Dear Editor,Leishmania transmitted by the bite of a female sandfly of the genus Lutzomyia.L.(V.) braziliensis, L.(V.) guyanensis, and L.(L.) amazonensis.American tegumentary leishmaniasis (ATL) is an infectious disease caused by protozoa of the genus Leishmania guyanensis. The bacteriological culture of the fragment from the dorsum of the hand was positive for the Gram-negative bacillus Pseudomonas aeruginosa. The radiological examination showed bone sequestration and destruction of the cortex of the distal and middle phalanges of the third finger, suggestive of chronic osteomyelitis (+5/day intravenously for 30 days and cefepime, according to the sensitivity identified in the antibiogram, at a dose of 1 g 2×/day for 10 days, resulted in significant improvement in the skin lesions (This case report describes a 49-year-old male patient, a farmer, without comorbidities, from Maués, state of Amazonas, Brazil. He sought medical care at a Dermatology service complaining of a condition which had started three years before, with a papule on the proximal phalanx of the third finger, progressing to an ulcer that extended to the dorsum of the right hand. Considering the clinical picture, nine direct tests were performed to search for amastigotes, all with negative results. Different types of treatments with antibiotics and corticoids were prescribed without improvement, and with worsening and progression of the lesions for the last six months. On examination, an ulcer was observed on the dorsum of the right hand, covered by yellowish crusts, with clear and erythematous borders, which extended to the phalanges, resulting in anatomical deformity of the third finger. There were also nodules following an ascending lymphatic path, in the right forearm, some of which showed painless ulceration, with raised erythematous borders, measuring approximately 2 cm A and 1 Bmyelitis . The com lesions . The patATL can be classified into localized cutaneous, disseminated, diffuse, and mucocutaneous leishmaniasis.Among the atypical forms of ATL, the verrucous, lupoid, eczematous, zosteriform, tumor, acneiform, and sporotrichoid forms have been reported.The diagnosis should be based on epidemiology, lesion characteristics, direct examination, and culture. In atypical cases, histopathological examination and PCR are fundamental tools.5Direct examination is the most frequently used method for diagnosis because it is simple, inexpensive and easy to perform. However, the probability of finding the parasite is inversely proportional to the time of evolution of the skin lesions, being rare after one year.On histopathology, intense granulomatous inflammatory infiltrate is observed, and histiocytes, epithelioid and giant cells, lymphocytes, plasma cells, some eosinophils, and depending on the time of evolution, macrophages containing amastigotes can be seen.Leishmania guyanensis was crucial for the correct diagnosis and starting treatment.PCR, a method based on parasite DNA amplification, has a sensitivity and specificity of 100% in the typical forms and a sensitivity of 94% in atypical presentations.Pseudomonas aeruginosa, as well as the radiological alterations suggestive of persistent chronic osteomyelitis in the radiological control, suggest that the bone lesions observed in the present case were caused by contiguity from the secondary infection.The rare bone involvement reported in cases of ATL and proven infection by Despite its wide distribution in Brazil, atypical presentations of ATL can make the diagnosis difficult. Therefore, the relevance of epidemiology and PCR in atypical lesions is highlighted, as well as the importance of an early diagnosis, so that sequelae or mutilations can be prevented.None declared.Dina Fabrício da Silva: Approval of the final version of the manuscript; drafting and editing of the manuscript; collection, analysis, and interpretation of data; intellectual participation in the propaedeutic and/or therapeutic conduct of the case; critical review of the literature; critical review of the manuscript.Sidharta Quercia Gadelha: Approval of the final version of the manuscript; drafting and editing of the manuscript; collection, analysis, and interpretation of data; intellectual participation in the propaedeutic and/or therapeutic conduct of the case; critical review of the literature; critical review of the manuscript.Andréa de Souza Cavalcante: Approval of the final version of the manuscript; design and planning of the study; intellectual participation in the propaedeutic and/or therapeutic conduct of the case; critical review of the literature; critical review of the manuscript.Rosilene Viana de Andrade: Approval of the final version of the manuscript; design and planning of the study; participation in the writing of the histopathological report; critical review of the literature; critical review of the manuscript.Jorge Augusto de Oliveira Guerra: Approval of the final version of the manuscript; design and planning of the study; intellectual participation in the propaedeutic and/or therapeutic conduct of the case; critical review of the literature; critical review of the manuscript.Alcidarta dos Reis Gadelha: Approval of the final version of the manuscript; design and planning of the study; intellectual participation in the propaedeutic and/or therapeutic conduct of the case; critical review of the literature; critical review of the manuscript.None declared.


Background and Objectives: The purpose of this study is to enhance the quality of life in elderly patients with lung cancer by understanding relations of uncertainty, appraisal of uncertainty, self-efficacy, and quality of life targeting elderly patients with lung cancer receiving anticancer therapy, and also analyzing the factors affecting the quality of life based on Mishel’s theory. Materials and Methods: The subjects were a total of 112 lung cancer patients aged 65 or older receiving anticancer therapy. The data was collected by using self-report questionnaires targeting patients in hemato-oncology at Chungbuk National University Hospital. The data were analyzed using descriptive statistics, a t-test, an analysis of variance, Pearson’s correlational coefficients, and hierarchical regression analysis. Results: In stage 1, anticancer therapy (chemotherapy) , economic condition (low) , the number of anticancer therapies (three times or more) , and education (graduation from high school or higher)  were influencing factors . In stage 2, self-efficacy , appraisal of uncertainty: danger , appraisal of uncertainty: opportunity , the number of anticancer therapies (three times or more) , and anticancer therapy (chemotherapy)  were influencing factors, which showed 74.2% explanatory power . Conclusions: In order to improve the quality of life of subjects, it would be necessary to develop interventions for raising their self-efficacy by considering their degree of education, economic condition, the types and numbers of anticancer therapies, and understanding of the appraisal of uncertainty about the disease is assessed as an opportunity factor or a danger factor. In Republic of Korea, the elderly population aged 65 or older was 14.9% in 2019 [Meanwhile, thanks to the recent expansion of medical examinations and the development of treatment methods, the five-year relative survival rate of lung cancer patients has also improved . This meIn fact, recent studies have revealed that quality of life is a strong predictive factor of survival, highlighting its growing importance ,7. For iMoreover, the symptoms that lung cancer patients experience can have a negative impact on their physical, psychological, social, and spiritual well-being . InadequThe quality of life is a state of well-being that is subjectively appraised based on the general and overall situation or life experience in multidimensional areas such as physical, psychological, social, and functional . For canUncertainty refers to a lack of understanding of one’s disease, related treatments, post-treatment prognosis, and the inability to judge disease-related situations. If uncertainty persists throughout the course of the disease’s progression, it can be considered threatening as it delays the formation of cognitive structures and limits the ability to properly assess an individual’s situation . AccordiSince uncertainty in the early stages of disease becomes a changeable and destructive element, a patient appraises it as a ‘danger’. Once the uncertainty is continued, a certain order is built, and the uncertainty is appraised positively. In this case, it could be regarded as an ‘opportunity’ in life , so the In addition, self-efficacy is a dynamic process of appraising one’s own ability to perform actions necessary for coping with and adjusting to a potentially-threatening event . Due to This study is a descriptive survey research study for understanding the relations between uncertainty, appraisal of uncertainty, self-efficacy, and quality of life targeting elderly patients with lung cancer and also analyzing the factors affecting the quality of life. The research subjects were 112 elderly patients with lung cancer receiving anticancer therapy from a tertiary hospital in Chungbuk. The criteria for selection are as follows: (1) male and female senior citizens 65 or older; (2) people who received chemotherapy once or more after getting diagnosed with primary lung cancer; (3) people who have insight into the disease and an ability to communicate; and (4) people who understand the purpose of this study and have submitted written consent to participate in this study. The criteria for exclusion are people who were diagnosed with a cognitive disorder or mental illness, which was verified in their medical records. The researcher directly distributed 114 questionnaires and then conducted a face-to-face survey. After excluding two improper questionnaires, 112 people were finally included as research subjects.This study verified sex, age, marital status, main caregiver, degree of education, breadwinner, and economic condition as the sociodemographic characteristics and also researched diagnosis, clinical stage of lung cancer, types of anticancer therapy, and the number of anticancer therapies as the disease-related characteristics.In order to measure uncertainty, this study used the instrument translated into Korean by Chung et al.  in 2005 For the appraisal of uncertainty, this study used the instrument translated and verified for validity by Kang  based onIn the research by Mishel and Sorenson , the relSelf-efficacy was measured using the Korean-version instrument   of the cThe quality of life was measured through the Korean-version functional assessment of cancer therapy scale-lung (FACT-L), version 4 , developThe data were collected from 12 October 2022 to 27 January 2023 after obtaining approval from the institutional review board of Chungbuk National University Hospital. The research subjects were elderly patients with lung cancer suitable for the criteria of selection among outpatients and hospitalized patients in hemato-oncology. I met the subjects in the outpatient counseling room of the Department of Hematology at Chungbuk National University Hospital and collected data. The researcher fully explained the purpose and methods of this study, the confidentiality related to participation in this study, and the possibility of withdrawing their participation at any time with no damage to the subjects. After that, the patients voluntarily signed the written consent for their participation. The subjects filled out the self-report questionnaires for themselves. For the patients who found it difficult to fill out the questionnaire, the researcher directly read the content of the questionnaire and took down their responses. It took an average of 20–30 min to complete the survey. The collected data was kept in a cabinet with locks. A password was set up for the PC, including the research data, so no one else but the researcher could read the data.