Active Design: Architectural Interventions for Improving Occupational Health Through Reducing Sedentary Behavior

Abstract

Objectives

To systematically review architects' literature concerning stair promoting design interventions for reducing sedentary behavior and improving occupational health.

Data Sources

English language, manuscripts published between 2000 and 2022 in Google scholar, Science Direct, PubMed, CINAHL, and ERIC.

Study Inclusion and Exclusion Criteria

The criteria for inclusion in this review include; Presence of two words from the searching term in the title, a study conducted by an architect (or at least one architect author), English language, published after 2000, investigate built environment and design features that influence stair use in the building.

Data Extraction

The data extraction process included; Author (year), country, study design, type of buildings, the population of the study, duration of the study, measured variables (dependent and independent), measurement tool, analysis and outcomes.

Data Synthesis

Extracted data were synthesized in a tabular format and analytical figures with narratives summary.

Result

Nine features of the built environment that affect stair use determined from the literature; safety, motivations, appeal and comfort, and legibility were the most common features in the studies, followed by connectivity, building codes, and elevator programming. The good quality of mentioned features positively affects stair use level and vice versa. However, the review also reports a shortage of architects in both practice and research concerning active stair design.

Conclusion

Stair use is of great importance in increasing physical activity and improving occupational health in the workplace. Architects and designers should pay special attention to the design of staircases and encourage their everyday use by considering the largest number of features that encourage stair use.

Keywords

active design occupational health physical activity stair use architecture intervention sedentary behavior

Objectives

Sedentary behavior is highly associated with early death and a variety of negative health outcomes, including all-cause mortality, cardiovascular disease, cancer, diabetes, obesity, and many other non-communicable diseases (NCD). According to the WHO recommendations, adults should engage in at least 150-300 min of moderate-intensity aerobic physical activity per week, 75-150 min of vigorous-intensity aerobic physical activity per week, or an equivalent combination of moderate- and vigorous-intensity aerobic physical activity per week.¹ Over the last two decades, the dominant mode of work in developed and high-income countries has evolved toward computer-based labor. As a result, many people spend their days at work sitting at their desks performing sedentary tasks.^2,3 The workplace is considered to be an important and ideal setting for health promotion interventions. It has a large impact on our physical activity and sedentary behavior through different settings, including personal, organizational, and physical environmental interventions. A systematic review conducted in 2018 identified three spatial scales on which the physical environment in and around the workplace impacts employees’ physical activity and sedentary behavior, which were the workstation scale, building scale, and neighborhood scale.⁴ Each scale contains several components that contribute to increasing daily physical activity, as illustrated in Figure 1.

Figure 1.

Three spatial scales of the built environment affect physical activity in the workplace.⁴

Architects could have a more significant influence on health than physicians. According to the famous old phrase “prevention is better than cure,” which is often attributed to the Dutch philosopher Desiderius Erasmus around the year 1500, promoting healthy lifestyles and preventing illness is a fundamental principle of public health and improving the health of the general population. The built environment affects human health, behavior, and lifestyle in a variety of ways, including inadequate ventilation, poor indoor air quality, chemical contaminants from indoor or outdoor sources, excessive cold or heat, noise, and inadequate illumination.⁵ Therefore, architects play a critical role in improving public health by preventing illness but not curing it through designing healthy and activity-friendly buildings.⁶

Among all the construction aspects and components, the staircase is the simplest and most accessible technique to increase workplace physical activity.⁷ Stair usage rather than elevator or escalator use is a viable intervention for boosting moderate physical activity because it demands a lifestyle choice (people must get to their destination) and has little or no financial cost to the individual. Additionally, because stairs are required by construction code in multistory buildings, they provide an easy way to boost physical activity.⁸ According to Harvard University research, those who walked 20 floors each week had a 20% lower risk of having a stroke or dying for any reason. According to Harvard University research, those who walk 20 floors every week are 20% less likely to get a stroke or die for any reason. Additionally, adding two minutes to each day of stair climbing can help people lose at least 1.2 pounds each year.^9,10

