Farhana Manzoor, Nandita Islam Pia, R. Rahman, Naheyan Bin Rahman, Debashish Debnath, Hasan Shahriar Rahman, Masood Mohammed Abdul Aziz, F. Ferdaus, Nahida Sultana, Kazi Shafiqul Halim, Mohammad Gilam Iqbal, Israt Jahan Ummon, Bui Vu Binh, Le Thi Tra My, Le Thi Cuc, Le Thanh Tung, Ngo Huy Hoang, Nguyen Thi Minh Chinh, Nguyen Thi Thanh Huong, Pham Thi Thuy Chinh, Mai Thi Thanh Thu, Essi Ylistalo, Katariina Kunnas, Annukka Huuskonen, Nina Smolander, Anabela de Sousa Salgueiro Oliveira, João Manuel Garcia do Nascimento Graveto, João Gonçalo Ribeiro Pardal, Paulo Jorge dos Santos Costa, Pedro Miguel dos Santos Dinis Parreira
The modernization of healthcare delivery is a reality in various international settings. To ensure efficient and safe use of the diverse forms of healthcare technology available, professionals and students must be receptive to incorporating such tools into their practice. Currently, there is no instrument in Bangladesh to assess healthcare students’ technology acceptance. Objective: To translate, culturally adapt, and validate the Usability Evaluation Questionnaire (UtEQ) among Bangladeshi healthcare students. Method: A cross-sectional study with a methodological approach was conducted in two phases. The first phase involved the translation of the UtEQ questionnaire to Bengali, following the six stages proposed by Beaton et al. In the second phase, the psychometric properties of the questionnaire were evaluated using a non-probability sample of 486 undergraduate healthcare students from three higher education institutions in Bangladesh. Confirmatory factor analysis was performed, and the Cronbach’s alpha coefficient was estimated to find out the internal consistency. Results: Internal consistency was found to be excellent for all scale dimensions, ranging from 0.88 to 0.92, while confirmatory factor analysis showed adequate goodness-of-fit indicators. Conclusion: The UtEQ-B provides a reliable and valid method for healthcare educators and researchers to assess technology acceptance among healthcare students during clinical training in Bangladesh.
{"title":"HOW DO MEDICAL AND NURSING STUDENTS VIEW HEALTHCARE TECHNOLOGY? A PSYCHOMETRIC VALIDATION STUDY OF THE USABILITY EVALUATION QUESTIONNAIRE IN BANGLADESH","authors":"Farhana Manzoor, Nandita Islam Pia, R. Rahman, Naheyan Bin Rahman, Debashish Debnath, Hasan Shahriar Rahman, Masood Mohammed Abdul Aziz, F. Ferdaus, Nahida Sultana, Kazi Shafiqul Halim, Mohammad Gilam Iqbal, Israt Jahan Ummon, Bui Vu Binh, Le Thi Tra My, Le Thi Cuc, Le Thanh Tung, Ngo Huy Hoang, Nguyen Thi Minh Chinh, Nguyen Thi Thanh Huong, Pham Thi Thuy Chinh, Mai Thi Thanh Thu, Essi Ylistalo, Katariina Kunnas, Annukka Huuskonen, Nina Smolander, Anabela de Sousa Salgueiro Oliveira, João Manuel Garcia do Nascimento Graveto, João Gonçalo Ribeiro Pardal, Paulo Jorge dos Santos Costa, Pedro Miguel dos Santos Dinis Parreira","doi":"10.29073/jim.v4i2.767","DOIUrl":"https://doi.org/10.29073/jim.v4i2.767","url":null,"abstract":"The modernization of healthcare delivery is a reality in various international settings. To ensure efficient and safe use of the diverse forms of healthcare technology available, professionals and students must be receptive to incorporating such tools into their practice. Currently, there is no instrument in Bangladesh to assess healthcare students’ technology acceptance. Objective: To translate, culturally adapt, and validate the Usability Evaluation Questionnaire (UtEQ) among Bangladeshi healthcare students. Method: A cross-sectional study with a methodological approach was conducted in two phases. The first phase involved the translation of the UtEQ questionnaire to Bengali, following the six stages proposed by Beaton et al. In the second phase, the psychometric properties of the questionnaire were evaluated using a non-probability sample of 486 undergraduate healthcare students from three higher education institutions in Bangladesh. Confirmatory factor analysis was performed, and the Cronbach’s alpha coefficient was estimated to find out the internal consistency. Results: Internal consistency was found to be excellent for all scale dimensions, ranging from 0.88 to 0.92, while confirmatory factor analysis showed adequate goodness-of-fit indicators. Conclusion: The UtEQ-B provides a reliable and valid method for healthcare educators and researchers to assess technology acceptance among healthcare students during clinical training in Bangladesh.","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"3 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88487872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carla Carvalho, Ana Pinto, Soraia Oliveira, Maria Inês Matos, Paulo Santos-Costa
Burnout affects physical and psychological health and is considered a major public health threat. The COVID-19 pandemic brought numerous social and economic challenges to organizations across the different work sectors, enhancing the risk of workers experiencing Burnout. However, the influence of the COVID-19 pandemic on the study of Burnout Syndrome remains unclear. To address this challenge, we analyzed pre-pandemic and post-COVID-19 outbreak research trends in this field. A comparative bibliometric analysis was conducted for the pre-pandemic period (01/2015 to 12/2019) and after the COVID-19 outbreak (01/2020 to 06/2021). Twelve thousand eighty-one publications were analyzed. Exponential growth in annual research activity on this subject was found since the COVID-19 outbreak. After 2020, the keyword “COVID-19” is often associated with “Burnout”, showing a clear international focus on this field. Research output disparities among the most affected countries have been found, with increased publications in countries such as the United States of America, China, Spain and Italy, while others have understudied this subject (e.g., India, Brazil, France). Further bibliometric analyses in this scope are recommended.