® Statistics 27.0 software made by IBM Corporation, Armonk, NY, USA, the general characteristics and disease-related characteristics of subjects were calculated through descriptive statistics such as real numbers, percentages, mean, and standard deviation. This study conducted the t-test and ANOVA for comparing the quality of life according to the general characteristics and disease-related characteristics of subjects and used the Scheffe test for the post-analysis. This study used the mean and standard deviation for the degree of uncertainty, appraisal of uncertainty: opportunity, appraisal of uncertainty: danger, self-efficacy, and quality of life of subjects, used Pearson’s correlational coefficients for relations of uncertainty, appraisal of uncertainty: opportunity, appraisal of uncertainty: danger, self-efficacy, and quality of life of subjects, and conducted hierarchical regression analysis for the factors affecting the quality of life of subjects.Using the SPSS± 5.65 years, and the range of age was 65~87 years. The most responses were obtained in married couples  for marital status, spouses  for main caregivers, and oneself or pensioners  for breadwinners. In terms of disease-related characteristics, most responses were obtained in non-small cell lung cancer  for diagnosis and stage III or IV  for the clinical stage. The types of anticancer therapy included immunotherapy , targeted therapy , chemotherapy , and radiotherapy and chemotherapy . In terms of the number of people receiving anticancer therapy, 73 people (65.2%) received it once.The general characteristics and disease-related characteristics of subjects are listed in p = 0.015), economic condition , types of anticancer therapy , and number of anticancer therapies  of subjects. In other words, people who graduated from high school or higher showed a higher quality of life than people who graduated from middle school or lower. The people who responded to economic conditions as middle showed a higher quality of life than the people who responded as low. In terms of the types of anticancer therapy, people who received immunotherapy or targeted therapy showed a higher quality of life than people who received chemotherapy. In the number of receiving anticancer therapy, the people with the first or second time showed higher quality of life than people with three times or more. There were no differences in the quality of life according to other general characteristics or disease-related characteristics.The comparison of the quality of life according to the general characteristics and disease-related characteristics of subjects is shown in The degree of uncertainty, appraisal of uncertainty: danger, appraisal of uncertainty: opportunity, self-efficacy, quality of life, and sub-areas of quality of life are shown in p < 0.001), appraisal of uncertainty: danger , appraisal of uncertainty: opportunity , and self-efficacy . In other words, the higher the degree of uncertainty and the higher the appraisal of uncertainty as a danger, the lower the quality of life of the participants. In addition, the higher the degree of self-efficacy and the higher the appraisal of uncertainty as an opportunity, the higher the quality of life of the participants.The relations of uncertainty, appraisal of uncertainty: danger, appraisal of uncertainty: opportunity, self-efficacy, and quality of life of subjects are shown in The analysis on the factors affecting the quality of life of subjects are presented in p < 0.001), economic condition (low) , the number of anticancer therapies (three times or more) , and graduation from high school or higher  showed statistically significant results, and those variables explained 36.5% of the quality of life of subjects . In the results of analyzing by adding uncertainty, appraisal of uncertainty: danger, appraisal of uncertainty: opportunity, and self-efficacy to the general characteristics and disease-related characteristics in step 2, self-efficacy , appraisal of uncertainty: danger , appraisal of uncertainty: opportunity , the number of anticancer therapy (three times or more) , anticancer therapy (chemotherapy)  were significant variables explaining the quality of life. As the explanatory power was increased by 37.7% compared to step 1, it totaled 74.2%, which was statistically significant .In the results of conducting the hierarchical regression analysis, in step 1, the degree of education, economic condition, types of anticancer therapy, and the number of anticancer therapies that showed significant differences among the general characteristics and disease-related characteristics were input. As a result, the variables such as anticancer therapies (chemotherapy) , or when receiving chemotherapy three or more times. Their variables explained 36.5% of the subject’s quality of life. In the second stage, the subject’s quality of life decreased when receiving anticancer therapy (chemotherapy) or more than three times of anticancer therapy. Additionally, the quality-of-life score increased by 0.1 points every time the subject’s score perceived uncertainty evaluation as an opportunity increased by 1 point, and the quality of life decreased by 0.18 points every time the score perceived as a danger increased by 1 point. In addition, each time the self-efficacy score increased by 1 point, the quality of life increased by 0.16 points. Their variables explained 74.2% of the subject’s quality of life. In the first stage, among the general characteristics that affect the quality of life and disease-related characteristics, chemotherapy was found to have the highest influence. Symptoms such as fatigue, nausea, vomiting, loss of appetite, and weight loss resulting from chemotherapy make it difficult for patients to have confidence in their future . As a reThe study also revealed that the quality of life tends to decrease as the number of chemotherapy cycles increases. These findings are consistent with a recent study by Hyun and Kim , which sThe most significant influencing factor in the second stage was self-efficacy, which affects quality of life. The study confirmed that higher self-efficacy is associated with a higher quality of life, which is consistent with other studies demonstrating the significant impact of self-efficacy on cancer patients’ quality of life ,51. AccoNext, the factors that were identified as affecting the quality of life were the appraisal of uncertainty as danger and the appraisal of uncertainty as opportunity. The appraisal of uncertainty has also been observed in studies of prostate cancer patients  and breaMeanwhile, in this study, it was confirmed that uncertainty does not affect quality of life. There was a difference from Kim’s  study, wThis study is significant in the aspect of understanding the degree of uncertainty, appraisal of uncertainty, self-efficacy, and quality of life of elderly patients with lung cancer receiving anticancer therapy and also verifying the factors affecting the improvement of the quality of life of elderly patients with lung cancer. However, since this study included elderly patients with lung cancer from a single university hospital for convenience and did not include a sufficient number of subjects, generalizing the results of this study to elderly patients with lung cancer is limited. Furthermore, it needs to be careful when interpreting the results of this study, as there could be influences according to the treatment stage and symptoms following the types of anticancer drugs. As a result of influencing factors that affect the quality of life of elderly patients with lung cancer, self-efficacy, appraisal of uncertainty: danger, appraisal of uncertainty: opportunity, the number of anticancer therapy (three times or more), anticancer therapy (chemotherapy), economic condition (low), and education (graduation from high school or over) were significant influencing factors. Accordingly, in order to improve the quality of life of elderly patients with lung cancer, we analyze the degree to which uncertainty is evaluated as an opportunity or danger, reduce what is recognized as a danger, help them recognize it as an opportunity, and increase self-efficacy. In addition, intervention is needed in consideration of education, economic conditions, the type of anticancer therapy, and the number of anticancer therapy.First, there should be expert interventions for improving the quality of life of elderly patients with lung cancer receiving anticancer therapy. It is highly possible for elderly patients with lung cancer to experience uncertainty and declining quality of life in the process of treating their cancer. Thus, to raise the quality of life of elderly patients with lung cancer, it is urgent to develop intervention programs for establishing effective management measures by considering the degree of education, economic condition, and types and several anticancer therapies. In particular, the type of treatment and the number of treatments require active expert intervention. Explanations to the patients and mutual cooperation between experts and patients will improve the quality of life.In addition, there should be consideration of the appraisal of uncertainty: danger, opportunity, and self-efficacy. Furthermore, there should be research on the quality of life of cancer patients using Mishel’s theory of uncertainty.