Contemporary health promotion places a strong emphasis on the influence of the physical environment on people’s health behaviors.¹¹ The alliance between health and architecture majors creates a healthy design by providing opportunities for increased physical activity and reducing the possibility of chronic and non-communicable diseases NCD, particularly obesity.¹² Recently, several nations eg United States, United Kingdom, Australia, Canada, and Netherland introduce the active design concept which is a multi-disciplinary design approach seeking to design and adapt living and working places to encourage activity in everyday lives, making the active lifestyle an easy choice.^13-21 Active design is a new idea in design that integrates planning and building ideas to increase physical activity and decrease sedentary behavior. The multidisciplinary approach to active design aims to transform evidence-based research into practical design solutions by addressing aspects of the built environment that promote daily physical activity and reduce workers' sitting time.^22-25 Based on the most recent academic research and best practices in the field, Active Design presents a manual of ideas for urban designers, architects, and interior designers for creating healthier buildings, streets, and urban environments.¹³

Despite the evidence from health promotion initiatives about the benefits of using staircases in workplaces and providing guidelines for architects to encourage physical activity, there is a shortage in both practice and research studies among architects and designers involving stairs in everyday use. The majority of research regarding physical activity in buildings especially in workplaces is in the field of medicine, human behavior, sport and exercise.

This study is the first of its kind in investigating architectural interventions in promoting occupational health by reviewing architects’ literature concerning factors and features affecting stair use in the workplace.

Methods

Data Sources

This systematic review was performed according to the PRISMA (preferred reported items for systematic reviews and meta-analysis) guidelines as demonstrated in Figure 2. Relevant studies were identified through a comprehensive search using five databases (Google Scholar, Science Direct, PubMed, ERIC, and Semantic Scholar) and also a snowball search strategy of relevant studies was conducted. Databases were searched for the period between September 2021 and December 2021 using a wide range of Boolean keywords including; “architecture”, “building design”, “active design”, “physical activity”, “occupational health”, “stair use”, and “stair design”, which are highly relevant to the key topics of the field of research. A filter was set in all five databases to search for “journal articles” and “conference proceedings” that were published after 2000, coinciding with the emergence of the active design concept. Active design encompasses a set of interventions for increasing physical activity on an urban and building scale. However, stair climbing is considered the most effective and costless intervention in daily routine life. Therefore, the author limits the articles to those studies that focus on stair design interventions in buildings.

Figure 2.

Study screening and selection according to the Preferred Reporting for Systematic Review Protocols (PRISMA) guidelines.

Inclusion and Exclusion Criteria

The search process in five databases gives 302 results that match the search terms. In searching for duplicates, four studies were removed. After that, the studies were screened against five criteria. Criteria (1): the title should at least contain two of the keywords that have been used as search terms in five different databases. 245 studies were excluded in the step of screening for titles. Criteria (2): after eliminating unrelated titles, a search for author(s) specialty was conducted. Contrary to popular belief, an architect plays a more important role in maintaining good health than a physician. Therefore, this study focused on the role of architectural intervention in improving occupational health through introducing physical activity into daily work life. As a result, only studies conducted by authors with expertise in architecture, design, and the built environment are included in this study. This is done by screening the specialization of each author(s) of the studies that pass the first filter. In this step, 32 studies that didn’t match the criteria (2) were excluded. After the first and second step exclusions, the abstract and full text were screened against the criteria (3): the study should be in the English language. Criteria (4): the study should investigate the built environment and design features that promote stair use. Criteria (5): the study should be conducted on a building scale, not an urban scale. In the end, a total of 11 studies that match the mentioned criteria were included for review.

Data Extraction and Data Synthesis

First-round data extraction included (1) author (year), (2) country, (3) study design, (4) type of building, (5) Study population, (6) Study duration, (7) Measured variables (dependent and independent), (10) measurement tool, (11) analysis, and (12) results. Later, each article was scanned independently and precisely to extract the mentioned items. Another scan for articles was performed, extracting the factors and design interventions that may contribute to increasing stair use. Finally, all extracted factors and design interventions are illustrated in an analytical diagram regarding the authors.