{"title":"COVID-19 PANDEMIC’S INFLUENCE ON THE STUDY OF BURNOUT: A BIBLIOMETRIC ANALYSIS","authors":"Carla Carvalho, Ana Pinto, Soraia Oliveira, Maria Inês Matos, Paulo Santos-Costa","doi":"10.29073/jim.v4i2.733","DOIUrl":"https://doi.org/10.29073/jim.v4i2.733","url":null,"abstract":"Burnout affects physical and psychological health and is considered a major public health threat. The COVID-19 pandemic brought numerous social and economic challenges to organizations across the different work sectors, enhancing the risk of workers experiencing Burnout. However, the influence of the COVID-19 pandemic on the study of Burnout Syndrome remains unclear. To address this challenge, we analyzed pre-pandemic and post-COVID-19 outbreak research trends in this field. A comparative bibliometric analysis was conducted for the pre-pandemic period (01/2015 to 12/2019) and after the COVID-19 outbreak (01/2020 to 06/2021). Twelve thousand eighty-one publications were analyzed. Exponential growth in annual research activity on this subject was found since the COVID-19 outbreak. After 2020, the keyword “COVID-19” is often associated with “Burnout”, showing a clear international focus on this field. Research output disparities among the most affected countries have been found, with increased publications in countries such as the United States of America, China, Spain and Italy, while others have understudied this subject (e.g., India, Brazil, France). Further bibliometric analyses in this scope are recommended.","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"10 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87262266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Masood Mohammed Abdul Aziz, F. Ferdaus, Nahida Sultana, Farhana Manzoor, Nandita Islam Pia, R. Rahman, Naheyan Bin Rahman, Kazi Shafiqul Halim, Mohammad Gilam Iqbal, Israt Jahan Ummon, Nguyen Huu Tu, Le Thi Tra My, Duong Thi Thu Huyen, Le Thanh Tung, Ngo Huy Hoang, Nguyen Thi Minh Chinh, Nguyen Thi Thanh Huong, Pham Thi Thuy Chinh, Hoang Thi Minh Thai, Essi Ylistalo, Katariina Kunnas, Annukka Huuskonen, Nina Smolander, Anabela de Sousa Salgueiro Oliveira, João Manuel Garcia do Nascimento Graveto, João Gonçalo Ribeiro Pardal, Paulo Jorge dos Santos Costa, Pedro Miguel dos Santos Dinis Parreira
In an aging society, healthcare professionals and students face increasing demands to actively involve patients in the decision-making process regarding their health conditions and lifestyles. Self-management support is considered a best practice that aligns with the patient-centered care paradigm in Bangladesh. However, there is currently no instrument available to assess healthcare professionals’ competencies in this field, particularly during their early education and training period. The aim of this study was to translate the Self Efficiency and Performance in Self-management Support (SEPSS) instrument into Bangla and validate its psychometric properties in a sample of undergraduate healthcare students in Bangladeshi higher education institutions. A cross-sectional study was conducted to assess the reliability, validity, and cultural appropriateness of the Bangla version of SEPSS-36 among 486 nursing and medical students. Confirmatory factor analysis was carried out using the chi-square model fit index (CMIN), comparative fit index (CFI), and Root Mean Square Error of Approximation (RMSEA) as fit indices. The internal consistency was estimated by the Cronbach alpha coefficient. The results indicate that the CMIN (2.658) and RMSEA (.058) values suggest that the sample data and hypothetical model are an acceptable fit in the analysis, with satisfactory CFI values (.895). The reliability for all SEPSS dimensions was acceptable. The Bangla version of the SEPSS questionnaire is a valid and reliable instrument that can assist healthcare educators and researchers in determining students’ competencies within this domain.