As the only blood vessels that can directly be seen in the whole body, pathological changes in retinal vessels are related to the metabolic state of the whole body and many systems, which seriously affect the vision and quality of life of patients. Timely diagnosis and treatment are key to improving vision prognosis. In recent years, with the rapid development of artificial intelligence, the application of artificial intelligence in ophthalmology has become increasingly extensive and in-depth, especially in the field of retinal vascular diseases. Research study results based on artificial intelligence and fundus images are remarkable and provides a great possibility for early diagnosis and treatment. This paper reviews the recent research progress on artificial intelligence in retinal vascular diseases . The limitations and challenges of the research process are also discussed. In 1956, artificial intelligence (AI) was first proposed. As a branch of computer science, the purpose of AI is to develop and study computer methods to simulate and expand human intelligence and perform complex tasks . MachineWith the rapid development of computer science in recent years, AI has made significant progress. AI has been applied in the field of medicine, especially in ophthalmology, and the clinical application of AI is particularly extensive. AI has been used to develop AI models for automatic diagnosis, screening, classification and treatment, especially in ophthalmic diseases such as ocular surface diseases , anterioRetinal vascular disease (RVD) is a major retinal disease. The vascular system of the retina is one of the components of the systemic circulatory system. There are many causes of retinal vascular diseases, including the effects of local eye diseases and systemic diseases on retinal vessels, which can be divided into the following categories: 1) retinal vascular obstructive diseases, such as retinal vein occlusion; 2) the effects of systemic diseases on retinal vessels, such as diabetes and hypertension; 3) retinal vascular inflammatory immune diseases, such as retinal periphlebitis; and 4) retinal vascular abnormalities and developmental abnormalities, such as retinopathy of prematurity. Retinal vascular disease can cause irreversible damage to retinal cells and can seriously affect the vision of patients. If patients are not treated in time, they will experience serious vision loss or blindness. Therefore, for patients with retinal vascular disease, early detection, diagnosis, and treatment are particularly important, but relatively insufficient resources for ophthalmic diagnosis and treatment greatly limit the early diagnosis and treatment of retinal vascular diseases. In recent years, AI has become increasingly used in ophthalmology, especially in image recognition and processing of retinal vascular diseases, which provides a new possibility for early diagnosis and treatment. This review summarizes the research achievements of AI for the diagnosis of retinal vascular diseases in recent years and discusses the limitations and challenges of the research.Using the AI model by Diabetes is a common metabolic disease that causes extensive damage to many tissues and organs in the body. Diabetic retinopathy (DR) is one of the most serious microvascular complications of diabetes and a common cause of blindness . The incBy analyzing the fundus examination images of DR patients, AI can complete the automatic diagnosis of DR, which is of great significance in improving the diagnostic and work efficiency of doctors. To build an AI model that can automatically detect DR, Hypertensive retinopathy (HR) is a common retinal vascular disease caused by long-term hypertension . Fundus In many studies, AI has been used to screen and diagnose HR, and the AI model constructed in this study showed good screening and diagnostic performance and has the potential for clinical application. AI is also used in the classification and grading of HR, which is expected to be used clinically to reduce the pressure on doctors. Retinal vein occlusion (RVO) is one of most common retinal vascular disease, second only to diabetic retinopathy, and more common in older patients . The patAs an important clinical assistant tool, AI has been widely used in the early screening of retinal vein occlusion, and especially in areas where lacking medical resources, AI can play an important role. To assist in screening for retinal vein occlusion, In addition, AI can help clinicians diagnose RVO by identifying and segmenting the characteristic lesions in the images of patients with RVO, thus reducing the workload of clinicians. Retinopathy of prematurity (ROP), also called retrolental fibroplasia, is a proliferative retinopathy of immature or low birth weight infants . Most ofTo automatically diagnose ROP, In recent years, AI model has made a lot of research achievements in assisting the clinical staging and grading diagnosis of ROP. In order to assist in the grading and staging of ROP, To detect the blood vessels in areas I, II, and III of children with ROP and to assist in assessing the severity of ROP, Age-related macular degeneration (AMD), also known as senile macular degeneration, is common in Europe, the United States, and other developed countries and is the main cause of blindness in the elderly in developed countries. Its incidence increases with age . At presTo assist clinicians in diagnosing age-related macular degeneration and distinguishing its different types, AI has carried out a lot of research in this area, with remarkable results. In addition to extensive research on the diagnosis and classification of AMD, AI has been used to predict the severity, disease progression, and therapeutic effect in patients with age-related macular degeneration. Based on the referenced studies, AI is widely used in retinal vascular diseases, especially in image recognition and data analysis. Although AI model shows superior performance in assisting the diagnosis, identification, screening, staging and grading of retinal vascular diseases, AI model also faces many limitations and challenges in the research process, which will seriously affect the further research of artificial intelligence in retinal vascular diseases and hinder its clinical application. Below, we list the main limitations and challenges of AI in research on retinal vascular diseases. 1) Image quality in the dataset : The imaAt present, the use of AI technology to assist clinicians in the study of ophthalmic images and other ophthalmic examinations is a current major focus. The combination of AI and ophthalmology will greatly improve the diagnosis of ophthalmic diseases, especially retinal vascular diseases based on the analysis of fundus images. The diagnosis model based on AI will be beneficial for the early detection, diagnosis, and treatment of retinal vascular diseases. Although the application of artificial intelligence in the field of ophthalmology has made a lot of research results, but from the overall situation, it is only the beginning. With further developments in computer science and technology, the application of AI in the field of ophthalmology will be more and more widely used in the field of ophthalmology. In addition, with the deepening of research, in addition to image processing and recognition, other artificial intelligence technologies will also carry out related research in the field of ophthalmology, so as to promote the continuous development of ophthalmology.


Currently, there is an active introduction of modern types of psychosocial treatment (PST). At the same time, an important direction is the evaluation of the effectiveness of PST, the identification of factors affecting it, which determines the urgency of research in this area.To evaluate the effectiveness of psychosocial treatment of patients with schizophrenia at different stages of psychiatric care; to build regression models to identify factors that influence the effectiveness of psychosocial treatment.Clinical and psychopathological, statistical, as well as a battery of tests: PANSS, CGI; Drug Attitude Inventory ; Insight Scale for Psychosis ; «SF-36 Health Status Survey» ; URICA ; The Social Adjustment Scale-Self ; PSP  and a number of other scales. 90 patients with schizophrenia in the community, inpatient department of psychiatric hospital, day hospital participated in the basic PST program, which included psychoeducation, motivational training, social and cognitive skills training. At each stage, PST was received by 30 patients who did not differ significantly in age and other socio-demographic characteristics, but were characterized by different quality of remission, the duration of the PST program was 3 months. The assessment of the patients’ condition was carried out before and after the rehabilitation program.A significant improvement in the indicators on the PANSS scale was found in patients of all three groups, as evidenced by a reduction of more than 10 points in the total score of the scale. As a result of the PST program, patients of all three groups have improved to varying degrees their awareness of the disease understanding of the need for drug treatment, increased motivation, and have shown a tendency to improve a number of cognitive functions. The participants of the program demonstrated an increase in the level of activity and purposefulness of activity, as well as the ability to master new social skills and implement them. Correlation and regression analysis, during which more than 100 factors were studied, allowed us to identify the most significant factors that positively or negatively affected the effectiveness of PST: severity of the condition, duration of illness, age of onset of the disease, age of referral to the service, number of hospitalizations, type of remission, observation group, level of education, marital status, family support, family relationships, having friends, having income.The effectiveness of the basic PST program has been shown. However, the work on evaluating the effectiveness of the PST should be continued, especially for the development of information criteria and a tool for its evaluation.None Declared


