon revenue and auto-cameras are designed for patients with severe memory loss. All the images, sound around them, and experiences were captured and stored, so as to help them recall where they have been and what they have done at any time. AI intelligent speakers accompanied the elderly to chat. A social robot named Elli Q could gradually get to know the elderly and help them with online social networking and online games. An alcove immersive social software solved the problem of spatial distance and could experience the reality of offline social interaction. With VR and AI technology, all-around immersive global travel, shopping, fitting, and exploration can be experienced without leaving home. With the microchips implanted in the human brain, human consciousness was digitized. It is expected to be used for reconnecting the patient with the outside world who suffered from injury to the brain and nerves. Combined with nano-robot targeted therapy, brain-computer interface (BCI) will give more exciting medical application prospects.The metaverse is the next stage of internet mode to break the limitation of the real world. The physical world, the spiritual world, and the knowledge world are connected, and the human-machine and the spirit-machine are combined to give the elderly unlimited super ability and freedom, and bloom their lives and realize their dreams again.Metaverse is used in some time-dependent first aid processes, such as sudden death, stroke, myocardial infarction, fall, shock, asthma, choking, epilepsy, acute abdomen, and other sudden diseases of the elderly. There are two main stages: the pre-hospital stage and the treatment stage in the hospital. All the processes can be mimicked in fine-grain by digital twin technology. The time flow and information flow of life of the patients can be intelligently replayed, helping to identify the abnormalities and respond quickly. Using digital twin technology, a twin script based on the real ambulance and emergency environment using various sensors was digitally reconstructed, which highly restored the details of emergency facilities and equipment, integrated rendering and seamless roaming. The digital pre-judgment in the pre-h stage is very important for deciding what level of rescue action the rescuers trigger in the second stage. According to the patient's condition, decide whether the first aid team is triggered and the hospital needs to make preparations during the transfer. Virtual services make the physical world more efficient, more convenient, more secure, and lower cost.The metaverse requires the support of computing power and underlying technology, engine, platform, and APP. Among them, underlying technologies include digital twin, extended reality (XR), and internet of things (IoT) . It was launched by the international cooperation team in 2020 and promoted in the community. The brief structure is as follows.The project module includes four components: decentralized application (DAPP), gateway, donor networks, and distributed autonomous corporation (DAC). The SINSO DAPP component can quickly match the experts for consultation. Based on the smart contract of the distributed autonomous company (DAC), users uploaded data through the API interface of the Gateway component. The data were labeled and classified on the Gateway component and preprocessed to protect privacy. On the Donor networks component, users' data assets were converted into non-fungible token (NFT) assets and automatically matched the purchasers. Authorized inquirers find files through the address in the blockchain, using the public key and private key to generate encryption keys to re-encrypt the files and feed them back to the inquirer. Data sharing was realized and value flowed on the premise of maximizing privacy and data security. On the DAPP components, the members were continuously expanded and encouraged from pilot area to large-scale demo area, from many micro metaverse to decentralized medical infrastructure, such as metacommunity and meta hospital.The periphery of SINO needs to be largely improved at this stage. A considerable part of the work is still similar to the process of road and bridge construction. Anonymous sharing of the medical data all over the world is a huge project for the medical industry, and the construction work is always on the road.We tried to plan the foreseeable blueprint of the metaverse in medicine through the existing applications. Although the current technology has not kept up with the imagination, at least what we can predict is that the market demand and application scope will increase continuously with the maturity of the technology. The metaverse will stimulate medical innovation and upgrade in a new way. It will make medical diagnosis and treatment more accurate, fast, and convenient, and its position will develop from auxiliary to dependent and indispensable function. In particular, the metaverse will break the rule of geriatric diagnosis and treatment habits. The proportion of self-service and remote diagnosis and treatment will increase. The management role of hospitals will be weakened, and hospitals will become a distributed node and lose their central position.On the other hand, because the world is facing uncertainty risks , in the short term, aging medicine is also subject to uncertainty pressures, such as shrinking internal demand, supply shocks, and weakening expectations, and the development and application of geriatric metaverse products are also restricted. Furthermore, the technology has its own limitations. For example, a 3D experience is not ideal since the digital twin is still at an early stage. The construction cost is high. The small metaverse established dispersedly without a unified standard will face problems when integrating later. The research and development of methods for multimodal technology integration lag behind. The XR equipment access to the metaverse is not convenient. With more and more clients accessing, the problems caused by large concurrent network connections need to be solved. Therefore, it needs to be deeply integrated with different industries to form a unified standard for sharing data, and finally can be integrated. Although the prospect is not very clear at present, in the long run, the metaverse is the way to the future of medicine.The world will be at the peak of aging. Long-term and unremitting efforts should be made to improve this social problem. It is necessary to take population-based AD prediction and mental healthcare as long-term goals. Fortunately, with the advent of population aging, we are entering the fourth industrial revolution triggered by AI technology, which brings hope to solve many aging-related problems. As an innovative medical environment, the metaverse in medicine represents a milestone of intelligent medicine. People from all fields actively seize positions in the metaverse. In particular, with the global epidemic, a growing need for uncontact medicine and healthcare for the elderly has emerged, which put forward the demand for non-face-to-face social communication. Through the platform of the metaverse in medicine, the elderly users will activate their own strength, reshape the elderly health system and lifestyle, and experience the paradigm of self-monitoring, self-diagnosis, self-healing, and self-care. It may help the elderly from a consumer group to a self-service group with the ability of sustainable development. As more data are added to the metaverse in medicine, this new paradigm will become an important preventive tool for the diagnosis and treatment of cognitive decline and AD.HZ is responsible for drafting some contents of AI and metaverse. J-YG is responsible for literature retrieval. YC is responsible for the conception, drafting, and revision of the thesis. All authors contributed to the article and approved the submitted version.This work was supported in part by the funds of the Collaborative Education Project of Industry-University Cooperation of the Ministry of Education of China (202102100053); the Key Talents Project of Maternal and Child Health Care in Jiangsu Province (SFY202103); and the Top Medical Expert Project of Tai Hu Ren Cai Plan (2021-9).The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


According to the World Health Organisation goals of treatment of drug addiction are: reducing of drug use and craving, improving of health, well-being and social functioning of the affected individual, prevention of future harms by decreasing the risk of complications and relapse. Wellness means a sense of overall well-being incorporating numerous aspects of an individual’s life. These include physical, mental, emotional, intellectual, occupational, and spiritual aspects. For those who suffer from mental and substance use disorders, wellness means feeling a sense of purpose in life, being actively involved in work or play that is satisfying, finding happiness, having joyful relationships, and having a healthy body and living environment. .We will present different dimensions of wellness and describe how to incorporate these dimensions into drug addiction treatment.Presentation of theoretical frame and description of treatment programme at the Center for Treatment of Drug Addiction Ljubljana.When each of wellness dimensions is balanced, it is easier to maintain recovery process and avoid the triggers of relapse.In the context of wellness, treatment goal is to maximize the capacity of person to feel, think and act in ways that enhance his/her ability to enjoy life and deal with the challenges he/she face. Wellness lifestyle includes a balance of health habits such as adequate sleep and rest, productivity, exercise, participation in meaningful activity, nutrition, productivity, social contact, and supportive relationships.No significant relationships.