Results

Study Year and Country

After completing the full-text evaluation and using the aforementioned search criteria, 11 articles met our criteria for a study investigating the influence of staircase design on encouraging or discouraging stair use. Before reading, critical ideas for getting information were classified to conduct later data analysis. According to our search strategy and inclusion criteria, no research was found during the period 2000-2004. Figure 3 shows that there has been growth in terms of scientific research from 2005 until 2016, which coincides with the blooming of the active design concept, in which many countries have developed guidelines for activity-friendly buildings with stair design as the main strategy for achieving the active design goal. However, the growth curve has slowed significantly since 2016. Figure 4 demonstrates that 50% of selected studies were conducted in the United States. It is worth mentioning that the first guidelines for guiding architects and urban designers to incorporate physical activity into daily life in urban and building design were published in New York City in 2010.

Figure 3.

Number of studies by year of publication.

Figure 4.

Number of studies by country of publication.

Narrative Summary of Studies

As illustrated in Table 1, Six of the studies were observational studies investigating different aspects of the built environment and the effects of stair design on stair use. Nicoll²⁶ conducted an observational study in 10 academic buildings in Canada to investigate the impact of physical environmental features on stair use, which has been extracted from previous studies. Physical environmental features were operationalized quantitatively by using spatial measures or by developing indices to measure qualitative attributes, while stair use was measured objectively using an active infrared monitor. Regression analysis showed that stair use is highly affected by four factors: appeal, comfort, convenience, legibility, and safety. Each factor is categorized into several variables, making a total of 18 variables. As a consequence of the investigation, 10 variables out of 18 having a statistically significant link to stair use were revealed. Five of them are operationalized convenience factors, four are operationalized legibility factors, and the last one is an operationalized comfort factor. In another study, Nicoll and Zimring²⁷ discuss the use of stairs in high-rise buildings as a strategy for increasing physical activity among employees in their workplaces. They argued that although almost every building provides stairs and elevators as a means for vertical circulation, people tend to use the elevators while the stairs are almost neglected. An observational study was conducted to evaluate employees’ perceptions toward the “push” strategy for mandating stair use through the provision of skip-stop elevators regarding their satisfaction, behavior, and physical activity. Stair use was measured using infrared monitors for 6 months in a 13-story California Department of Transportation office building, as well as a self-reported survey for measuring employees’ attitudes and perceptions. The result showed that satisfaction toward stair arrangement in the skip-stop strategy is increased and that stair use becomes more acceptable over time since 72.8% of participants recorded the daily use of skip-stop stairs. A regression study of self-reported stair flights traveled and travel preferences revealed that only the fastest travel time and a preference for stair usage were associated with stair travel frequency.

Table 1.

Summary of studies examining stair use interventions.

Author, year		Nicoll (2007)²⁶	Nicoll and Zimring (2009)²⁷	McGann et al (2013)²⁸	Kim and Steinfeld (2014)²⁹	McGann et al (2015)³⁰	Moatari-Kazerouni et al (2015)³¹
Country		Canada	America	Australia	America	Australia	America
Study design		Observation (case-study)	Observation (case study)	Qualitative/observation	Observation (case study)	Observation (case study)	Observation (cases study)
Type of buildings		Academic buildings	Office building	Workplace	Museum and students union	Three university buildings	Teaching hospital
Population of study		x	299	x	x	111	55
Duration of study		x	24 week	x	Museums; 1 day- student union; 2 days	28 weeks	x
Measured variables	Ind. V.	Physical environment features	Stair and elevator design (skip-stop elevator)	Building design guidelines	Interactive staircase	Building spatial typology, staircase design quality	Design interventions
Measured variables	Dep. V.	Stair use	Workers’ satisfaction and physical activity (stair use)	Physical activity (stair use)	Stair accidents	Sitting time, standing time, step counts, stair use, workers’ perception	Stair use
Measurement tools		Stair use (active infrared monitor) physical environment features (quantitative spatial measure and developing indices to measure qualitative attributes)	Active infrared monitor + self-report questioner	x	Video record + checklist +self-reported questioner	Diagrammatic analysis of building plans, accelerometer, questioner	Online questioner
Analysis		Regression	Regression	Subjective	Subjective	Descriptive	Statistical