To analyze the concept of Health Advocacy from the methodological framework of the Evolutionary Model.The concept of interest was evaluated from the perspective of published studies identified in the databases: Web of Science, CINAHL, EMBASE, SCOPUS, MEDLINE and articles of interest. The attributes were determined from 19 scientific productions. Data were analyzed using thematic analysis, proposed by Bardin.The following operational definition was obtained: Health Advocacy is an intentional action, implemented jointly and in favor of individuals and communities, especially for those who suffer from health inequalities, with the aim of preserving and improving health, well-being and empowerment for health promotion.Thus, a broader concept of Health Advocacy was abstracted, from the micro to the macro, which contemplates the development of the patient’s autonomy; includes individuals and groups in care plans and involves them in political activities as possibilities to provide assistance and correct health inequalities. Among these assumptions, one can mention the guidance for health promotion. This, as a practice, involves empowerment to increase control over the factors that influence and impact health.In this perspective, the Galway Consensus, agreed in June 2008, subsidizes the implementation of health promotion actions through the standardization of fundamental competences to promote health, divided into nine domains: Favoring change, Health Advocacy, Partnership, Communication, Leadership, Diagnosis, Planning, Implementation and Evaluation and research. The document also emphasizes that the values and principles of health promotion are based on health determinants, equity, social justice and respect for diversity.Among the nine domains of competences, there is the concept of Health Advocacy, which is defined in the document Core Competencies in Health Promotion (CompHp), endorsed by the European Union, as: Claiming with and in favor of individuals, communities and organizations to improve health, well-being and capacity building for action in health promotion.It is understood that concepts are built throughout history, bringing significant contributions to the construction of knowledge. They are formed by identifying features common to a class of objects or phenomena. They are dynamic and strongly influenced by public socialization and interaction, and their development varies according to the social context,5. These concepts can be applied to advocacy exercised by a professional and directed at different individuals or groups and understood at macro and micro levels. Thus, the authors did not identify a study that would clarify this distinction, leading the concepts to be often used interchangeably.The concept of Health Advocacy, although defined in the literature, has gaps in terms of establishing well-defined limits and differentiating it from other similar concepts, such as Patient Advocacy, Environmental Advocacy, Self-advocacy and Nursing Advocacy,7.Additionally, there is a need to expand the investigation of the concept of Health Advocacy specifically in the field of Nursing (the CompHP definition has a multidisciplinary character), since the Health Advocacy exercised expressly by nurses has particular characteristics. However, exploring this concept can make the discussion about its applicability in nursing practice scenarios visible, expanding the understanding of the term and highlighting its relevance.The study aims to analyze the concept of Health Advocacy based on the methodological framework of the Evolutionary Model in order to make it possible to clarify the term and its distinction from similar ones, establishing a theoretical basis to guide practice and future studies.Concept analysis study, built from the methodological framework of the Evolutionary Model. According to the model, concepts are ideas, being better defined based on their use and the description of their set of attributes. It is a continuous process, subject to change, depending on the context, time and situation. The analysis of a concept must follow an inductive method, in which a consensus on the term is identified, its historical aspects are evaluated and elements of agreement and disagreement are determined in different areas.The concept analysis comprises six activities: 1. Identification of the concept of interest and associated expressions, in order to select the most appropriate terminology; 2. Choice of scenario and sample. In a literature-based analysis, setting refers to the period and areas or type of literature to be included; the sample is best available described in the relevant or pertinent literature; 3. Data collection and management to: highlight the attributes of the concept; and its contextual bases, antecedents, consequences and sociocultural and temporal variations, in order to understand the situations in which the concept can be used; 4. Data analysis, in general, through thematic analysis; 5. Identification of an example, when applicable, in order to clarify the application of the concept of interest; 6. Interpretation of results, with determination of implications, hypotheses and contributions to the future or continued development of the concept.In this study, the concept of interest in Health Advocacy was defined from the perspective of published and indexed studies in scientific databases: Web of Science, CINAHL, EMBASE, SCOPUS, MEDLINE/PUBMED and references to articles related to the concept. These databases were chosen due to the availability of productions with complex and detailed discussions on the topic. The CINAHL base was specifically chosen for its focus on Nursing and the others, given the efficiency of its coverageThe following inclusion criteria were used: original studies, reflective or reviews studies related to the theme of Health Advocacy; published in Portuguese, English or Spanish. Opinion articles, letters to the editor, previous notes were excluded; duplicate studies; research protocols; studies that did not describe the concept of Health Advocacy; and studies unavailable digitally or physically in full. The term Health Advocacy was used to search, and 4,001 results were identified. Excluding duplicates, 1,561 studies remained, which were read title and abstract, using a total of 19 articles that met the aforementioned criteria in this study.. The research protocol consists of nine data collection indicators: reference; year of publication; country of origin; concept; attributes; background; consequences; substitute terms; related concepts; use of the concept and application over time.For the follow-up of the study, a research protocol was adopted, which allowed its systematization, inductive reflective-critical reading and conceptual analysis. This protocol was chosen because it had already been used in another similar study, which also followed the activities described in the Evolutionary Model.The characterization of each of the elements proposed by Rodgers for concept analysis was used, as follows: Background - Aspects, situations and phenomena that contributed to the construction of the concept; Consequences - Refer to characteristics or phenomena generated after the construction of the concept; Substitute terms - Terms or expressions used that have the same meaning in articles; Related concepts - Concepts that contribute to the constitution of the evaluated concept; Attributes - Terms or expressions that characterize the concept. To clarify the application of the concept, the examples were demonstrated through the list of publications revealing the practical application of the concept, called empirical references and interpreted by contrasting the interdisciplinary findings.Data were analyzed using the thematic content analysis proposed by Bardin to carry out the analyzes and followed three phases: pre-analysis; exploration of the material and; treatment of results, inference and interpretation. The concepts extracted from each study were listed and the coding units were systematically identified in each text. Subsequently, these units were grouped into categories, called attributes. Finally, a single concept emerges from themes present in each category, listed considering the frequency and relevance of the inferred meaning of the coding units. To clarify the application of the concept, the examples were demonstrated through the list of publications revealing the practical application of the concept, called empirical referents and illustrated concomitantly with the antecedents and consequences. The results were displayed in tables and figures and interpreted by contrasting the interdisciplinary findings.Data were analyzed using content analysis, proposed by Bardin to carry out the analyzes and followed three phases: pre-analysis; exploration of the material and; treatment of results, inference and interpretationThe attributes of the Health Advocacy concept were grouped into four parts: starting point of the concept, who implements it, who benefits from it and what it achieves (objective), as shown in .Most authors describe Health Advocacy as an action and some qualify or attribute some requirements to it, such as: intentionality; planning; not biomedical, necessarily; and that goes beyond the regular demands. In addition, another author emphasizes Health Advocacy as a job, since it is configured as any practice that involves intention, time and effort. However, since Health Advocacy is characterized as an action, it is understood that its existence is configured in a field of practice. It is understood that the stimulus for initiating the Health Advocacy action will depend on basic conditions, such as individual beliefs.There is reference to Health Advocacy as a mindset and skill,28. An example of this occurs in the digital context, of social media, where a variety of topics are superficially discussed, without, however, presenting the potential to cause change.With regard to the characteristics of the action of Health Advocacy, it is a deliberate act. In this way, he must carry within himself the will to transform a reality, to intercede. Although it is understood that advocacy can manifest itself at macro and micro levels, there is a range of activities that should not be considered Health Advocacy,11. Thus, two important components of the concept of Health Advocacy emerge, the participation and empowerment of those who have a place to speak on the subject.The second group of attributes refers to the person responsible for implementing Health Advocacy. Different actors are reported in the literature, including individuals, groups, health professionals, organizations, communities and society. Therefore, it is understood that any individual or group can practice Health Advocacy. Authors emphasize that the action must be carried out jointly with the beneficiary. Corroborating this is the emphasis on the need to include training on Health Advocacy in the nursing curriculum. Furthermore, the search using the terms “Health Advocacy” and “Nursing” showed that publications specifically using the terminology Health Advocacy in this area are rare.Health advocacy implemented by nurses has particular characteristics, since it requires specific skills and actions from them, in addition to presenting facilities and barriers inherent in the area of nursing. However, this type of advocacy, while necessary, has