{"title":"CULTURAL ADAPTATION AND PSYCHOMETRIC VALIDATION OF THE SELF EFFICIENCY AND PERFORMANCE IN SELF-MANAGEMENT SUPPORT (SEPSS) QUESTIONNAIRE IN UNDERGRADUATE NURSING AND MEDICAL STUDENTS OF BANGLADESH","authors":"Masood Mohammed Abdul Aziz, F. Ferdaus, Nahida Sultana, Farhana Manzoor, Nandita Islam Pia, R. Rahman, Naheyan Bin Rahman, Kazi Shafiqul Halim, Mohammad Gilam Iqbal, Israt Jahan Ummon, Nguyen Huu Tu, Le Thi Tra My, Duong Thi Thu Huyen, Le Thanh Tung, Ngo Huy Hoang, Nguyen Thi Minh Chinh, Nguyen Thi Thanh Huong, Pham Thi Thuy Chinh, Hoang Thi Minh Thai, Essi Ylistalo, Katariina Kunnas, Annukka Huuskonen, Nina Smolander, Anabela de Sousa Salgueiro Oliveira, João Manuel Garcia do Nascimento Graveto, João Gonçalo Ribeiro Pardal, Paulo Jorge dos Santos Costa, Pedro Miguel dos Santos Dinis Parreira","doi":"10.29073/jim.v4i2.765","DOIUrl":"https://doi.org/10.29073/jim.v4i2.765","url":null,"abstract":"In an aging society, healthcare professionals and students face increasing demands to actively involve patients in the decision-making process regarding their health conditions and lifestyles. Self-management support is considered a best practice that aligns with the patient-centered care paradigm in Bangladesh. However, there is currently no instrument available to assess healthcare professionals’ competencies in this field, particularly during their early education and training period. The aim of this study was to translate the Self Efficiency and Performance in Self-management Support (SEPSS) instrument into Bangla and validate its psychometric properties in a sample of undergraduate healthcare students in Bangladeshi higher education institutions. A cross-sectional study was conducted to assess the reliability, validity, and cultural appropriateness of the Bangla version of SEPSS-36 among 486 nursing and medical students. Confirmatory factor analysis was carried out using the chi-square model fit index (CMIN), comparative fit index (CFI), and Root Mean Square Error of Approximation (RMSEA) as fit indices. The internal consistency was estimated by the Cronbach alpha coefficient. The results indicate that the CMIN (2.658) and RMSEA (.058) values suggest that the sample data and hypothetical model are an acceptable fit in the analysis, with satisfactory CFI values (.895). The reliability for all SEPSS dimensions was acceptable. The Bangla version of the SEPSS questionnaire is a valid and reliable instrument that can assist healthcare educators and researchers in determining students’ competencies within this domain.","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"64 1","pages":""},"PeriodicalIF":4.8,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84989812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acquired immune deficiency syndrome (AIDS) is a worldwide epidemic caused by human immunodeficiency virus (HIV) infection. Newer medicines for eliminating the viral reservoir and eradicating the virus are urgently needed. Attempts to locate relatively safe and non-toxic medications from natural resources are ongoing now. Natural-product-based antiviral candidates have been exploited to a limited extent. However, antiviral research is inadequate to counteract for the resistant patterns. Plant-derived bioactive compounds hold promise as powerful pharmacophore scaffolds, which have shown anti-HIV potential. This review focuses on a consideration of the virus, various possible HIV-controlling methods and the recent progress in alternative natural compounds with anti-HIV activity, with a particular emphasis on recent results from natural sources of anti-HIV agents.
Please cite this article as: Mandhata CP, Sahoo CR, Padhy RN. A comprehensive overview on the role of phytocompounds in human immunodeficiency virus treatment. J Integr Med. 2023; 21(4):332–353.
{"title":"A comprehensive overview on the role of phytocompounds in human immunodeficiency virus treatment","authors":"Chinmayee Priyadarsani Mandhata, Chita Ranjan Sahoo, Rabindra Nath Padhy","doi":"10.1016/j.joim.2023.05.001","DOIUrl":"10.1016/j.joim.2023.05.001","url":null,"abstract":"<div><p><span>Acquired immune deficiency syndrome (AIDS) is a worldwide epidemic caused by human immunodeficiency </span>virus<span> (HIV) infection. Newer medicines for eliminating the viral reservoir and eradicating the virus are urgently needed. Attempts to locate relatively safe and non-toxic medications from natural resources are ongoing now. Natural-product-based antiviral candidates have been exploited to a limited extent. However, antiviral research is inadequate to counteract for the resistant patterns. Plant-derived bioactive compounds hold promise as powerful pharmacophore scaffolds, which have shown anti-HIV potential. This review focuses on a consideration of the virus, various possible HIV-controlling methods and the recent progress in alternative natural compounds with anti-HIV activity, with a particular emphasis on recent results from natural sources of anti-HIV agents.</span></p><p><span>Please cite this article as: Mandhata CP, Sahoo CR, Padhy RN. A comprehensive overview on the role of phytocompounds in human immunodeficiency virus treatment. </span><em>J Integr Med</em>. 2023; 21(4):332–353.</p></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"21 4","pages":"Pages 332-353"},"PeriodicalIF":4.8,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10170917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1016/j.joim.2023.05.003
Ming-min Xu , Yu Guo , Ying Chen , Wei Zhang , Lu Wang , Ying Li
Objective
Abnormalities in the gut microbiota and intestinal short-chain fatty acid (SCFA) levels are implicated in the pathogenesis of functional constipation (FC). Electro-acupuncture (EA) has been shown to improve constipation-related symptoms and rebalance the gut microbiota. However, it is currently unknown whether the gut microbiota is a key mechanistic target for EA or how EA promotes gut motility by regulating the gut microbiota and SCFAs. Therefore, we assessed the effects of EA in FC mice and pseudo-germfree (PGF) mice to address these questions.
Methods
Forty female Kunming mice were randomly separated into a normal control group (n = 8), an FC group (n = 8), an FC + EA group (n = 8), a PGF group (n = 8) and a PGF + EA group (n = 8). The FC group and FC + EA group were treated with diphenoxylate to establish the FC model; the PGF group and PGF + EA group were given an antibiotic cocktail to initiate the PGF model. After maintaining the model for 14 d, mice in the FC + EA and PGF + EA groups received EA stimulation at the ST25 and ST37 acupoints, once a day, 5 times per week, for 2 weeks. Fecal parameters and intestinal transit rate were calculated to assess the efficacy of EA on constipation and gastrointestinal motility. Colonic contents were used to quantify gut microbial diversity using 16S rRNA sequencing, and measure SCFA concentrations using gas chromatography-mass spectrometry.