Author, year		Arslan and Erkan (2020)³²	Zimring et al (2005)³³	Mansi et al (2009)³⁴	Kim and Steinfeld (2016)³⁵	Khairuddin et al (2021)³⁶
Country		Turkey	America	America	America	Malaysia
Study design		Experimental	Literature review	Literature review	Literature review	Mixed method
Type of buildings		x	x	x	Public and residential building	Four educational building
Population of study		400	x	x	578 stair	x
Measured variables	Ind.V.	Stair dimension. Human body anthropometric dimension	Features of the built environment	Stair design and policy	Staircase design features	Staircase and walking routes
Measured variables	Dep. V.	User satisfaction	Physical activity	Stair use	Safety and hazard	Physical activity
Measurement tools		Video camera prototype stair model *questioner	x	x	Checklist	Checklist
Analysis		Correlation	Qualitative	Qualitative	Qualitative	Subjective

From another perspective, McGann et al²⁸ investigate the consistency and contradiction between workplace design and health promotion strategies and how both architecture and health discipline can work together to reduce sedentary behavior, which counts as a health risk factor in contemporary life. A qualitative observational study was conducted to evaluate stair and elevator design guidelines from a health promotion perspective. The result shows that even though stairs are recommended as a better living option for improved health, they are not encouraged through building design guidelines. Staircases have the feeling of a fire escape and back-of-house, while the elevator gives a sense of hospitality through elegant, attractive, and comfortable design.

Kim and Steinfeld²⁹ in their study compared the influence of interactive staircases and conventional staircases on users’ behavior and safety. They define interactive stairs as stairs that have features such as signs, music, and artwork. For this purpose, an observational study using a checklist was held in three buildings: two museums, and one educational institution, measuring four variables regarding users’ behavior: tread gaze, glances at the tread, diverted gaze, and handrail use, and three variables regarding safety and incidents, including hesitation, mistyping, and loss of balance. The data was collected through video analysis of staircases in three buildings. The result showed that the rate of hesitation, mishap, and loss of balance was similar across all staircases. However, a higher rate of trade gaze and the use of handrails are reported in interactive staircases. The findings showed that interactive staircases are just as safe as any other conventional staircase, but they do influence the behavior of people using them. For a high-purpose, efficient staircase, evaluating the safety and impact of user behavior is required before implementing any interactive stair design features. McGann et al³⁰ evaluate the impact of different staircase design approaches on workers’ movement patterns and attitudes in three university buildings dating back to three different decades (the 1970s, 1980s, and 1990s). A cross-sectional study for three buildings with office-based working types was conducted, relating three parameters; building design, workers’ physical activity, and attitude to movement. Physical activity (sedentary, light, vigorous) was measured using a self-reported survey and by using an accelerometer. The floor plans of three buildings were analyzed in terms of building circulation (horizontal and vertical), toilets/services, kitchens, lunchrooms, and break-out spaces, and the data from the accelerometer on the plans was statistically analyzed. The results showed that the average sedentary behavior in 3 buildings is 80%, with a difference of 2% between the three buildings and an average length of bouts of 40 min. The study found that the building with a well-designed staircase recorded the highest level of moderate physical activity as well as the highest mean step count per day. However, none of the three buildings were designed to support the recommended physical activity and sedentary behavior guidelines for health.

Moatari-Kazerouni et al³¹ investigated the factors that affect the decision of using stairs or elevators. They state that even though there is a lot of evidence suggesting that using staircases in the workplace can be good for health, little is known about strategies that encourage employees to use them. The study was done at a teaching hospital in the midwestern United States. It looked at how often people used stairs and elevators, why they used them, and what they thought about the physical changes that would make them want to use stairs. The outcome of the study showed that the number of floors traveled, the direction of travel (up or down), and accessibility were the most prominent reasons given by the participants for using the stairs or elevator. Of the 12 design suggestions that were rated by participants, the cardio indicator, stair numbering, motivational sign, and creative lighting were the four most preferred design suggestions as recorded by participants. Besides, respondents suggested several changes to the engineering and design of staircases; By conducting an experimental study, Arslan and Erkan³² examine the trade size that provides physical comfort and user satisfaction since ergonomic factors in stair design greatly influence the usability of the stairs. 400 volunteers participated in an experimental study examining the relationship between human body anthropometric dimension, stair dimension (tread width and riser height), and users’ satisfaction. The result found that there is a substantial correlation between people’s heights and preferred stair dimensions. In each country, the standard for stair design should be consistent with the average height of people. For instance, in this study in Turkey, the average height of people was around 170 cm, and the preferred stair dimension according to the experiment was (T = 30.8 cm, R = 17.8 cm). Three studies use the review method for investigating different aspects of the built environment and the effects of stair design on stair use. Zimring et al³³ discussed the impact of built environment design on physical activity and the health of individuals. A study of the literature on the relationship between built environment design and physical activity was conducted, and as a result of the review, a model was adopted as a guide for designing activity-friendly buildings. According to the model, three factors influence physical activity, including the personal factor, the social/organizational factor, and the built environment factor. The author proposed that the built environment affects physical activity on four spatial scales: urban design, site selection, building design, and building element design. According to the studies, the staircase is one of the most efficient building elements that contributes to increasing physical activity in the building. Stairs are a planning requirement for almost every building; they provide a cost-effective, accessible, and within-reach way of adding physical activity to daily life. Several interventions proved to be effective for promoting stair use; point of decision prompts, aesthetic interventions such as artwork, and music, taking into consideration the distance and accessibility of the stairs.