little potential for long-term change. It is noteworthy that there are more vocal types of Health Advocacy and others that are more silent, so that health professionals tend to exercise the type that best suits their practices and lives.Among the studies on Health Advocacy in the context of nursing, those focusing on actions at the micro level, directed at individual patients and with an emphasis on barriers related to interprofessional relationships and institutional conflicts of interest, stand out.An example of Health Advocacy at the macro level would be actions to increase funding sources or change protocols for accessing gender-affirmative treatments by transgender people; and for micro advocacy it would be to help an individual patient who does not meet all the requirements present in a given protocol to gain access to gender reassignment treatment. They can be inspired to face contemporary and future challenges, reflecting on the work of nursing personalities, such as Lillian Wald, Dorothea Dix and Florence Nightingale. These historic leaders embraced and shaped the delivery of population-based health care and advocacy and policy making.When nurses practice advocacy, their own power, professional status, and job satisfaction are enhancedThis is followed by the division of attributes with the detailing of the beneficiaries of the Health Advocacy action. The terms individuals and collectivities, likewise, broadly cover all beneficiaries, even in cases where the action will be in favor of cases and causes. By way of clarification, cases such as advocacy exercised at micro levels are understood, in general, advocacy directed at a patient; causes, on the other hand, is configured in advocacy exercised at the macro level, with objectives that will benefit collectivities.Attributes two and three may be responsible for the variability of concepts related to Health Advocacy. It was observed that, in the context of health, there is a tendency to name the type of advocacy based on who performs it or benefits from it. The use of the term patient advocacy is frequently observed, for example, when the action is directed at a sick person; or the term advocacy in nursing when the action is implemented by nurses. These different usages result in confusion in the understanding and application of the terminologies.,5. However, it is commonly used interchangeably with Health Advocacy, even though Health Advocacy is not restricted to the benefit of patients. Therefore, the existence of a conceptual hierarchy is assumed.The concept of patient advocacy has been discussed previously. Other authors describe health advocacy as a combination of individual and social actions aimed at obtaining political commitment, social acceptance, policies and support systems. It is observed that in both examples they cite mechanisms and omit the actual purpose of the activity.Finally, the attributes related to the objectives to be achieved were grouped together. When it comes to the desired result, it is observed that some authors do not distinguish between recommendations for how to reach the intended objective itself. For example, authors state that health advocacy is an intentional action by health professionals to address health determinants that negatively impact individuals or the communityIn any case, a variety of different objectives were identified, which included: (a) structural changes, such as obtaining political commitment, social acceptance, policies and support systems, influencing authorities and individuals, addressing systemic problems, promoting social changes, economic, educational, and political, address health determinants, mobilize resources, influence health policy, create system change, reduce health threats, and address unhealthy systems; (b) curative perspectives, aiming to alleviate suffering, achieve health, guarantee access to care and the health system, implement the right to health and meet a health need; and (c) preventive perspective and health promotion, to achieve health promotion objectives, with a view to developing health promotion actions; and improve health and well-being.. In Brazil, equity is one of the principles of the health system and should be taken into account in the management of health actions and resources.Knowing that health is socially determined, for example by economic conditions, housing, food; actions to result in real impact on health require structural changes. At the same time, considering the range of demands, it is important that the strategies consider the need for health equityHealth Advocacy is based on the values of health promotion. Thus, a broader concept of health is assumed, contemplating individual perspectives and empowerment to maintain health. For example, when there is a movement to implement culture, leisure and sports activities in the community for the elderly population, there is a demand for health, instead of exclusively curative.Therefore, from the determination of the most relevant attributes, the operational definition was arrived at: Health Advocacy is configured as an intentional action, implemented jointly and in favor of individuals and collectivities, especially for those who suffer from inequities in health, with the aim of preserving or improving health, well-being and empowering for health promotion.,30.Although the terminology Health Advocacy appears in studies published from 1974 to 1993, the publications referred to the term without proceeding with its previous definition or continuing with the concept of advocacy only. Some researchers have tried to construct a clear definition or framework for understanding Health Advocacy; however, these efforts met with limited success. As a result, there remained a divergence of understandings and wide variability in the enactment of Health Advocacy. It is observed that the concept emphasizes examples of mechanisms through which Health Advocacy manifests itself but fails to highlight elements of empowerment and detailing the characteristics of the objectives to be achieved.The World Health Organization in the Glossary of Health Promotion defines Health Advocacy as the combination of individual and social actions to acquire political engagement, policy support, social acceptance and support of systems or programs to achieve goals.In the Brazilian context, the Health Reform can be considered a Health Advocacy action, as it sought to reduce social inequalities and structural changes in the health care model. However, even so, the greatest challenge for the realization of the right to health in Brazil is to develop health democracy, related to the effective participation of society in strategic decision-making that result in the realization of the universal, equal and integral right to health. However, a model is lacking to explain the term. Some important elements can be added to the concept, such as the deliberate character of the action, the emphasis on health inequities, the objectives, in addition to aspects related to the maintenance of well-being or health. Additionally, the term collectivities, or groups, better encompasses other aggregations of individuals, such as health professionals.The document Core Competencies in Health Promotion (CompHp), endorsed by the European Union, published in 2012, defines Health Advocacy as: Advocating with and on behalf of individuals, communities and organizations to improve health and well-being and to develop capacity for health promotion actionsFinally, the virtual era adds a new scenario, or even a new element to the concept of Health Advocacy: the location. While, in general, Health Advocacy actions are taking place at the level of institutions, especially those of direct health care, in recent decades, with the use of the internet and social networks, the digital context has gained preponderance. Characteristics such as democratization and the expansion of the reach of information offer this technology enormous potential to generate changes.The study brings a broader concept of Health Advocacy, from the micro to the macro, in which it contemplates the development of the patient’s autonomy; includes individuals and groups in care plans and involves them in political activities as possibilities to provide assistance and correct health inequalities. In this way, understanding the concept of Health Advocacy makes nurses more empowered in terms of practice, defending patients and families, as well as favoring health reforms.It is expected to contribute to a more consistent use of the concept of Health Advocacy, for its use prior to its operationalization in practice, since health advocacy encompasses a wide range of activities such as: encouraging patients to engage in healthy behaviors , helping patients navigate health care , and engaging in systems and policy-level activism  to provide assistance and correct health inequalities.


Objectives: The central sterile services department (CSSD) offers a variety of procedures, including collecting contaminated medical equipment from various agencies through a process of washing, cleaning, packing, and sterilization, followed by storage and distribution to internal and external departments. Plans to expand and open service to the Center of Excellence continue, which will result in a rapid increase in the processing of specialized medical devices. The Center of Excellence is a source of education, learning, teaching, and practice in the cleaning, disposal, and sterile treatment of medical devices. We sought to improve the quality of sterile medical equipment to satisfy international standards of safety. Methods: We implemented a 7-stage process in the CSSD and we developed a checklist with 8 categories of environmental development based on APSIC guidelines. We provided knowledge to CSSD employees, developed their skills, and promoted attitudes in various areas, including sterile work standards, the use of sterilization machines, and infection prevention and control both inside and outside the facility. Results: We established inventory control systems, storage guidelines, and disbursement of medical supplies and equipment in the CSSD. To improve machine use in sterilization treatment or disposal, we educated staff and provided practice of machine skills according to instructions for use. Information technology (IT) was used for the distribution process, medical device identification, recording sterilization, and statistical logging of sterilization and sterile services. Conclusions: Overall, we improved the quality of CSSD services and knowledge and practice of CSSD staff, and we achieved compliance with international standards. These measures ensure the safety of service providers and patients and build trust in the quality of CSSD services and output.