Results
EA significantly shortened the first black stool defecation time (P < 0.05) and increased the intestinal transit rate (P < 0.01), and fecal pellet number (P < 0.05), wet weight (P < 0.05) and water content (P < 0.01) over 8 h, compared with the FC group, showing that EA promoted gut motility and alleviated constipation. However, EA treatment did not reverse slow-transit colonic motility in PGF mice (P > 0.05), demonstrating that the gut microbiota may play a mechanistic role in the EA treatment of constipation. In addition, EA treatment restored the Firmicutes to Bacteroidetes ratio and significantly increased butyric acid generation in FC mice (P < 0.05), most likely due to the upregulation of Staphylococcaceae microorganisms (P < 0.01).
Conclusion
EA-mediated resolution of constipation occurs through rebalancing the gut microbiota and promoting butyric acid generation.
Please cite this article as: Xu MM, Guo Y, Chen Y, Zhang W, Wang L, Li Y. Electro-acupuncture promotes gut motility and alleviates functional constipation by regulating gut microbiota and increasing butyric acid generation in mice. J Integr Med. 2023; Epub ahead of print.
{"title":"Electro-acupuncture promotes gut motility and alleviates functional constipation by regulating gut microbiota and increasing butyric acid generation in mice","authors":"Ming-min Xu , Yu Guo , Ying Chen , Wei Zhang , Lu Wang , Ying Li","doi":"10.1016/j.joim.2023.05.003","DOIUrl":"10.1016/j.joim.2023.05.003","url":null,"abstract":"<div><h3>Objective</h3><p><span>Abnormalities in the gut microbiota and intestinal short-chain fatty acid (SCFA) levels are implicated in the pathogenesis of </span>functional constipation (FC). Electro-acupuncture (EA) has been shown to improve constipation-related symptoms and rebalance the gut microbiota. However, it is currently unknown whether the gut microbiota is a key mechanistic target for EA or how EA promotes gut motility by regulating the gut microbiota and SCFAs. Therefore, we assessed the effects of EA in FC mice and pseudo-germfree (PGF) mice to address these questions.</p></div><div><h3>Methods</h3><p>Forty female Kunming mice were randomly separated into a normal control group (<em>n</em> = 8), an FC group (<em>n</em> = 8), an FC + EA group (<em>n</em> = 8), a PGF group (<em>n</em> = 8) and a PGF + EA group (<em>n</em><span><span><span> = 8). The FC group and FC + EA group were treated with diphenoxylate to establish the FC model; the PGF group and PGF + EA group were given an antibiotic cocktail to initiate the PGF model. After maintaining the model for 14 d, mice in the FC + EA and PGF + EA groups received EA stimulation at the ST25 and ST37 </span>acupoints, once a day, 5 times per week, for 2 weeks. Fecal parameters and intestinal transit rate were calculated to assess the efficacy of EA on constipation and </span>gastrointestinal motility<span><span>. Colonic contents were used to quantify gut microbial diversity using </span>16S rRNA sequencing, and measure SCFA concentrations using gas chromatography-mass spectrometry.</span></span></p></div><div><h3>Results</h3><p>EA significantly shortened the first black stool defecation time (<em>P</em> < 0.05) and increased the intestinal transit rate (<em>P</em> < 0.01), and fecal pellet number (<em>P</em> < 0.05), wet weight (<em>P</em> < 0.05) and water content (<em>P</em><span> < 0.01) over 8 h, compared with the FC group, showing that EA promoted gut motility and alleviated constipation. However, EA treatment did not reverse slow-transit colonic motility in PGF mice (</span><em>P</em><span><span> > 0.05), demonstrating that the gut microbiota may play a mechanistic role in the EA treatment of constipation. In addition, EA treatment restored the Firmicutes to </span>Bacteroidetes<span> ratio and significantly increased butyric acid generation in FC mice (</span></span><em>P</em><span> < 0.05), most likely due to the upregulation of Staphylococcaceae microorganisms (</span><em>P</em> < 0.01).</p></div><div><h3>Conclusion</h3><p>EA-mediated resolution of constipation occurs through rebalancing the gut microbiota and promoting butyric acid generation.</p><p>Please cite this article as: Xu MM, Guo Y, Chen Y, Zhang W, Wang L, Li Y. Electro-acupuncture promotes gut motility and alleviates functional constipation by regulating gut microbiota and increasing butyric acid generation in mice. <em>J Integr Med</em>. 2023; Epub ahead of print.</p></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"21 4","pages":"Pages 397-406"},"PeriodicalIF":4.8,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9795656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1016/j.joim.2023.05.002
Amir Mohammad Jaladat , Mahdi Alizadeh Vaghasloo , Fatemeh Atarzadeh , Mohammad Hossein Ayati , Amir Hooman Kazemi , Emine Akin , Mohammad Hashem Hashempur
Kaiy (medieval cautery) is an ancient method of heat therapy in traditional Persian medicine (TPM). Some of its important applications have been neglected during the medical revolution. Meanwhile, different treatment modalities that incorporate heat, including moxibustion, have progressed in traditional Chinese medicine. In this study, we reviewed the main TPM textbooks that were written specifically in the field of kaiy. We considered the traditional teachings in the context of contemporary information, gathered from the scientific literature about moxibustion and modern cauterization. Some surgical therapeutic indications of kaiy (e.g., debridement and coagulative procedures) have been advanced by the innovation of electro-cauterization. However, those therapeutic applications that were based on the TPM humoral theory for relieving body coldness or myofascial pains—which are similar to moxibustion usages—have not received the same attention. Apart from the broad similarities of kaiy and moxibustion as thermal therapies with similar indications, there is a striking correspondence between kaiy point mapping and acupoints. Therefore, further research on different kaiy aspects is recommended.