On the other hand, Mansi et al³⁴ examine the health issues that may arise as a result of a lack of physical activity, particularly in the workplace, where individuals spend the majority of their waking hours, as well as how changes in stair design may help solve the problem. Through a literature review, health problems, stair design interventions, problems, challenges, and suggestions for design and policy change were investigated. The result indicates that obesity is one of the main consequences of physical inactivity that leads to many health problems. Stair use has been proven to be effective in boosting moderate physical activity into daily life since it needs no personal financial expense and includes a lifestyle choice. However, regulations and codes for stair design, especially fire safety regulations, treat stairs as a way of escape from fire rather than as a recommended daily activity. Stairs should be well-presented, secure, and easily accessible to make them more usable.

Kim and Steinfeld³⁵ review current stair design practices in the architectural press, assess the extent to which safe design practices are included in staircase research, and highlight topics that have not yet been addressed in staircase research. Method: literature research was done to evaluate photos of built staircases in public and residential buildings that were featured in Architectural Record articles and advertising between 2000 and 2012 by developing a checklist identifying and categorizing stair design hazards into four categories: railing, steps, visibility, and some other factors. Result: Out of 578 staircases, 61.42% recorded at least one hazard from the 16 hazards listed in the checklist, and most of them were in public buildings. Most typical design hazards include railings that are broken or missing, lengthy staircases that are too narrow, open risers, and a lack of visibility at the edges of the treads. A multi-method study conducted by Khairuddin et al³⁶ focuses on the active design approach through building layout, aiming to analyze, and assess the design of building layout in Malaysian architecture concerning active, sustainable approaches from literature and guidelines. Based on the active design parameters that have been extracted from the literature (staircase and supportive walking routes), both qualitative and quantitative analyses of three educational buildings were performed. The factors affecting staircase use extracted from the literature include location, imageability, and design. The result showed that both the components (staircase and supportive walking routes) of the building layout were not designed for proper physical activity but were only designed to accomplish the technical function. For example, the staircases are intended solely to comply with fire regulations rather than to promote physical exercise. The same is true for walking routes; there is no goal or strategy to encourage or promote walking or other forms of physical activity.

Design Interventions

Three factors identified by Nicoll²⁶ and Zimring et al³³ that affect the use of stairs are personal, social/organizational, and physical environmental factors. Nine features of the built environment were extracted from the reviewed studies with 35 categories of stair design influencing voluntary stair use. Of all studies, Nicoll’s study is the most inclusive in terms of physical environmental factors that affect stair use. Figure 5 is an analytical diagram of extracted design interventions.

Figure 5.

Analytical diagram for factors influencing stair use.

Figure 6 provides a statistic of stair design interventions in reviewed studies. Six studies out of 11 highlight safety factors for increasing stair use. Safety of stairs includes 3 categories; Maintenance, Natural surveillance, stair dimensional, and provision of the railing. Motivational techniques followed safety by including the point of decision prompts artwork, music, step numbering, cardio indicator, and current location map. Four studies focus on comfort and appeal as design interventions for promoting stair use.

Figure 6.

Factors affecting stair use.