Entropy, entitled Information and Divergence Measures, covers various aspects and applications in the general area of Information and Divergence Measures.The present Special Issue of Measures of information appear everywhere in probability and statistics. They play a fundamental role in communication theory. They have a long history dating back to the papers of Fisher, Shannon, and Kullback. There are many measures each claiming to capture the concept of information or simply being measures of divergence or distance between two probability distributions. Numerous generalizations of such measures also exist. The concept of distance is important in establishing the degree of similarity and/or closeness between functions, populations, and distributions. The intense engagement of many authors with entropy and divergence measures demonstrates the significant role they are playing in the sciences. Indeed, distances and entropies are related to inferential statistics, including both estimation and hypothesis testing problems ,3,4,5,6,All the articles included in this Special Issue were reviewed and accepted for publication because they have been found to contribute research works of the highest quality and at the same time, they highlight the diversity of the topics in this scientific area. The issue presents twelve original contributions that span a wide range of topics. In , the aut


To further promote the effective governance of rural human settlements in China, it is necessary to summarize and organize the research on rural human settlements that has been undertaken in the last decade. This paper analyzes the current status of rural human settlements research from the perspectives of Chinese literature and English literature. It takes the core documents included in WOS (Web of Science) and CNKI  as samples, and produces a visual analysis of the authors, institutions, disciplines, and research hotspots for rural human settlements research with the help of CiteSpace V and other measurement software, focus on identifying the similarities and differences between CNKI and WOS in the study of rural human settlements. The results show that the number of papers is increasing; cooperation between Chinese researchers and institutions needs to be further strengthened; the existing research has achieved interdisciplinary integration; the research hotspots are converging, but China pays more attention to the study of the hard environment, such as the macro level of rural human settlements and the natural ecological environments of residence, and lacks insight into the soft environment, such as the main body of residences, social relations, and individual needs in the urban fringe. This study is conducive to promoting the integrated development of urban and rural areas in China, promoting the revitalization and development of rural areas in China, and achieving social equity. The rural human settlement environment refers to the places that rural residents rely on for production, life, and residence. With the implementation of the rural revitalization strategy, rural human settlements have attracted much attention and become an important part of rural revitalization. The report of the 19th National Congress of the Communist Party of China officially proposed action to be carried out for the rectification of rural human settlement environments. Since then, the study of rural human settlement environments has gained the attention of domestic scholars. In February 2018, the General Offices of the CPC Central Committee and the State Council issued the Three-year Action Plan for the Improvement of Rural Human Settlements (2018–2020). In 2021, the General Offices of the CPC Central Committee and the State Council issued the five-year Action Plan for the improvement of Rural Human Settlements (2021–2025). The improvement of rural human settlements has entered a new stage [In order to fully reflect the reliability and comprehensiveness of the data, the Chinese and English documents in this paper are from the CNKI platform and WOS platform, respectively, which represent one of the most authoritative databases in Chinese and English.Chinese studies were screened through the CNKI platform, and data sources were selected from Peking University Core, EI, and CSSCI. The search conditions were as follows: the subject was rural human settlements OR village human settlements; the document type is academic journal; the language is Chinese; the matching method was selected as accurate; the time span is 1 January 2013–8 June 2022. Due to the requirements of the research tools, the title information was exported in the form of Refworks, EndNote, and NoteExpress text, and imported into NoteExpress software for data cleaning and manual cleaning. In order to prevent the contents of master’s and doctoral theses and conferences from duplicating the contents of journals, some documents, such as master’s and doctoral theses and conference theses, as well as book reviews, conferences, solicitations, news articles, etc., which were not relevant to the research topic, were eliminated, and 292 effective documents were finally obtained. For English literature screening through WOS, the following search conditions were entered for the basic search: the database is a core collection of Web of Science; the theme is rural residential environment or rural living environment; the document types are article and review; the language is English; the time span is 1 January 2013–8 June 2022. A total of 2991 documents were searched. After the duplications were processed in the same way as that described for the Chinese documents, a total of 2990 valid documents were retained.http://www.sationline.cn/#!/, Tianjin, China), Note Express , and CiteSpace V , a literature measurement software used around the world. SATI is a document catalog information analysis tool, which converts text data such as CNKI, WANFANG DATA, and the China Science and Technology Journal Database, and extracts and counts data including keywords, authors, and institutions for the construction of a common word matrix and the conversion of different matrices [The research tools used were SATI4.0  was used to analyze the literature data, and 1407 keywords were found from 2013 to 2022, among which 895 were independent keywords, with an average of 4.82 keywords per article. SATI software  algorithm was used to obtain the rural human settlements keyword clustering diagram . There aThe smaller the number in the clustering label, the more keywords it contains. Taking the first three significant clusters as an example , the cluAccording to the above graphic analysis, the research themes and trends related to rural human settlements in CNKI can be divided into the following areas.The first point relates to rural revitalization and rural human settlement environment research. At present, most Chinese research on rural human settlements is related to the development of rural revitalization. Based on the background of rural revitalization, Liu Chunxia’s paper analyzes the current status of rural residential environment improvement in Henan Province, and puts forward countermeasures, such as developing rural industries, unified village planning, and the intensive use of public funds . Li BohuThe second point pertains to research on the residential environment. Residential environment research is the focus of this area of rural residential environment research, and mainly considers water and sanitation improvement, garbage treatment, sewage treatment, and the construction of public service facilities. It advocates the construction of a new countryside and a livable countryside. However, domestic research on the living environment focuses more on the improvement of the natural environment, and less on the study of the human and cultural environment in relation to the rural living environment. Zhou Chuanbin designed an ecological engineering model for a rural courtyard, with “planting—breeding—toilet—cleaning—water cellar” as the main line, demonstrating a micro-ecological cycle, with the production and life integration of a compound ecological courtyard . Ma JunqThe third area pertains to residential space research. China is a vast country. Due to the varying climate, terrain, and other natural environmental features, as well as traditional national culture and social and economic conditions, there are regional differences in residential spaces. Lin Chuanhong analyzes the spatial patterns of rural human settlements in Anhui Province from three perspectives: production space, living space, and ecological space . From thAs shown above, a knowledge graph analysis was undertaken for the research of rural human settlements in CNKI. Then, statistics and trend analysis were conducted for the research of rural human settlements with the data of literature included in WOS, so as to understand the overall and directional nature of international research in this field. This aspect of the study aimed to generate follow-up research on rural human settlements.As can be seen from In terms of the countries that have published papers on rural human settlements, this paper selects the top 10 countries according to the number of published papers . It can According to the analysis of the network of cooperative institutions that was conducted using CiteSpace V software see , there aThe top 10 disciplines of English research on rural human settlements were selected see , and theAccording to the SATI analysis, the number of total authors and independent authors in the study of rural human settlements in the past decade is 15,290 and 13,662, respectively, with an average of 5.12 authors per article. Through an analysis of the author cooperation network, conducted using CiteSpace, Introduction to land use and rural sustainability in China, Liu Y.S. offered an examination of the impact of shifts in human socio-economic activities on changes in land use and related policy making from both Chinese and global perspectives [The type of reference nodes in the literature data was analyzed using CiteSpace V, and the time slice was set as one year with a time span of 2013–2022. Other settings were set to the default. pectives . Conceptpectives . Thus, tA total of 11,635 keywords and 6968 independent keywords were retrieved through WOS, with an average of 3.89 keywords per article. According to the word frequency list of CiteSpace V, the top 20 high-frequency keywords were selected see . Among tThe WOS bibliographic information was imported into CiteSpace V software, the type of Keyword node was analyzed, the time slice was set to one year, and the keyword clustering view was obtained after running the software . There wThe keyword clustering was converted into a time graph , showingAccording to the above chart analysis, the themes and trends in rural human settlements research in WOS can be summarized as follows.The first area pertains to residential environment research. English literature mainly discusses the impact of living environments on human health, in relation to asthma, depression, obesity, and other diseases, as well as the relationship between mental health and neighborhood relations. Studies have shown that the degree of exposure to natural environments affects mental health. Beyer, K.’s article examining the relationship between green spaces and mental health and the role of green space in non-urban settings suggests that “greening” may be a potential strategy for improving populations’ mental health in the United States . EngemanThe study of residential subjects is another key area. In WOS, scholars have carried out classification research on the main part of residence when studying the rural residential environment, especially the elderly, women, children, and young people. The most important active groups in rural human settlements are the elderly, women, children, and other vulnerable groups. According to Burholt, V., the rural environment intensifies the difficulty of social participation and access to social resources, and it enhances the loneliness of the elderly in their later years . In addiBased on the literature analysis conducted using SATI4.0, Note Express, and CiteSpace V, this paper drew a knowledge map of rural human settlements research from 2013 to 2022. We summarized and compared the number of papers, authors, research institutions, subject areas, research hotspots and trends, as well as important literature on rural human settlements in CNKI and WOS. The main conclusions are as follows:In terms of the number of published papers, both CNKI and WOS have shown a rising trend in the number of papers published on rural human settlements research. Both of them attach great importance to rural human settlements research, and their research prospects are broad.In terms of research authors and institutions, compared with WOS, CNKI lacks communication and cooperation between research authors and research institutions, and has not yet formed a complete and close cooperation network. However, Chinese research authors and research institutions have close cooperation with other countries’ research authors and research institutions internationally, and they play an important role in these networks. The core group of authors and cooperating institutions in international research on rural human settlement environment has formed a relatively complete cooperative network.In this study, we can find that the study of rural human settlements in WOS integrates geography, environmental science, planning, ecology, economics, management, history, pathology, and other disciplines, realizing interdisciplinary research. The research on rural human settlements in CNKI has also achieved interdisciplinary research, but the degree of interdisciplinary integration is not as high as that in WOS.The research hotspots in CNKI are rural revitalization, living environment, and living space, and more of them are based on rural revitalization to promote rural revitalization and development. It focuses on the transformation of the living environment, including the transformation of water and toilets, garbage disposal, and sewage treatment, and the construction of public service facilities. The living spaces of different regions are mainly studied from the perspectives of production, life, ecology, and “living space”, especially in relation to changes in traditional settlements in China. Because China has a long history and culture, the change in settlements reflects the different choices living subjects make regarding their living environments in different periods . GeneralIt can be seen from the above studies that the research on rural human settlements has broad prospects. In future research, Chinese scholars should connect with the hotspots of international rural human settlements research, set out the national conditions, combine the actual situations of different regions and types of rural areas in China, and establish a system theory and policy suitable for the development of rural human settlements in China. Scholars should aim to strengthen the research on the subject of rural human settlements, social relations, individual needs, and the impact of urbanization on rural human settlements from a micro perspective and continue to conduct in-depth research on the human environment, housing structures, infrastructure, and urban–rural integration. We will continue to learn from countries with valuable practical experience and provide a meaningful reference for effectively promoting the integrated development of urban and rural areas in China, promoting rural revitalization and development and social equity.