Please cite this article as: Jaladat AM, Alizadeh Vaghasloo M, Atarzadeh F, Ayati MH, Kazemi AH, Akin E, Hashempur MH. Similarities and differences between kaiy in Persian medicine and moxibustion in Chinese medicine. J Integr Med. 2023; 21(4):354–360.
{"title":"Similarities and differences between kaiy in Persian medicine and moxibustion in Chinese medicine","authors":"Amir Mohammad Jaladat , Mahdi Alizadeh Vaghasloo , Fatemeh Atarzadeh , Mohammad Hossein Ayati , Amir Hooman Kazemi , Emine Akin , Mohammad Hashem Hashempur","doi":"10.1016/j.joim.2023.05.002","DOIUrl":"10.1016/j.joim.2023.05.002","url":null,"abstract":"<div><p><em>Kaiy</em><span><span> (medieval cautery) is an ancient method of heat therapy in traditional Persian medicine (TPM). Some of its important applications have been neglected during the medical revolution. Meanwhile, different treatment modalities that incorporate heat, including </span>moxibustion<span>, have progressed in traditional Chinese medicine. In this study, we reviewed the main TPM textbooks that were written specifically in the field of </span></span><em>kaiy</em>. We considered the traditional teachings in the context of contemporary information, gathered from the scientific literature about moxibustion and modern cauterization. Some surgical therapeutic indications of <em>kaiy</em><span> (e.g., debridement and coagulative procedures) have been advanced by the innovation of electro-cauterization. However, those therapeutic applications that were based on the TPM humoral theory for relieving body coldness or myofascial pains—which are similar to moxibustion usages—have not received the same attention. Apart from the broad similarities of </span><em>kaiy</em> and moxibustion as thermal therapies with similar indications, there is a striking correspondence between <em>kaiy</em><span> point mapping and acupoints. Therefore, further research on different </span><em>kaiy</em> aspects is recommended.</p><p>Please cite this article as: Jaladat AM, Alizadeh Vaghasloo M, Atarzadeh F, Ayati MH, Kazemi AH, Akin E, Hashempur MH. Similarities and differences between <em>kaiy</em> in Persian medicine and moxibustion in Chinese medicine. <em>J Integr Med</em>. 2023; 21(4):354–360.</p></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"21 4","pages":"Pages 354-360"},"PeriodicalIF":4.8,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9797272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patients with gynecological cancer commonly use complementary and alternative medicine (CAM) methods to cope with the disease. However, despite the existence of treatment strategies, the effect of fear and anxiety caused by coronavirus disease 2019 (COVID-19) pandemic on attitudes about CAM use is unclear. This study was carried out to investigate the effect of fear and anxiety experienced by patients with gynecological cancer during the COVID-19 pandemic on their attitudes towards the use of CAM.
Methods
This is a cross-sectional and descriptive study that included 177 women with gynecological cancer; participants were recruited from a social networking site for cancer patients in Turkey between June and December 2021. Data were collected using an online survey that included the Personal Information Form, the Fear of COVID-19 Scale, the Coronavirus Anxiety Scale, and the Attitude Towards Holistic Complementary and Alternative Medicine Scale. Descriptive statistics, t-test, Pearson’s correlation test, and simple linear and multiple regression analyses were performed to analyze the data.
Results
During the pandemic, 55.4% of the participants reported using CAM methods, but only 22.6% were using CAM before the pandemic. The participants who used CAM during the pandemic also scored higher on the fear of COVID-19 and coronavirus anxiety scales (20.69 ± 5.37 and 13.09 ± 6.29, respectively) compared to the participants who did not use CAM (9.29 ± 2.72 and 6.35 ± 2.06, respectively). Fear of COVID-19 accounted for 52% of the CAM attitude score, while coronavirus anxiety accounted for 15% of the CAM attitude score. Fear of COVID-19 and coronavirus anxiety together accounted for 53% of CAM attitude.
Conclusion
Gynecological cancer patients with high levels of COVID-19-related anxiety and fear during the pandemic used CAM more. Given that the psychological effects of the pandemic will continue in the coming years, CAM use should be evaluated as a coping strategy, especially due to the COVID-19-related anxiety and fear experienced by patients with gynecological cancer. While the rational and effective CAM methods should be supported, strategies should be developed to prevent misuse of CAM and its interference in prescribed medical treatments.
Please cite this article as: Uslu-Sahan F, Yesilcınar I, Kurt G, Hancer E, Guvenc G. Effects of COVID-19 fear and anxiety on attitudes towards complementary and alternative medicine use in women with gynecological cancer during the COVID-19 pandemic. J Integr Med. 2023; 21(4): 377–384.