Conclusions

This study is a systematic review of previous studies to ascertain the current state of evidence regarding active design strategies and their implementation in workplaces, as well as their impact on physical activity, health, and behavior of employees, from an architectural standpoint, as presented in the previous sections of this review. The reviewed articles varied in methodology from observational, literature review, mixed-method, and pre-post natural experiment. However, the amount of study undertaken by architects on how to promote physical activity through design is insufficient. Many corporations and organizations are turning to architectural and design communities for workplace solutions that improve employee health as more firms and organizations embrace employee wellness. The core principle behind the active design is to turn inactive office settings into places that encourage healthy living. The building design provides a great opportunity to promote frequent and significant physical activity. The majority of people spend up to 90% of their days indoors, frequently engaged in sedentary occupations. For many, actions such as climbing stairs or rising from a desk to use office equipment, while brief, is the most accessible and cost-effective way to engage in some form of regular physical activity during extended periods of inactivity. Lack of physical activity is currently one of the top 10 significant risk factors for death around the globe. Part of the reason for the fall in physical activity is related to occupational restrictions and modern society’s sedentary lifestyle.

To promote the concept of a healthy living style through exercise among the local community, the Community Active Design makes use of proper space planning and design to pique citizens' curiosity and interest in exploring the nature of the space around them, which can subtly influence their living habits, improving their health and well-being and fostering a healthy community. Creating activity-friendly buildings is largely dependent on the integration of active design principles into the building’s circulation systems (particularly its stairs and elevators), individual elements, programs, and activity spaces. Stair climbing can be a low-cost and relatively accessible way to add everyday physical activity, but many building staircases are inaccessible or unpleasant and elevators are far more convenient. Architects and designers should work towards “focus on stairs rather than elevators as the primary means of vertical circulation for individuals who can ascend the stairs” according to the 2010 Active Design Guidelines. The Active Design checklist for building in general and high-rise buildings in particular needs an integrated vertical circulation system that includes stair use between adjacent floors. Innovative stair design plays a substantial role in incorporating physical activity into their daily lives which enhances the likelihood of bettering an individual’s health. However, in contrast to health promotion initiatives and despite the guidelines for active building design, the office building elements and layout, particularly the vertical circulation like elevators and staircases are designed to fulfill only the functional and program requirements. In other words, the result of this study reveals that the principles of innovative staircase design have been ignored remarkably in multi-story buildings and more focus has been on attractive elevator design and ensuring the comfort of the user without considering physical activity and health.

So What?

What Is Already Known on This Topic?

The active design provides an opportunity to incorporate incidental physical activity into daily life through the design of a built environment for improving health and limiting the risk of negative health outcomes of a sedentary lifestyle. Promoting stair use is one of the most obvious strategies of active design in buildings, particularly in the workplace in which people spend most of their time.

What Does This Article Add?

While active design call architects and designers to design activity-friendly buildings, little response from architects has been noted. Staircases in building particularly multi-story buildings are specified for the fire-escape purpose. In contrast to health promotion activities, the design of vertical circulation in buildings (elevators and staircases) promotes sedentary behavior. This systematic review investigates the stair design interventions from architects’ literature that affect stair use and thus increase occupational physical activity.

What Are the Implications for Health Promotion Practice or Research?

This study recommends architects consider active design strategies in their design for future buildings as a strategy for limiting the spread of chronic diseases and improving occupational health.

Footnotes

Acknowledgments

The manuscript has been read and approved by all the authors. The requirements for authorship as stated in the ICMJE guidelines have been met and that each author believes that the manuscript represents honest work.

Author Contributions

All authors contributed equally to the preparation of this article.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iDs

Faris Ali Mustafa

Janan Sabah Ali

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Amin

Maharimi

. Active design: promoting physical activity through building layout. IOP Conf Ser: Earth Environ Sci. 2021; 842:012068.

Active Design: Architectural Interventions for Improving Occupational Health Through Reducing Sedentary Behavior - A Systematic Review

Abstract

Objectives

Data Sources

Study Inclusion and Exclusion Criteria

Data Extraction

Data Synthesis

Result

Conclusion

Keywords

Objectives

Methods

Data Sources

Inclusion and Exclusion Criteria

Data Extraction and Data Synthesis

Results

Study Year and Country

Narrative Summary of Studies

Design Interventions

Conclusions

So What?

What Is Already Known on This Topic?

What Does This Article Add?

What Are the Implications for Health Promotion Practice or Research?

Footnotes

Acknowledgments

Author Contributions

Declaration of Conflicting Interests

Funding

ORCID iDs

References