During recent years, remarkable progress has been made in the development of new materials. Advanced structured materials, including smart and nano materials, have opened up new engineering possibilities because of their specific properties  that are not found in nature, and can be significantly changed by a user in a controlled manner to make them appropriate for certain applications. Due to their unique properties, smart and nano materials have been of interest in countless areas of technical application, in various systems and structures, including intelligent and adaptive sensing or actuation, as well as active control. An understanding of the relationships between their structures and properties is of crucial importance for the practical utilization of these materials.Over the past several years, a series of approaches for progress in structural control and healthy monitoring have left paramount impacts on our everyday lives. This has shaped the framework of many engineering fields. Given the current state of quantitative and principled methodologies, nowadays, it is possible to rapidly and consistently evaluate the structural safety of mechanical systems, industrial machines, and modern concrete buildings, etc., to test their capability for serving their intended purpose. However, unsolved, problematic, and new challenges exist. Unmolded nonlinearities, ineffective sensor placement, and the effects of confounding influences due to operational and environmental variabilities still harm the effectiveness of the state of structural control and healthy monitoring systems. A typical integrating structural control and health monitoring system is shown in The aim of this Special Issue is to gain new, unique knowledge about the relationships between the structures and physico-mechanical and chemical properties of new materials, including finding ways to structure the control and development of new methods for structural healthy monitoring. Another goal is to gather the main contributions of academics and practitioners in mechanical, aerospace, and civil engineering to provide a common ground for improvements to these approaches to structural control and healthy monitoring, by using the unique properties of smart and nano materials. Studies concerning sensor technologies, vibration-based techniques, artificial-intelligence-based methods, and related fields are all welcome, in both numerical and experimental form.Structural health monitoring;Structural control;Smart materials and structures;Nanomaterials and nanocomposites;Sensors and actuators;Energy harvesting;Artificial intelligence;Damage detection;System identification;Machine learning;Sensor placement;Intelligent structure systems.The keywords of this Special Issue are:Evidently, the articles accepted for publication will cover all the topics and it is expected that the manuscripts published here are of interest to researchers working in improving the materials utilized in structural control and health monitoring.The manuscripts of this Special Issue can be classified according the topics provided in Considering the knowledge of the guest editors of this Special Issue, the preservation of the structural integrity of the damaged parts is distinguished by a control and repair procedure through establishing the smart and nanomaterials effect, in which local moment and force are induced in these materials by applying the converse effect of the structure, in order to break the increase in stress and strain levels due to the external load, thus decreasing the criticality of the damage. Additionally, entering structural health monitoring (SHM) and artificial intelligence (AI) techniques into the procedure of controlling and repairing the damage to structures will definitely highly affect the avoidance of a premature collapse of mechanical and civil structures such as pipelines, houses, bridges, aerospace, and offshore platforms. In this Special Issue, we underwent efforts to collect contributions from active researchers in the fields of structural control and health monitoring, and also mechanical, structural, electrical, material, and other engineering fields. It will act as a platform for sharing. Furthermore, researchers may provide transparent views and indices for their research areas through challenges and opportunities. In short, this sharing can help researchers to develop new ideas, particularly in the early stages of this research field.


In order to effectively protect rare and endangered plants, 27 provincial-level administrative regions in North Asia (the Asian part of Russia) have compiled and published local Red Data Books. In this study, the names (with synonyms) of vascular plants in the 27 provincial Red Books were digitalized and merged into a database of rare and endangered vascular plants in North Asia. The purpose is to reflect the species composition, geographic distribution pattern, and protection level of these plants and their inclusion in the national Russian Red Data Book and the IUCN Red List, and provide a reference for formulating conservation strategies. The dataset has a total of 2079 species, 160 subspecies, and 53 varieties belonging to 667 genera and 143 families. It contains data on 2292 taxa, including family name, genus name, species name and synonyms, protection level, and other information. We also analyzed the main influencing factors, existing problems of rare and endangered vascular plant species, and suggestions for addressing them. We conclude that, to date, the IUCN criteria have not been applied consistently in all regions, leading to an excessive number of species being recorded in the Red Data Books of Asian Russia; specifically, one-third of all floral species are in the regional Red Data Books. Based on this list, scientific and practical measures for protection, reproduction, and rational use are formulated. Since 1963, the International Union for Conservation of Nature and Natural Resources (IUCN) has maintained the list, also known as the Red List of Threatened Species   containeDuring the development of the government decree in 1996, Red Data Books were officially established in all regions of Russia. The first official regional Red Books began to appear in the Altai Territory and the Novosibirsk region in 1998 ,8. The mThis article provides a comprehensive analysis of the rare and endangered vascular plants included in all 27 Red Data Books at the provincial level in the Asian part of Russia , and all of them are listed in a database that has been created.2, or approximately 77% of Russia’s territory. In the west, the border runs mainly along the middle of the Ural Mountains, separating the European and Asian parts of the Russian Federation. The northern and eastern boundaries are bounded by the Arctic and Pacific Oceans. Along the southern border, the region shares borders with Kazakhstan, Mongolia, the People’s Republic of China, and North Korea. North Asia includes the Ural Federal District, the Siberian Federal District, and the Far Eastern Federal District, with a total of 27 provincial administrative regions  extends from southwest to northeast. In North Asia, there are four major rivers: the Ob, the Lena, the Yenisei, and the Amur Rivers. The climatic characteristics of North Asia vary from coastal oceanic to strongly continental in inland Siberia . There aAlthough the 27 provincial-level regions in North Asia have compiled and published lists of rare and endangered vascular plants, the information is scattered in certain regions, with a degree of dispersion and locality. There are still some species for which the accepted name is not generally accepted internationally, and there is the issue of synonyms. The purpose of this paper is to integrate the Red Book species lists of 27 provincial distribution areas in Asian Russia and form a distribution map of rare and endangered vascular plants in North Asia, and to reveal the status of threatened vascular plants and the influencing factors. We attempted to compile an integrated checklist of Red Book vascular plants of North Asia in order to contribute to the protection and rational use of these species.We collated 143 families, 667 genera, 2079 species, 160 subspecies, and 53 varieties  from the checklists of rare and endangered vascular plant species in 27 regional Red Data Books in North Asia .Oxytropis, Astragalus (both in Fabaceae), and Carex (Cyperaceae) ranked in the top three  indicate that in terms of family classification, Fabaceae, Asteraceae, and Ranunculaceae ranked in the top three . In termop three .Among North Asia’s 27 provincial distribution regions, rare and endangered vascular plant species (including subspecies and varieties) are unevenly distributed across different areas. This includes the Yamal-Nenets Autonomous Area, located in the Arctic region of the Western Siberian Plain, which has the lowest number at only 61 taxa. Krasnoyarsk Territory has the highest number with 328 taxa, and the regions with the second-highest numbers are the Republic of Sakha (Yakutia) and Khabarovsk Territory, with 265 taxa a.Among the 27 provincial-level regions in North Asia, the proportion of rare and endangered vascular plants to the total number of vascular plants is between 6% (Republic of Tuva) and 18% (Kurgan Region) b. The Red Data Book of the Russian Federation  includesThe comparative analysis results indicate that among all 2292 species (subspecies and varieties) of rare and endangered vascular plants in the 27 provincial regions of North Asia, 65 families, 115 genera, and 190 species (subspecies and varieties) were on the IUCN’s Red List of vascular plants , represeWe analyzed the similarities and differences in the assessment criteria of threat levels in the three sets of data in this paper. The results show that the evaluation criteria of the Russian national and local red lists conform to the basic framework of the IUCN evaluation criteria, with supplements added and improvements made at the same time see . The IUCBased on the relationship between the assessment standards of the IUCN and Russia, we determined the endangered level of 2292 threatened taxa in North Asia . Among tBased on the descriptions in the Red Book, we conducted incomplete statistics on the influencing factors of the 2292 threatened species, which mainly include 12 types: residential and commercial development, agriculture and aquaculture, energy production and mining, transportation and service corridors, biological resource use, human intrusion and disturbance, natural system modifications, plant diseases and