{"title":"Effects of COVID-19 fear and anxiety on attitudes towards complementary and alternative medicine use in women with gynecological cancer during the COVID-19 pandemic","authors":"Fatma Uslu-Sahan , Ilknur Yesilcınar , Gonul Kurt , Elif Hancer , Gulten Guvenc","doi":"10.1016/j.joim.2023.06.003","DOIUrl":"10.1016/j.joim.2023.06.003","url":null,"abstract":"<div><h3>Objective</h3><p>Patients with gynecological cancer commonly use complementary and alternative medicine (CAM) methods to cope with the disease. However, despite the existence of treatment strategies, the effect of fear and anxiety caused by coronavirus disease 2019 (COVID-19) pandemic on attitudes about CAM use is unclear. This study was carried out to investigate the effect of fear and anxiety experienced by patients with gynecological cancer during the COVID-19 pandemic on their attitudes towards the use of CAM.</p></div><div><h3>Methods</h3><p>This is a cross-sectional and descriptive study that included 177 women with gynecological cancer; participants were recruited from a social networking site for cancer patients in Turkey between June and December 2021. Data were collected using an online survey that included the Personal Information Form, the Fear of COVID-19 Scale, the Coronavirus Anxiety Scale, and the Attitude Towards Holistic Complementary and Alternative Medicine Scale. Descriptive statistics, <em>t</em>-test, Pearson’s correlation test, and simple linear and multiple regression analyses were performed to analyze the data.</p></div><div><h3>Results</h3><p>During the pandemic, 55.4% of the participants reported using CAM methods, but only 22.6% were using CAM before the pandemic. The participants who used CAM during the pandemic also scored higher on the fear of COVID-19 and coronavirus anxiety scales (20.69 ± 5.37 and 13.09 ± 6.29, respectively) compared to the participants who did not use CAM (9.29 ± 2.72 and 6.35 ± 2.06, respectively). Fear of COVID-19 accounted for 52% of the CAM attitude score, while coronavirus anxiety accounted for 15% of the CAM attitude score. Fear of COVID-19 and coronavirus anxiety together accounted for 53% of CAM attitude.</p></div><div><h3>Conclusion</h3><p>Gynecological cancer patients with high levels of COVID-19-related anxiety and fear during the pandemic used CAM more. Given that the psychological effects of the pandemic will continue in the coming years, CAM use should be evaluated as a coping strategy, especially due to the COVID-19-related anxiety and fear experienced by patients with gynecological cancer. While the rational and effective CAM methods should be supported, strategies should be developed to prevent misuse of CAM and its interference in prescribed medical treatments.</p><p>Please cite this article as: Uslu-Sahan F, Yesilcınar I, Kurt G, Hancer E, Guvenc G. Effects of COVID-19 fear and anxiety on attitudes towards complementary and alternative medicine use in women with gynecological cancer during the COVID-19 pandemic. <em>J Integr Med</em>. 2023; 21(4): 377–384.</p></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"21 4","pages":"Pages 377-384"},"PeriodicalIF":4.8,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10249343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9802507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1016/j.joim.2023.06.002
Hae-Chang Yoon
Objective
Coronavirus disease 2019 (COVID-19) has spread worldwide, and several virus variants have emerged. Vaccines are administered to help prevent the infection. In Republic of Korea, most people take herbal medicine. This study investigated the use of herbal medicine to counter the side effects of COVID-19 vaccines.
Methods
This cross-sectional study was conducted using an online survey. Chi-square tests were used to determine differences in the use of herbal medication according to sociodemographic characteristics. Independent two-sample and paired t-tests were performed to examine the effect and satisfaction of herbal medicine use for countering the side effects of COVID-19 vaccines. One-way analysis of variance was used to determine vaccine-related differences.
Results
A total of 233 and 181 participants received the first and second doses of COVID-19 vaccines, respectively. The majority of herbal medicine users were in their thirties, had a bachelor’s degree, suffered from side effects of vaccination, and received Vaxzevria for their first COVID-19 vaccine dose and Comirnaty for their second dose. The herbal medicine group had a higher satisfaction level of post-vaccination side effects than the non-herbal medicine group (P < 0.0001). The numeric rating scale scores for vaccination side effects were lower among participants who took herbal medication to alleviate those symptoms (P < 0.0001). The most commonly used herbal formula was Shuanghetang.
Conclusion
A third of participants receiving COVID-19 vaccines used herbal medication to counter the side effects of vaccination. The use of herbal medicine was associated with age, education level, vaccine brand, and whether side effects of vaccination occurred. Herbal medication use was associated with greater satisfaction compared to vaccine recipients not using herbal medication.
Please cite this article as: Yoon HC. Herbal medicine use in Republic of Korea to alleviate side effects of COVID-19 vaccines: A cross-sectional study. J Integr Med. 2023; 21(4):361–368.
{"title":"Herbal medicine use in Republic of Korea to alleviate side effects of COVID-19 vaccines: A cross-sectional study","authors":"Hae-Chang Yoon","doi":"10.1016/j.joim.2023.06.002","DOIUrl":"10.1016/j.joim.2023.06.002","url":null,"abstract":"<div><h3>Objective</h3><p>Coronavirus disease 2019 (COVID-19) has spread worldwide, and several virus variants have emerged. Vaccines are administered to help prevent the infection. In Republic of Korea, most people take herbal medicine. This study investigated the use of herbal medicine to counter the side effects of COVID-19 vaccines.</p></div><div><h3>Methods</h3><p>This cross-sectional study was conducted using an online survey. Chi-square tests were used to determine differences in the use of herbal medication according to sociodemographic characteristics. Independent two-sample and paired <em>t</em>-tests were performed to examine the effect and satisfaction of herbal medicine use for countering the side effects of COVID-19 vaccines. One-way analysis of variance was used to determine vaccine-related differences.</p></div><div><h3>Results</h3><p>A total of 233 and 181 participants received the first and second doses of COVID-19 vaccines, respectively. The majority of herbal medicine users were in their thirties, had a bachelor’s degree, suffered from side effects of vaccination, and received Vaxzevria for their first COVID-19 vaccine dose and Comirnaty for their second dose. The herbal medicine group had a higher satisfaction level of post-vaccination side effects than the non-herbal medicine group (<em>P</em> < 0.0001). The numeric rating scale scores for vaccination side effects were lower among participants who took herbal medication to alleviate those symptoms (<em>P</em> < 0.0001). The most commonly used herbal formula was Shuanghetang.</p></div><div><h3>Conclusion</h3><p>A third of participants receiving COVID-19 vaccines used herbal medication to counter the side effects of vaccination. The use of herbal medicine was associated with age, education level, vaccine brand, and whether side effects of vaccination occurred. Herbal medication use was associated with greater satisfaction compared to vaccine recipients not using herbal medication.</p><p>Please cite this article as: Yoon HC. Herbal medicine use in Republic of Korea to alleviate side effects of COVID-19 vaccines: A cross-sectional study. <em>J Integr Med</em>. 2023; 21(4):361–368.</p></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"21 4","pages":"Pages 361-368"},"PeriodicalIF":4.8,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10249366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9796710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1016/j.joim.2023.06.006
Biao Gao , Yi-cui Qu , Meng-yu Cai , Yin-yin Zhang , Hong-tao Lu , Hong-xia Li , Yu-xiao Tang , Hui Shen
Objective
This study investigated trends in the study of phytochemical treatment of post-traumatic stress disorder (PTSD).