insect pests, geological events, climate change and severe weather, and low ability of species to reproduce and spread, with narrow distribution. We counted a total of 6679 items of risk factor data, and their proportions are shown in The local Red Data Book for North Asia’s 27 provincial administrative regions includes 143 families, 667 genera, and 2292 species (subspecies and varieties) , with 69Based on the three sets of data in this paper, these numbers basically reflect the geographical distribution pattern of rare and endangered vascular plants in North Asia a. It canStipa pulcherrima K. Koch has decreased due to pasture cultivation, and the species may be endangered or disappear [Eutrema cordifolium Turcz. ex Ledeb. [Micranthes brachypetala  Tkach [Based on the statistical results of the influencing factors of threatened species, it is evident that the most important factors are human economic activity, livestock farming and ranching, tourism and recreation, gathering of terrestrial plants, logging and wood harvesting, mining and quarrying, roads and railroads, climate change and severe weather, and fire and fire suppression. For example, in the Trans-Urals, the abundance of isappear ,33,35. Ix Ledeb. ,21,22 anv) Tkach ,17,18 isAt the level of the 27 regions in North Asia, the number of Red Book species (subspecies and varieties) accounts for 6% (Tuva Republic) to 18% (Kurgan Region) of all vascular plants in the region b. HoweveCeratophyllum demersum L. and Potamogeton pectinatus L. (Stuckenia pectinata (L.) Börner), and the Red Book of the Irkutsk region includes Hydrocharis morsus-ranae L. and Sagittaria sagittifolia L., which are on the edge of their range. Of the total 224 vascular plants in the Amur region Red Book, 81 are on the edge of the distribution area or ecological distribution area, accounting for 36% of the total.The vast territory of Asian Russia, from both west to east and north to south, includes the limits of distribution of many species. The populations of many plant species that are on the edge of their range are often less resilient than those in the center of the range. It was shown for aquatic species that growing at the limits of their global range was the most frequent reason for their inclusion in regional Red Data Books of Asian Russia, and 61 species represent 64% of the list . Thus, tTriglochin maritima L. and Spirodela polyrhiza (L.) Schleid. are included in the Red Data Book of Kamchatka Territory [Potamogeton perfoliatus L. in the Red Data Book of Chukotka Autonomous Area [Elatine, Coleanthus subtilis (Tratt.) Seidel ex Roem. et Schult., and Ranunculus reptans L. are often included in Red Data Books, although they are often not threatened, as they are widespread. These species, as a rule, have no commercial value and are not collected by local people. In this case, conservation management decisions will hardly affect the abundance of the taxon in nature. In the case of a threatened taxon, as a rule, we are looking at the action of anthropogenic factors, which can be weakened or removed by making managerial decisions.A large number of taxa are listed in the regional books of the Asian part of Russia because some of our colleagues confuse the concepts of “rare” species and “endangered” species. Regarding the former, the rarity of a taxon is often associated with natural causes or their ecological and biological features. erritory , and Potous Area . Some plIt was shown that most of the aquatic plants in the regions of Asian Russia are not considered to be threatened; approximately one-half have stable populations, there are no data for one-third of the species, and one-fifth of the species are increasing, while most of the protected species in the region listed in the Red Data Book of Russia are declining (94%) . Most ofHydrilla verticillata (L. f.) Royle, which is commonly found in neighboring plain regions, is among the rare species in the Red Book. Some species have a wide distribution, but are rare because of their association with cold oligotrophic lakes .Some Red Books list species whose distribution is regulated by purely natural factors . As an example, in the Republic of Altai , with a A notable effect of climate change is the northward range expansion of both widespread native species and non-native species, which has already been recorded for some aquatic plants and many southern species now occurring north of their conventional ranges . It is iIt is also inappropriate to include such species in the regional Red Data Books . UsuallyAs of 2020, six regions of Asian Russia did not have up-to-date floristic reports; in 11 regions, these reports were presented by key manuals in which the keys for identifying plants take up a lot of space, and only 10 had full-fledged reports (flora or synopsis of flora) . HoweverAfter combining the vascular plant lists in the Red Books of 27 provincial distribution areas and removing duplicate data, a total of 2440 records were obtained. When these records are matched against the Catalogue of Life, which includes 495 taxa synonyms, it can be seen that the proportion of synonyms in the data is as high as 22.0%. This shows that the problem of synonyms is widespread.Among the 27 provincial distribution areas in North Asia, the years of publication are different, as well as the standards for division. In most regions, the Red Books are compiled according to the requirements of the “Methodological recommendations for maintaining the Red Data Book of a constituent entity of the Russian Federation”. The assessment of taxa protection levels basically refers to the relevant assessment standards of the International Union for Conservation of Nature (IUCN) and the Red Data Book of the Russian Federation . AccordiFirst, descriptions should indicate the conservation status of the taxon in all neighboring regions. In this case, if an author uses other categories (including those recommended by IUCN), the data for the region become incomparable with the data for neighboring regions. And since the Red Books in neighboring regions are usually published in different years, we do not know how this contradiction could be resolved.Second, as we pointed out above, the flora of many regions of Russia is still poorly studied. Not all regions of the country have a sufficient number of qualified botanists. As shown by a seminar on the use of IUCN criteria in the Russian Federation at the regional level held in Moscow in the early 2000s, the floristic information available for most regions of the country does not allow a qualitative determination of the categories of protection for many plant taxa. There are Russian studies on the current situation with rarity categories and recommendations for changing it ,45,46,47Today, we can state that the prepared and approved letter of the Ministry of Natural Resources of the Russian Federation No. 02-12-53/5987 dated 27 July 2006, “Methodological recommendations for maintaining the Red Book of a constituent entity of the Russian Federation” .Thus, we summarized the information about compiling red lists in the vast territory of Asian Russia, which surpasses Canada, China, and all of Europe in size. Russia has a long way to go, starting from understanding the importance of and providing state support for the branch of knowledge known as conservation biology in order to study population dynamics and threats. It is necessary to rebuild the entire system of compiling red lists of species in need of protection. Undoubtedly, it is necessary to adopt the vast global experience gained by the IUCN in compiling the Red Lists ). We collected and digitalized the vascular plant data in the Red Data Book of the Russian Federation (514 species (subspecies and varieties) altogether) [https://www.iucnredlist.org/search (accessed on 28 January 2023)).We followed the administrative divisions of the Asian part of Russia comprising 27 first-level regions: 12 regions (oblasts), six territories (krais), five republics, three autonomous areas (autonomous okrugs), and one autonomous region (autonomous oblast) . The namogether)  and the ogether) ,37,38,39This dataset includes the rare and endangered vascular plants listed in 27 provincial-level Red Books in North Asia (published or released), with a data volume of 2292 items see . The dathttp://www.sp2000.org.cn/names_match_services (accessed on 2 November 2022)). The spelling of names and authors in the Catalogue of Life was accepted as well. A few names that were missing in this global index of species were nevertheless included in the checklist. In this dataset, the classification is based on PPGI [To harmonize the taxonomy and nomenclature applied in different data sources, we followed the taxonomy of the 2019 Annual Checklist of the Catalogue of Life ( on PPGI  for lyco on PPGI , and APG on PPGI  for angiBased on the Red List of vascular plants in 27 regions of North Asia, we calculated the numbers and distribution patterns from the Red Data Book of the Russian Federation and the IUCN Red List. We analyzed the similarities and differences in the assessment criteria for threat levels in the three sets of data in this paper, and selected a unified IUCN standard for merging and other comparative analyses. We also attempted to summarize and analyze the factors influencing these threatened species.Our research shows a huge disproportion, with one-third of North Asia’s vascular plants being included under different classes of protection in the regional Red Data Books of Asian Russia. One of the common shortcomings of a significant number of regional Red Data Books is the inclusion of many species that are not actually threatened by extinction and do not need special protection measures.The most significant problems of the regional Red Books of Asian Russia, according to the authors, are confusion between the concepts of “rare” species and “endangered” species, the frequent inclusion of species at the borders of ranges, the inclusion of species under the control of natural factors, the inclusion of species characteristic of individual stages of restorative succession, insufficient knowledge of the territory and a lack of data on population dynamics, and organizational problems associated with maintaining the books.It is necessary to change the situation, and a more critical approach is needed for the selection of species to include in Red Data Books. The main criteria for including taxa in Red Books should be that their existence is threatened as a result of human activities and that we have the ability to influence their process of extinction.