Methods
The Web of Science database (2007–2022) was searched using the search terms “phytochemicals” and “PTSD,” and relevant literature was compiled. Network clustering co-occurrence analysis and qualitative narrative review were conducted.
Results
Three hundred and one articles were included in the analysis of published research, which has surged since 2015 with nearly half of all relevant articles coming from North America. The category is dominated by neuroscience and neurology, with two journals, Addictive Behaviors and Drug and Alcohol Dependence, publishing the greatest number of papers on these topics. Most studies focused on psychedelic intervention for PTSD. Three timelines show an “ebb and flow” phenomenon between “substance use/marijuana abuse” and “psychedelic medicine/medicinal cannabis.” Other phytochemicals account for a small proportion of the research and focus on topics like neurosteroid turnover, serotonin levels, and brain-derived neurotrophic factor expression.
Conclusion
Research on phytochemicals and PTSD is unevenly distributed across countries/regions, disciplines, and journals. Since 2015, the research paradigm shifted to constitute the mainstream of psychedelic research thus far, leading to the exploration of botanical active ingredients and molecular mechanisms. Other studies focus on anti-oxidative stress and anti-inflammation.
Please cite this article as: Gao B, Qu YC, Cai MY, Zhang YY, Lu HT, Li HX, Tang YX, Shen H. Phytochemical interventions for post-traumatic stress disorder: A cluster co-occurrence network analysis using CiteSpace. J Integr Med. 2023; 21(4):385–396.
目的探讨植物化学物质治疗创伤后应激障碍(PTSD)的研究趋势。方法使用“植物化学物质”和“PTSD”两个搜索词检索Web of Science数据库(2007-2022),并汇编相关文献。进行网络聚类共现分析和定性叙述综述。结果已发表研究的分析中包括301篇文章,自2015年以来,这一数字激增,近一半的相关文章来自北美。该类别以神经科学和神经病学为主,有两本期刊《成瘾行为》和《药物和酒精依赖》发表了最多关于这些主题的论文。大多数研究都集中在创伤后应激障碍的迷幻干预上。三个时间线显示了“物质使用/大麻滥用”和“迷幻药/药用大麻”之间的“起伏”现象。其他植物化学物质在研究中只占很小的比例,主要集中在神经甾体周转、血清素水平和脑源性神经营养因子表达等主题上。结论植物化学物质与创伤后应激障碍的研究在国家/地区、学科和期刊中分布不均。自2015年以来,研究范式转变为迄今为止迷幻研究的主流,导致了对植物活性成分和分子机制的探索。其他研究集中在抗氧化应激和抗炎方面。请引用这篇文章:高B,瞿YC,蔡梅,张YY,鲁HT,李HX,唐YX,沈H.创伤后应激障碍的植物化学干预:使用CiteSpace的聚类共现网络分析。国际医学杂志,2023;21(4):385–396。
{"title":"Phytochemical interventions for post-traumatic stress disorder: A cluster co-occurrence network analysis using CiteSpace","authors":"Biao Gao , Yi-cui Qu , Meng-yu Cai , Yin-yin Zhang , Hong-tao Lu , Hong-xia Li , Yu-xiao Tang , Hui Shen","doi":"10.1016/j.joim.2023.06.006","DOIUrl":"10.1016/j.joim.2023.06.006","url":null,"abstract":"<div><h3>Objective</h3><p>This study investigated trends in the study of phytochemical treatment of post-traumatic stress disorder (PTSD).</p></div><div><h3>Methods</h3><p>The Web of Science database (2007–2022) was searched using the search terms “phytochemicals” and “PTSD,” and relevant literature was compiled. Network clustering co-occurrence analysis and qualitative narrative review were conducted.</p></div><div><h3>Results</h3><p>Three hundred and one articles were included in the analysis of published research, which has surged since 2015 with nearly half of all relevant articles coming from North America. The category is dominated by neuroscience and neurology, with two journals, <em>Addictive Behaviors</em> and <em>Drug and Alcohol Dependence</em>, publishing the greatest number of papers on these topics. Most studies focused on psychedelic intervention for PTSD. Three timelines show an “ebb and flow” phenomenon between “substance use/marijuana abuse” and “psychedelic medicine/medicinal cannabis.” Other phytochemicals account for a small proportion of the research and focus on topics like neurosteroid turnover, serotonin levels, and brain-derived neurotrophic factor expression.</p></div><div><h3>Conclusion</h3><p>Research on phytochemicals and PTSD is unevenly distributed across countries/regions, disciplines, and journals. Since 2015, the research paradigm shifted to constitute the mainstream of psychedelic research thus far, leading to the exploration of botanical active ingredients and molecular mechanisms. Other studies focus on anti-oxidative stress and anti-inflammation.</p><p>Please cite this article as: Gao B, Qu YC, Cai MY, Zhang YY, Lu HT, Li HX, Tang YX, Shen H. Phytochemical interventions for post-traumatic stress disorder: A cluster co-occurrence network analysis using CiteSpace. <em>J Integr Med</em>. 2023; 21(4):385–396.</p></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"21 4","pages":"Pages 385-396"},"PeriodicalIF":4.8,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10176046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1016/j.joim.2023.06.001
Arthur Yin Fan
In October 2021, an international collaborative study on the use of electroacupuncture (EA) to treat inflammation was published in the journal Nature by Dr. Qiufu Ma’s team. Based on the results of EA on inflammation in the mouse model of lipopolysaccharide inflammatory storm, the study showed that the distal effect of acupuncture can be achieved by “driving the vagus-adrenal axis (through the adrenal medulla, by releasing catecholamines).” PROKR2Cre-marked sensory neurons, which innervate the deep hindlimb fascia but not the abdominal fascia, are crucial for driving this axis. The study suggests the existence of specificity distribution of acupoints, that different EA stimulation intensities or different needle penetration depths have different therapeutic effects, that photosensitive stimulation may be a substitute for needle acupuncture, and that massage, stretching and body movements may also activate PROKR2Cre-markable dorsal root ganglion sensory neurons and elicit anti-inflammatory effects. However, results of some other studies are contrary to the conclusions of Ma’s team. For examples: low-intensity EA at GB30 point significantly reduced the inflammation in the rat model of persistent inflammation, which is more relevant to the real daily acupuncture practice, and this effect was partly related to the adrenal cortex and associated with the stimulation of corticosterone and adrenocorticotropic hormone; manual acupuncture (similar to the low-intensity EA) at KI3, Zhichuan point (an extra point), etc. was effective in a severe COVID-19 patient with sepsis; stimulating ST25 with low-intensity EA or manual acupuncture was effective against gastrointestinal inflammations; the above mentioned points are not in an area enriched with PROKR2Cre-marked sensory nerve endings. Evidence shows that the mechanism of EA against inflammation includes modulating multi-systems, multi-levels and multi-targets, which does not limit to “driving the vagus-adrenal axis.”
Please cite this article as: Fan AY. Anti-inflammatory mechanism of electroacupuncture involves the modulation of multiple systems, levels and targets and is not limited to “driving the vagus-adrenal axis.” J Integr Med. 2023; 21(4):320–323.
{"title":"Anti-inflammatory mechanism of electroacupuncture involves the modulation of multiple systems, levels and targets and is not limited to “driving the vagus-adrenal axis”","authors":"Arthur Yin Fan","doi":"10.1016/j.joim.2023.06.001","DOIUrl":"10.1016/j.joim.2023.06.001","url":null,"abstract":"<div><p><span>In October 2021, an international collaborative study on the use of electroacupuncture (EA) to treat inflammation was published in the journal </span><em>Nature</em><span> by Dr. Qiufu Ma’s team. Based on the results of EA on inflammation in the mouse model of lipopolysaccharide<span> inflammatory storm, the study showed that the distal effect of acupuncture<span> can be achieved by “driving the vagus-adrenal axis (through the adrenal medulla, by releasing catecholamines).” PROKR2</span></span></span><sup>Cre</sup><span><span>-marked sensory neurons, which innervate the deep hindlimb<span> fascia but not the abdominal fascia, are crucial for driving this axis. The study suggests the existence of specificity distribution of </span></span>acupoints<span>, that different EA stimulation intensities or different needle penetration depths have different therapeutic effects, that photosensitive stimulation may be a substitute for needle acupuncture, and that massage, stretching and body movements may also activate PROKR2</span></span><sup>Cre</sup><span><span><span>-markable dorsal root<span><span> ganglion sensory neurons and elicit anti-inflammatory effects. However, results of some other studies are contrary to the conclusions of Ma’s team. For examples: low-intensity EA at GB30 point significantly reduced the inflammation in the rat model of persistent inflammation, which is more relevant to the real daily acupuncture practice, and this effect was partly related to the </span>adrenal cortex and associated with the stimulation of </span></span>corticosterone and adrenocorticotropic hormone; manual acupuncture (similar to the low-intensity EA) at KI3, Zhichuan point (an extra point), etc. was effective in a severe COVID-19 patient with sepsis; stimulating ST25 with low-intensity EA or manual acupuncture was effective against </span>gastrointestinal inflammations; the above mentioned points are not in an area enriched with PROKR2</span><sup>Cre</sup><span>-marked sensory nerve endings. Evidence shows that the mechanism of EA against inflammation includes modulating multi-systems, multi-levels and multi-targets, which does not limit to “driving the vagus-adrenal axis.”</span></p><p>Please cite this article as: Fan AY. Anti-inflammatory mechanism of electroacupuncture involves the modulation of multiple systems, levels and targets and is not limited to “driving the vagus-adrenal axis.” <em>J Integr Med</em>. 2023; 21(4):320–323.</p></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"21 4","pages":"Pages 320-323"},"PeriodicalIF":4.8,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9789214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}